Estimating the Strength of Associations Between Prenatal Diet Quality and Child Developmental Outcomes: Results From a Large Prospective Pregnancy Cohort Study

Abstract

Our aim in this study was to estimate the strength of associations between prenatal diet quality and child behavioral, language, and motor functions in the Norwegian Mother and Child Cohort Study (1999–2008). We created a prenatal diet quality index (PDQI) based on adherence to Norwegian dietary guidelines. Child outcomes were defined as sum scores on the Child Behavior Checklist, the Ages and Stages Questionnaire, and the Child Development Index at ages 18, 36, and 60 months. Using a longitudinal cohort study design and Bayesian hierarchical modeling, we estimated association strengths using inverse probability weighting to account for selection bias. In total, 27,529 mother-child pairs were eligible for inclusion. A 1–standard-deviation increase in PDQI score was associated with an absolute reduction in outcome sum scores of 0.02–0.21 and a 3%–7% relative decrease, with larger decreases seen for language and motor functions than for behavioral functions. PDQI scores were inversely associated with all child functions, but the estimated strength of each association was low. The results indicate that the observed variations in PDQI scores in an industrialized Western society may not profoundly influence the child functions studied.

The associations between maternal and child diet quality and child ADHD – findings from a large Norwegian pregnancy cohort study

“…Reliability and validity of the PDQI in the MoBa sample have been reported previously [ 29 ]. We evaluate construct validity for the UPFI, and CDQI construct validity and reliability.…”

“…In addition, the UPFI score correlated with energy adjusted intakes of key nutrients in the FFQ in the expected direction (fibre (r = − 0.50), sugar (r = 0.59), protein (r = − 0.55) saturated fat (r = 0.30)), as well as with the PDQI (r = − 0.53). In a recent paper [ 29 ], we described reliability and construct validity for the PDQI.…”

“…The first index, called prenatal diet quality index (PDQI) (possible range of scores = 0–110), captures adherence to the Norwegian food-based dietary guidelines. We have previously used this index to investigate associations with child developmental outcomes [ 29 ]. The second index, called the ultra-processed food index (UPFI) (possible range = 0–100%), captures the relative contribution of ultra-processed foods to total energy intake.…”

“…We list an overview of the components in Table 1 . Detailed description of the calculation has been published in a previous article [ 29 ] and is included in Additional file 2 .…”

“…Moreover, the limited amount of literature investigating prenatal and child diet in relation to neurodevelopmental problems associated with ADHD has indicated that there exists a possible association [ 27 , 28 ]. However, these associations tend to be either small or from smaller studies [ 29 ]. Hence, there is a need for large population-based studies that investigate longitudinal associations between prenatal and early postnatal diet quality and ADHD.…”