Background: One factor capable of modulating antenatal immune responses is diet. This prospective study examined the association between maternal intake of specific types of fatty acids, cholesterol, fish and meat during pregnancy and the risk of wheeze and eczema in the offspring. Methods: Subjects were 763 mother-child pairs. Data on maternal intake during pregnancy were assessed with a diet history questionnaire. Data on wheeze and eczema based on criteria of the International Study of Asthma and Allergies in Childhood were obtained from a questionnaire completed by mothers 16-24 months postpartum. Results: Higher maternal intake of a-linolenic acid and docosahexaenoic acid during pregnancy was independently associated with a reduced risk of wheeze, but not eczema, in the offspring (adjusted odds ratios (ORs) between extreme quartiles 0.52 (95% CI 0.28 to 0.97) and 0.37 (95% CI 0.15 to 0.91), respectively). Higher maternal intake of n-6 polyunsaturated fatty acids and linoleic acid during pregnancy was independently related to an increased risk of infantile eczema but not wheeze (adjusted ORs 2.25 (95% CI 1.13 to 4.54) and 2.11 (95% CI 1.06 to 4.26), respectively). No significant exposureresponse relationships were observed between maternal consumption of total fat, saturated fatty acids, monounsaturated fatty acids, eicosapentaenoic acid, arachidonic acid, cholesterol, meat and fish and the ratio of n-3 to n-6 polyunsaturated fatty acid consumption during pregnancy and infantile wheeze or eczema. Conclusions: Maternal intake of a-linolenic acid and docosahexaenoic acid during pregnancy may be preventive against infantile wheeze. Maternal intake of n-6 polyunsaturated fatty acids, especially linoleic acid, during pregnancy may increase the risk of childhood eczema.One of the factors capable of modulating antenatal immune responses is diet. In particular, n-3 and n-6 polyunsaturated fatty acids can influence the Th1 and Th2 balance.1 A case-control study of US schoolchildren showed that maternal oily fish consumption at least monthly versus no consumption during pregnancy was significantly related to a decreased risk of early persistent asthma in the children.2 A significant preventive relationship was observed between maternal fish intake during pregnancy and the risk of atopic wheeze in the offspring at 6 years of age in a Spanish prospective cohort study.3 However, a cohort study in the Netherlands reported no association between maternal fish intake during pregnancy and the risk of wheeze in children from 1 to 8 years of age. 4 In cohort studies in Spain, Germany and the UK, a protective relationship was found between maternal fish intake during pregnancy and the risk of infantile eczema.3 5 6 The cohort study in Germany also showed significant positive associations of maternal intake of margarine and vegetable oils during pregnancy with the risk of eczema during the first 2 years in children.
5Our previous preliminary report found that higher maternal meat intake during pregnancy was significantl...