母亲怀孕期的一些饮食可能会促进胎儿Th2免疫应答，从而增加孩子出生后发生哮喘和变应性疾病的风险。为验证这种假设，Willers SM等对4146名孕妇（其中1327名有过敏体质）进行了调查，记录她们在怀孕最后一个月内进食水果、蔬菜、鱼、蛋、牛奶、奶制品、坚果及坚果类制品的情况。之后还对这些孕妇生下的孩子进行随访，直到8岁。分析孕妇进食情况与儿童哮喘发生的相关性。该研究共收集了2832名儿童的完整数据。分析两者相关性发现孕妇进食蔬菜、鱼、蛋、牛奶、奶制品和坚果与孩子哮喘发生无关。但坚果类制品可增加儿童喘鸣（与少摄入坚果类制品者相比，优势比1.42，95％可信区间1.06-1.89）、呼吸困难（优势比1.58，95％可信区间1.16-2.15），增加激素使用率（优势比1.62，95％可信区间1.06-2.46），以及加重哮喘症状（优势比1.47，95％可信区间1.08-1.99）。
结论：该研究结果表明孕妇每日摄入较多的坚果类制品可增加孩子哮喘发生的风险。但作者同时指出，该结论还需要得到更多同类研究的支持方能用于孕妇饮食摄入的参考。
结论：该研究结果表明孕妇每日摄入较多的坚果类制品可增加孩子哮喘发生的风险。但作者同时指出，该结论还需要得到更多同类研究的支持方能用于孕妇饮食摄入的参考。
（王苹莉 浙江医科大学附属第二医院呼吸科 310009 摘译）
（Am J Respir Crit Care Med. 2008 Jul 15;178(2):124-31.）
Willers SM, Wijga AH, Brunekreef B, Kerkhof M, Gerritsen J, Hoekstra MO, de Jongste JC, Smit HA. Maternal food consumption during pregnancy and the longitudinal development of childhood asthma. Am J Respir Crit Care Med. 2008 Jul 15;178(2):124-31.
RATIONALE: Maternal diet during pregnancy has the potential to affect airway development and to promote T-helper-2-cell responses during fetal life. This might increase the risk of developing childhood asthma or allergy. OBJECTIVES: We investigated the influence of maternal food consumption during pregnancy on childhood asthma outcomes from 1 to 8 years of age.
METHODS: A birth cohort study consisting of a baseline of 4,146 pregnant women (1,327 atopic and 2,819 nonatopic). These women were asked about their frequency of consumption of fruit, vegetables, fish, egg, milk, milk products, nuts, and nut products during the last month. Their children were followed until 8 years of age. Longitudinal analyses were conducted to assess associations between maternal diet during pregnancy and childhood asthma outcomes over 8 years.
MEASUREMENTS AND MAIN RESULTS: Complete data were obtained for 2,832 children. There were no associations between maternal vegetable, fish, egg, milk or milk products, and nut consumption and longitudinal childhood outcomes. Daily consumption of nut products increased the risk of childhood wheeze (odds ratio [OR] daily versus rare consumption, 1.42; 95% confidence interval [95% CI], 1.06-1.89), dyspnea (OR, 1.58; 95% CI, 1.16-2.15), steroid use (OR, 1.62; 95% CI, 1.06-2.46), and asthma symptoms (OR, 1.47; 95% CI, 1.08-1.99).
METHODS: A birth cohort study consisting of a baseline of 4,146 pregnant women (1,327 atopic and 2,819 nonatopic). These women were asked about their frequency of consumption of fruit, vegetables, fish, egg, milk, milk products, nuts, and nut products during the last month. Their children were followed until 8 years of age. Longitudinal analyses were conducted to assess associations between maternal diet during pregnancy and childhood asthma outcomes over 8 years.
MEASUREMENTS AND MAIN RESULTS: Complete data were obtained for 2,832 children. There were no associations between maternal vegetable, fish, egg, milk or milk products, and nut consumption and longitudinal childhood outcomes. Daily consumption of nut products increased the risk of childhood wheeze (odds ratio [OR] daily versus rare consumption, 1.42; 95% confidence interval [95% CI], 1.06-1.89), dyspnea (OR, 1.58; 95% CI, 1.16-2.15), steroid use (OR, 1.62; 95% CI, 1.06-2.46), and asthma symptoms (OR, 1.47; 95% CI, 1.08-1.99).
CONCLUSIONS: Results of this study indicate an increased risk of daily versus rare consumption of nut products during pregnancy on childhood asthma outcomes. These findings need to be replicated by other studies before dietary advice can be given to pregnant women.
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