Abstract
BACKGROUND: Maternal diet during pregnancy may shape the child's immune system and gut microbiota maturation, potentially influencing the risk of developing inflammatory bowel disease (IBD). Therefore, we examined maternal a posteriori dietary patterns during pregnancy and their associations with pediatric-onset IBD risk in offspring. METHODS: The study comprised mother-child pairs from the Danish National Birth Cohort, which is a nationwide cohort of Danish pregnant mothers and their children, enrolled in 1996-2002 and followed prospectively through national health registers. Maternal dietary patterns during pregnancy were identified using k-means cluster analysis of 37 food group intakes, assessed with a food frequency questionnaire in gestational week 25 (second trimester). Pediatric-onset IBD cases (diagnosed at ≤18 years) were identified in Danish health registers. Cox regression explored associations between maternal dietary patterns during pregnancy and risk of pediatric-onset IBD in offspring, using the most common dietary pattern as reference. RESULTS: Based on analysis of 56,097 mother-child pairs, of which 161 (0.29%) offspring developed pediatric-onset IBD, we identify five distinct maternal dietary patterns: diverse (n = 8388), non-recommended (n = 14,110), Mediterranean (n = 14,700), animal-based (n = 3808), and Western (n = 15,091). Notably, a diverse dietary pattern, characterized by high intakes of most food groups, is associated with 45% lower risk of pediatric-onset IBD in offspring compared to a Western pattern (hazard ratio: 0.55; 95% confidence interval: 0.31-0.97). No significant associations are observed for the other patterns. CONCLUSIONS: This large prospective cohort study shows that maternal adherence to a diverse dietary pattern during pregnancy may contribute to lower risk of pediatric-onset IBD in offspring.