Maternal use of dietary supplements during pregnancy is not associated with coeliac disease in the offspring: The Environmental Determinants of Diabetes in the Young (TEDDY) study

British Journal of Nutrition
Q1
Feb 2017
Citations:86
Influential Citations:4
Observational Studies (Human)
83
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Methods
International multicenter longitudinal prospective observational study (TEDDY) across six clinical centers in the USA (Colorado, Georgia, Washington) and Finland, Germany, Sweden. 424,788 newborns screened; 21,589 met inclusion criteria based on HLA genotyping; 8,676 enrolled and followed from birth to age 15 years. Coeliac disease autoimmunity (CDA) defined as persistently positive tissue transglutaminase autoantibodies (tTGA); coeliac disease defined by biopsy-confirmed or persistently elevated tTGA > 100 AU.
Intervention
Vitamin D, omega-3 fatty acid, and iron supplements taken orally during pregnancy for the duration of pregnancy; cumulative intake across pregnancy: Vitamin D 2014 μg; omega-3 fatty acids 111 g; iron 8806 mg.
Results
Maternal vitamin D, omega-3 fatty acids, and iron supplementation during pregnancy did not significantly modify offspring risk of CDA or coeliac disease (CD) by age 6. In adjusted models, vitamin D use (any vs none) showed a borderline increased risk for CDA in the binary analysis (HR 1.15; 95% CI 1.00–1.32; P = 0.04) but not in continuous (HR 0.98; 95% CI 0.94–1.02; P = 0.32) or ordinal analyses (HR 1.07; 95% CI 0.98–1.17; P = 0.15). No associations were found for n-3 fatty acids or iron with CDA or CD. Conclusion: Prenatal supplementation may boost nutrient intake but is unlikely to modify coeliac disease risk in offspring.
Limitations
Observational design; reliance on self-reported supplement use with potential recall bias; limited dietary data from foods; cross-country variation in supplementation; relatively few iron non-users may affect estimates; analyses focused on prenatal exposure; no data on iron supplementation in childhood; outcomes assessed up to about age 6 years; potential residual confounding.

Abstract

Abstract Perinatal exposure to nutrients and dietary components may affect the risk for coeliac disease (CD). We investigated the association between maternal use of vitamin D, n-3 fatty acids (FA) and Fe supplements during pregnancy and risk for CD ...