Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Divion of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Int J Epidemiol. 2017 Oct 1;46(5):1499-1508. doi: 10.1093/ije/dyx095.
Artificial sweeteners are widely replacing caloric sweeteners. Data on long-term impact of artificially sweetened beverage (ASB) consumption during pregnancy on offspring obesity risk are lacking. We prospectively investigated intake of ASBs and sugar-sweetened beverages (SSBs) during pregnancy in relation to offspring growth through age 7 years among high-risk children born to women with gestational diabetes.
In a prospective study of 918 mother-singleton child dyads from the Danish National Birth Cohort, maternal dietary intake was assessed by a food frequency questionnaire during pregnancy. Offspring body mass index z-scores (BMIZ) and overweight/obesity status were derived using weight and length/height at birth, 5 and 12 months and 7 years. Linear regression and Poisson regression with robust standard errors were used, adjusting for major risk factors.
Approximately half of women reported consuming ASBs during pregnancy and 9% consumed daily. Compared to never consumption, daily ASB intake during pregnancy was positively associated with offspring large-for-gestational age [adjusted relative risk (aRR) 1.57; 95% CI: 1.05, 2.35 at birth], BMIZ (adjusted β 0.59; 95% CI: 0.23, 0.96) and overweight/obesity (aRR 1.93; 95% CI; 1.24, 3.01) at 7 years. Per-serving-per-day substitution of ASBs with water during pregnancy was related to a lower overweight/obesity risk at 7 years (aRR 0.83; 95% CI: 0.76, 0.91), whereas SSB substitution with ASBs was not related to a lower risk (aRR 1.14; 95% CI: 1.00, 1.31).
Our findings illustrated positive associations between intrauterine exposure to ASBs and birth size and risk of overweight/obesity at 7 years. Data with longer follow-up are warranted.
人工甜味剂正在广泛替代含热量的甜味剂。关于怀孕期间摄入人工甜味饮料（ASB）对后代肥胖风险的长期影响的数据尚缺乏。我们前瞻性地研究了高危妊娠糖尿病女性所生的 918 对母婴单胎儿中，怀孕期间摄入 ASB 和含糖饮料（SSB）与通过年龄 7 岁的后代生长的关系。
在丹麦国家出生队列的一项前瞻性研究中，通过食物频率问卷在怀孕期间评估了母亲的饮食摄入量。使用出生时、5 个月和 12 个月以及 7 岁时的体重和身高/长度，得出后代体重指数 z 分数（BMIZ）和超重/肥胖状况。使用线性回归和泊松回归（带有稳健标准差），调整了主要危险因素。
大约一半的女性报告在怀孕期间摄入 ASB，9%的女性每天摄入。与从不摄入相比，怀孕期间每天摄入 ASB 与后代大于胎龄儿有关[调整后的相对风险（aRR）1.57；95%置信区间：1.05，2.35]，与出生时、BMIZ（调整后β 0.59；95%置信区间：0.23，0.96）和超重/肥胖（aRR 1.93；95%置信区间：1.24，3.01）有关。怀孕期间用 ASB 代替每份量水与 7 岁时较低的超重/肥胖风险相关（aRR 0.83；95%置信区间：0.76，0.91），而用 SSB 代替 ASB 与较低的风险无关（aRR 1.14；95%置信区间：1.00，1.31）。
我们的研究结果表明，宫内暴露于 ASB 与出生时的大小和 7 岁时超重/肥胖的风险呈正相关。需要进行更长时间随访的数据。
