Maternal plant-based diet during pregnancy with allergic and respiratory multimorbidity in childhood

<bold>Context:</bold> Nowadays, a plant-based diet is promoted as a sustainable option for both human and planetary health. However, effects on allergic and respiratory health, especially during critical windows of exposure such as pregnancy, have been little studied. <bold>Aim:</bold> To investigate the associations between maternal plant-based diet during pregnancy and allergic and respiratory multimorbidity in children. <bold>Methods:</bold> We included 9679 children from the ELFE study. Maternal diet was assessed using the healthful plant-based diet index (hPDI, positive scores for healthy plant foods, e.g. fruits and vegetables, and reverse scores for animal or less-healthy plant foods, e.g. sugary drinks and snacks) and the unhealthful plant-based diet index (uPDI, positive scores for less-healthy plant foods and reverse scores for animal or healthy plant foods). Five clusters of allergic and respiratory multimorbidity up to 5.5 years were previously identified: “asymptomatic” (ref.), “early wheeze without asthma”, “asthma only”, “allergies without asthma”, “multi-allergic”. Multinomial logistic regressions adjusted for potential maternal and sociodemographic confounders were conducted between quintiles of scores and clusters. <bold>Results:</bold> The second and fifth quintiles of maternal uPDI were associated with a higher risk of belonging to the “asthma only” cluster (aOR(95%CI) Q2 vs Q1 =1.29(1.01;1.65); Q5 vs Q1 = 1.41(1.06;1.87)). Non-linear associations were found for both scores with the “multi-allergic” cluster in children. <bold>Conclusion:</bold> In a nationwide birth cohort, the associations between plant-based diet during pregnancy and childhood respiratory and allergic multimorbidity seemed to differ according to diet quality.