title: Maternal dietary patterns during pregnancy and child internalising and externalising problems. The Generation R Study.
abstract: OBJECTIVE
  Maternal nutritional factors during pregnancy have been linked to foetal brain development and subsequent offspring behaviour. Less is known about associations between maternal dietary patterns and offspring behaviour.
  
  
  METHODS
  Within a population-based cohort, we assessed maternal diet using a food frequency questionnaire. Three dietary patterns were derived by means of Principal Component Analysis. Child internalising (emotionally reactive, anxious/depressed or withdrawn, having somatic complaints) and externalising problems (inattention, aggression) were assessed with the Child Behaviour Checklist at 1.5, 3 and 6 years in 3104 children. We assessed the association of maternal Mediterranean, Traditionally Dutch and Confectionary dietary pattern during pregnancy with child internalising and externalising problems.
  
  
  RESULTS
  After adjustment, the Mediterranean diet was negatively associated (ORper SD in Mediterranean score = 0.90, 95% CI: 0.83-0.97) and the Traditionally Dutch diet was positively associated with child externalising problems (ORper SD in Traditionally Dutch score = 1.11, 95% CI: 1.03-1.21). Neither diet was associated with internalising problems.
  
  
  CONCLUSIONS
  Both low adherence to the Mediterranean diet and high adherence to the Traditionally Dutch diet during pregnancy are associated with an increased risk of child externalising problems. Further research is needed to unravel the effects of nutrient interplay during and after pregnancy on child behavioural development.
authors.affiliation: The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.steenweg-degraaff@erasmusmc.nl.
authors.forename: Jolien
authors.initials: J
authors.lastname: Steenweg-de Graaff
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: h.tiemeier@erasmusmc.nl.
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.affiliation: Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: r.steegers@erasmusmc.nl.
authors.forename: Régine P M
authors.initials: RP
authors.lastname: Steegers-Theunissen
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: a.hofman@erasmusmc.nl.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Paediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: v.jaddoe@erasmusmc.nl.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: f.verhulst@erasmusmc.nl.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: s.roza@erasmusmc.nl.
authors.forename: Sabine J
authors.initials: SJ
authors.lastname: Roza
mesh_terms: D002648:Child; D002652:Child Behavior; D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D001523:Mental Disorders / Q000503:physiopathology*; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D010349:Patient Compliance; D011247:Pregnancy; D025341:Principal Component Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: CBCL; Child; Dietary patterns; Externalising problems; FFQ; GEE; Internalising problems; PCA; Prenatal; child behaviour checklist; food frequency questionnaire; generalised estimating equations; principal component analysis