title: First-trimester maternal protein intake and childhood kidney outcomes: the Generation R Study.
abstract: BACKGROUND
  Nutritional exposures during in utero development may have long-lasting consequences for postnatal renal health. Animal studies suggest that specifically maternal dietary protein intake during pregnancy influences childhood kidney function.
  
  
  OBJECTIVE
  We examined the associations of total, animal, and vegetable maternal protein intake during pregnancy with kidney volume and function in school-aged children.
  
  
  METHODS
  This study was conducted in 3650 pregnant women and their children who were participating in a population-based cohort study from early life onward. First-trimester energy-adjusted maternal protein intake was assessed with a food-frequency questionnaire. At the child's age of 6 y, we assessed kidney volume, estimated glomerular filtration rate (eGFR) using serum creatinine and cystatin C concentrations, and microalbuminuria using urine albumin:creatinine ratios.
  
  
  RESULTS
  First-trimester maternal total protein intake was associated with a higher childhood creatinine-based eGFR (difference: 0.06 mL × min(-1) × 1.73 m(-2); 95% CI: 0.01, 0.12 mL · min(-1) · 1.73 m(-2) per gram of protein intake). This association was mainly driven by vegetable protein intake (0.22 mL × min(-1) × 1.73 m(-2); 95% CI: 0.10, 0.35 mL · min(-1) · 1.73 m(-2) per gram of vegetable protein intake). These associations were not explained by protein intake in early childhood. First-trimester maternal protein intake was not significantly associated with childhood kidney volume, cystatin C-based eGFR, or the risk of microalbuminuria.
  
  
  CONCLUSIONS
  Our findings suggest that higher total and vegetable, but not animal, maternal protein intake during the first trimester of pregnancy is associated with a higher eGFR in childhood. Further follow-up studies are needed to investigate whether maternal protein intake in early pregnancy also affects the risk of kidney diseases in later life.
authors.affiliation: The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Kozeta
authors.initials: K
authors.lastname: Miliku
authors.affiliation: The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Trudy
authors.initials: T
authors.lastname: Voortman
authors.affiliation: The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Edith H
authors.initials: EH
authors.lastname: van den Hooven
authors.affiliation: the Departments of Epidemiology and.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: the Departments of Epidemiology and.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands v.jaddoe@erasmusmc.nl.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
mesh_terms: D000419:Albuminuria / Q000175:diagnosis / Q000652:urine; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D008460:Meat; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014675:Vegetables
chemical_list: D055316:Cystatin C; D004044:Dietary Proteins; D003404:Creatinine
keywords: kidney development; kidney function; kidney health; maternal diet; maternal protein intake; pediatrics