title: Maternal protein intake during pregnancy and linear growth in the offspring.
abstract: Observational and experimental evidence demonstrates that protein intake in infancy programs linear growth. To our knowledge, few studies have examined prenatal maternal protein intake.
  
  
  
  Our objective was to examine associations of maternal protein intake during pregnancy with offspring linear growth.
  
  
  
  We analyzed data from 1961 mother-child pairs in Project Viva. We assessed first- and second-trimester diet with the use of food-frequency questionnaires and analyzed protein intake as grams per kilogram prepregnancy weight per day. We used research measures of offspring length at birth and in infancy (∼6 mo), early childhood (∼3 y), and midchildhood (∼7 y), as well as clinical growth measures obtained from after birth through midchildhood. We calculated sex-specific birth length z scores for gestational age with the use of international reference data. We used mixed models with repeated length measures to predict individual length gain velocities for birth to <6 mo and 6 mo to 7 y of age, then used these velocities as outcomes in adjusted linear regression models with maternal protein intake as the main predictor.
  
  
  
  Mean (range) second-trimester protein intake was 1.4 g · kg-1· d-1(0.3-3.1 g · kg-1· d-1). After adjusting for maternal sociodemographics, gestational weight gain, maternal and paternal height, and (for postdelivery outcomes) child sex, gestational age, and breastfeeding duration, each 1-SD (0.36 g · kg-1· d-1) increment in second-trimester protein intake corresponded to a -0.10 (95% CI: -0.18, -0.03) change in birth length z score, a -0.03 cm/mo (95% CI: -0.05, -0.01 cm/mo) change in slope of length growth from birth to <6mo, and a -0.09 cm/y (95% CI: -0.14, -0.05 cm/y) change in slope of length growth from 6 mo to midchildhood. Results were similar for first-trimester intake.
  
  
  
  In a population with relatively high protein intake during pregnancy, higher protein intake was associated with shorter offspring birth length and slower linear growth into midchildhood. Results suggest that higher protein intake during pregnancy does not increase fetal and child growth and may even reduce early length growth. Project Viva was registered at clinicaltrials.gov as NCT02820402.
authors: Friedman School of Nutrition Science and Policy, Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA karen_switkowski@harvardpilgrim.org.
authors: Karen M
authors: KM
authors: Switkowski
authors: Jean Mayer-USDA Human Nutrition Research Center on Aging, and.
authors: Paul F
authors: PF
authors: Jacques
authors: Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA; and.
authors: Aviva
authors: A
authors: Must
authors: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Ken P
authors: KP
authors: Kleinman
authors: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Matthew W
authors: MW
authors: Gillman
authors: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors: Emily
authors: E
authors: Oken
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006128:Growth / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D039401:Prenatal Nutritional Physiological Phenomena; D055815:Young Adult
chemical_list: D004044:Dietary Proteins
keywords: cohort; linear growth; maternal diet; pregnancy; programming; protein