Anaemia affects more than 36% of all pregnancies globally and is associated with significant maternal and neonatal morbidity and mortality. Iron deficiency is widely recognised as the most common nutritional cause of anaemia but other nutrient deficiencies are also implicated, including the B vitamin riboflavin, albeit its role is largely under-investigated and thus typically overlooked. Riboflavin, in its cofactor forms flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN), is required for numerous oxidation-reduction reactions, antioxidant function, and in the metabolism of other B vitamins and iron. While clinical deficiency of riboflavin is largely confined to low-income countries, sub-clinical (functional) deficiency is much more widespread, including in high-income countries, and is particularly common among women of reproductive age and during pregnancy. Limited observational evidence from high-income populations suggests that suboptimal riboflavin status contributes to an increased risk of anaemia. Furthermore, randomised controlled trials in pregnant women from low- and middle-income countries have demonstrated beneficial effects of riboflavin on haematological status and anaemia. Various mechanisms have been proposed to explain the contribution of riboflavin deficiency to anaemia, with the strongest evidence pointing to an adverse effect on iron metabolism, given that riboflavin co-factors are required for the release of iron from storage ferritin in the production of red blood cells. Overall, this review investigates riboflavin intakes and status during pregnancy in different populations and evaluates the available evidence for the under-recognised role of riboflavin in the maintenance of haemoglobin concentrations together with its potential to protect against the development of anaemia during pregnancy.

The antioxidant capacity and the inflammatory potential of diet during pregnancy may represent a prevention opportunity for allergic and respiratory diseases. We aimed to investigate the associations between the antioxidant and the inflammatory potential of maternal diet in the last 3 months of pregnancy with allergic and respiratory diseases in children. Analyses were performed on 9679 mother–child pairs from the ELFE birth cohort. The dietary total antioxidant capacity (DTAC), without coffee, was estimated with the Trolox equivalent antioxidant capacity (TEAC), the total radical trapping antioxidant parameter (TRAP) and the ferric reducing-antioxidant power (FRAP). The inflammatory potential of the maternal diet was assessed by the energy-adjusted dietary inflammatory index (E-DII). Allergic and respiratory diseases in children up to 5·5 years were considered jointly through five allergic and respiratory multimorbidity clusters (‘asymptomatic’ - reference, ‘early wheeze without asthma’, ‘asthma only’, ‘allergies without asthma’ and ‘multi-allergic’). Multinomial logistic regressions were performed and adjusted for main confounders. A diet with a higher antioxidant potential was associated with a lower risk of belonging to the ‘early wheeze without asthma’ cluster (aOR (95 % CI) = 0·95 (0·90, 0·99) per sd of TEAC score). A higher E-DII was associated with a higher risk of belonging to the ‘asthma only’ cluster (aOR (95 % CI) = 1·09 (1·00, 1·19) per sd). No association was found with the ‘allergies without asthma’ or ‘multi-allergic’ clusters. An antioxidant-rich diet during pregnancy was associated with better respiratory health, while a pro-inflammatory diet was associated with poorer respiratory health in children up to 5·5 years, though the associations were weak.

Epidemiological evidence suggests that a higher intake of sugar during pregnancy is associated with a higher risk of childhood asthma and atopy. However, randomised trial evidence supporting such a link is lacking. This study aimed to examine whether a low glycaemic index (GI) dietary intervention during pregnancy decreases the risk of childhood asthma and eczema. This is a secondary analysis of 514 children from the ROLO trial. Healthy women were randomised to receive an intervention of low GI dietary advice or routine care from early pregnancy. Mothers reported current doctor-diagnosed eczema in their children at 2 years (n 271) and current doctor-diagnosed asthma and eczema in their children at 5 (n 357) and 9–11 years (n 391) of age. Multivariable logistic regression models were used test the effect of the intervention on child outcomes overall and stratified by maternal education. There was a suggestion of a reduction in asthma at 5 years of age in children whose mothers received the low GI dietary intervention during pregnancy compared with usual care (adjusted OR 0·46 (95 % CI 0·19, 1·09); P = 0·08). In stratified adjusted analyses, the intervention was associated with a reduced risk of asthma at 5 years of age in children born to mothers with incomplete tertiary level education but not in those with complete tertiary level education (OR 0·14 (95 % CI 0·02, 0·69); P = 0·010 and OR 1·03 (95 % CI 0·34, 3·13); P = 0·94, respectively). A low GI diet in pregnancy may reduce the risk of developing asthma in childhood, particularly amongst children born to mothers with lower educational attainment.

Paternal exposures (and other non-maternal factors) around pregnancy could have important effects on offspring health. One challenge is that data on partners are usually from a subgroup of mothers with data, potentially introducing selection bias, limiting generalisability of findings. We aimed to investigate the potential for selection bias in studies using partner data.

We characterise availability of data on father/partner and mother health behaviours (smoking, alcohol, caffeine and physical activity) around pregnancy from three UK cohort studies: the Avon Longitudinal Study of Parents and Children (ALSPAC), Born in Bradford and the Millennium Cohort Study. We assess the extent of sample selection by comparing characteristics of families where fathers/partners do and do not participate. Using the association of parental smoking during pregnancy and child birthweight as an example, we perform simulations to investigate the extent to which missing father/partner data may induce bias in analyses conducted only in families with participating fathers/partners.

In all cohorts, father/partner data were less detailed and collected at fewer timepoints than mothers. Partners with a lower socio-economic position were less likely to participate. In simulations based on ALSPAC data, there was little evidence of selection bias in associations of maternal smoking with birthweight, and bias for father/partner smoking was relatively small. Missing partner data can induce selection bias. In our example analyses of the effect of parental smoking on offspring birthweight, the bias had a relatively small impact. In practice, the impact of selection bias will depend on both the analysis model and the selection mechanism.

This scoping review addresses gaps in the existing literature on dietary guidelines for pregnant and lactating women globally. The study delves into adherence levels, identifies influencing factors and examines outcomes associated with these guidelines. Analysing food-based dietary guidelines (FBDG) from around the world, the review reveals that half of the countries lack FBDG, with only 15% providing tailored advice for pregnant and lactating women. Utilising data extracted from forty-seven articles across MEDLINE and EMBASE, the study highlights a scarcity of adherence studies, particularly in low- or middle-income countries (LMIC), and emphasises the lack of research during lactation. Overall adherence to dietary guidelines is low, with disparities in fruit, vegetable, whole grain and fish consumption. Positive correlations with adherence include age, education, employment, social class and certain medical histories, while negative correlations involve smoking, alcohol consumption, metropolitan residence and elevated BMI. The study documented significant associations between adherence and reduced risks of gestational complications but calls for further exploration of intermediate nutritional outcomes such as micronutrient deficiencies and child growth. Emphasising the urgency for globally standardised guidelines, especially in LMIC, this review provides a foundational call for prioritised studies and strategies to enhance dietary practices for pregnant and lactating women worldwide.

The present study investigated the relationships between maternal characteristics and subjective well-being (life satisfaction and optimism) among overweight Brazilian adult pregnant women. A cross-sectional study utilising baseline data from a randomised controlled clinical trial was conducted. A total of 330 women were investigated. Maternal characteristics (sociodemographic, obstetric and lifestyle) were obtained through a structured questionnaire. Data on dietary intake were collected through two 24-h dietary recalls, and the usual diet was estimated using the Multiple Source Method. Life satisfaction and optimism were assessed using validated instruments. Both unadjusted and adjusted linear regression models were employed to investigate the relationship between maternal characteristics and subjective well-being. Sleep quality was found to be positively associated with life satisfaction. Miscarriage and smoking during pregnancy were negatively associated with this sentiment. Additionally, a positive association was observed between optimism and maternal characteristics such as sleep quality, desired pregnancy and alcohol consumption in the previous 30 d. Furthermore, it was found that the consumption of sugary drinks, dietary fibre and Ca were positively associated with this same feeling. The present study showed that some maternal and food consumption characteristics were associated with subjective well-being among overweight pregnant women. It is, therefore, essential to recognise predictors of maternal mental health given their relevance to the field of public health.

Childbirth is a major life-changing event, this period is an opportunity to improve eating habits. The aim of this longitudinal study was to identify and characterise dietary changes in women according to their parity status. Dietary intake data from 4194 women of childbearing age included in the NutriNet-Santé cohort were derived using a FFQ, administered in 2014 and 2018, distinguishing between organic and conventional food consumption. Women were classified into four groups: ‘previous children’, ‘multiparous’, ‘primiparous’ and ‘nulliparous’. Multi-adjusted ANCOVA models were used to estimate the changes according to the parity group. Changes in food consumption towards a more plant-based, healthier and organic diet were observed in all four groups of women, although to various degrees. In multivariable models, ‘Nulliparous’ women showed a greater improvement in terms of ‘sustainable’ food consumption than ‘previous children’ women. ‘Primiparous’ women significantly increased their energy intake (+349 (269–429) kcal/d) and their consumption of dairy products (+30 (3–56) g/d), and they significantly decreased their consumption of alcohol (–23 (–32–15) g/d), coffee and tea (–107 (–155–60) g/d). Regarding organic food, ‘nulliparous’ women increased their consumption more than ‘previous children’ and ‘primiparous’ women were those who were most frequently in the top quintile of organic food increase. Although there were dietary changes in all groups of women according to their parity, childless women have a shift moving towards a more sustainable diet. Women who had a first child reduced their alcohol and caffeine consumption.

The practice of antenatal colostrum expression (ACE), or the extraction of colostrum from the breasts during pregnancy, has an interesting history and continues to evolve. This narrative review aims to describe how perception and practices of ACE have changed over time, summarise the evidence on ACE in maternal and infant care, and highlight areas for future research. The literature demonstrates that ACE is safe for low-risk women when done from around 36 weeks’ gestation. Women should be reassured that the skill of hand expressing is a valuable tool post-birth, regardless of whether they are able to collect colostrum antenatally or not. The collection and storage of colostrum in pregnancy can help avoid formula use in hospital, which may have follow on effects immune function and other areas. Ideally, colostrum collected during pregnancy would be kept safely frozen during the hospital stay and only defrosted and used during the stay if medically indicated, with parents supported through that process. Although ACE does not appear to improve long-term breastfeeding rates at present, it can increase confidence around breastfeeding. Further research in more diverse population groups, long-term breastfeeding and long-term health outcomes of using frozen antenatally expressed colostrum for babies (as compared to formula or fresh colostrum) would be valuable to gain a better understanding of the importance of ACE in maternity care.