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Persistence of COVID-19 symptoms in nonhospitalized individuals beyond a few months has not been well characterized. In this longitudinal study from the Faroe Islands, we present prevalence of long COVID in mainly nonhospitalized patients who were followed up for up to 8 months.All Faroese individuals with confirmed COVID-19 diagnosis from August to December 2020 were invited to participate in this study (n = 297). Demographic and clinical characteristics and self-reported symptoms were ascertained prospectively using a detailed questionnaire administered at repeated phone interviews.A total of 226 individuals participated at baseline (226/297, 76% participation rate), of whom 170 participants had more than 3 months follow-up. Of these, 39% (n = 67/170, 95% confidence interval [CI] 32-37%) reported persistent symptoms (median [range] 168 [93-231] days) after the acute phase and 8% (n = 14/170, 95% CI 5-13%) reported severe persistent symptoms. The most prevalent symptoms were fatigue (17%) and smell (17%) and taste (14%) dysfunction. Long COVID was more common in people reporting daily medication use (odds ratio 2.34, 95% CI 1.02-5.37).Our results show that symptoms may take months to resolve, even among nonhospitalized individuals, with a mild illness in the acute phase. Continued monitoring for long COVID is needed to evaluate the added risk of a potential public health concern.

Symptoms of long coronavirus disease (COVID) were found in 38% of 170 patients followed for a median of 22.6 months. The most prevalent symptoms were fatigue, affected taste and smell, and difficulties remembering and concentrating. Predictors for long COVID were older age and number of symptoms in the acute phase. Long COVID may take many months, maybe years, to resolve.

Close contacts of coronavirus disease (COVID-19) patients are at high risk for severe acute respiratory syndrome 2 (SARS-CoV-2) infection. We assessed the seroprevalence of SARS-CoV-2-specifi c antibodies among quarantined close contacts of COVID-19 patients in the Faroe Islands. We invited quarantined close contacts of COVID-19 index patients identifi ed during March 3-April 22, 2020, to participate in this study; 584 (81%) contacts consented and underwent serologic testing. Among the 584 participants, 32 (5.5%) were seropositive for total antibody against SARSCoV- 2. Household and young or elderly contacts had higher risk for seropositivity than other contacts.We found a secondary attack rate of 19.2%. Seroprevalence among close contacts was almost 10-fold higher than among the general population of the Faroe Islands. Regularly testing household close contacts of COVID-19 patients might help track the transmission of SARS-CoV-2.

Recently Skovlund et al. compared [1] incident cancer diagnoses in Denmark during the COVID-19 pandemic with corresponding figures in the previous 4 years, showing a substantial reduction in cancer...

Purpose: In this paper, we present age-standardized cancer incidence and mortality rates in the Faroe Islands. We also compare with the Nordic rates and show incidence rate ratios (IRR) and mortality rate ratios (MRR). Materials and methods: The Faroese cancer registry (FCR) was established in 1994, with incidence available from 1960 and mortality from 1983. The FCR is a part of the NORDCAN collaboration, where the different Nordic countries all report anonymized cancer data by standardized methods, ensuring comparability. Validation efforts revealed that 13% of cases had not been reported to the FCR from 2006 to 2019, emphasizing the need for continued validation efforts of cancer registries. After validation, we submitted the updated cancer cases to NORDCAN and now present this data, taken directly from the NORDCAN website (2019 data). Results: We found that the incidence of the summary group all cancers in the Faroe Islands increased from 1960 to 2019, while cancer mortality decreased from 1983 to 2019. Comparisons with Nordic rates showed significantly lower IRRs for cancer in all cancers, bladder and urinary tract, and skin cancer for both sexes, while IRR was lower for breast cancer in women and prostate cancer in men. Contrary, IRR was higher for rectum and kidney cancer in women and esophagus and testicular cancer in men. There was an increased MRR for cancer in female organs, bladder and urinary tract, and kidney cancer in women, and esophagus and pancreas cancer in men. In contrast, malignant hematopoietic diseases and melanoma in women had a lower MRR. Conclusions: Cancer incidence in the Faroe Islands was lower than in the other Nordic countries. Of particular interest, the incidence of testicular cancer saw a steep increase during the last 20 years, and an investigation into possible causes for this is needed.

We conducted a second nationwide severe acute respiratory syndrome coronavirus 2 seroprevalence study in the Faroe Islands during November 2020. We found crude seroprevalence was 0.3% and prevalence was 0.4% after adjusting for test sensitivity and specificity. This low seroprevalence supports the prevention strategies used in the Faroe Islands.

BACKGROUND: Intervention studies have shown that long-chain (LC) n-3 PUFA intake can prolong gestation but the dose-time-effect relations remain unresolved. OBJECTIVES: We examined the effect on gestation duration of 2 doses of supplemental LC n-3 PUFAs. METHODS: We undertook a 3-group parallel randomized controlled trial in areas of China with low (median: 2.1 g/d) and higher (14.3 g/d) fish intake. Unselected women (median: age, 26.2 y; BMI, 20. kg/m2) were randomly assigned at midgestation to take four 0.72-g identical gelatin capsules per day until the last day of the preterm period (

Aims: The Faroe Islands is considered a homogeneous society and has a low Gini coefficient, but the knowledge about the social distribution of health and disease is sparse. In a large population-based sample we investigated: (a) the association between socioeconomic position defined by level of education and the prevalence of type 2 diabetes mellitus by self-report in the Faroe Islands; and (b) to what degree lifestyle factors mediate the association. Methods: We used cross-sectional data from the population-based Public Health Survey Faroes 2015 ( n=1095). We present odds ratios for type 2 diabetes mellitus by socioeconomic position from logistic regression models. In our main model we adjusted for potential confounders and in a secondary model we additionally adjusted for potential mediating lifestyle factors. Results: Individuals with middle and low levels of education display higher odds ratios of type 2 diabetes mellitus of 2.80 (95% confidence interval 1.32–5.92) and 4.65 (95% confidence interval 1.93–11.17) in adjusted analysis, respectively, compared to their counterparts with high education. After adjustment for potentially mediating lifestyle factors the estimates were attenuated slightly, but a significant statistical association remained, with lifestyle-related mediating factors in total explaining 21% for middle education and 34% for low education participants. Conclusions: Our results demonstrate that there may be a social gradient in the distribution of type 2 diabetes mellitus in the Faroe Islands, and that the association is partly mediated by lifestyle factors.

Only a few studies have assessed the long-term duration of the humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).In this nationwide longitudinal study from the Faroe Islands with close to full participation of all individuals on the Islands with PCR confirmed COVID-19 during the two waves of infections in the spring and autumn 2020 (n=172 & n=233), samples were drawn at three longitudinal time points (3, 7 and 12 months and 1, 3 and 7 months after disease onset, respectively).Serum was analyzed with a direct quantitative IgG antibody binding ELISA to detect anti–SARS-CoV-2 spike RBD antibodies and a commercially available qualitative sandwich RBD ELISA kit measuring total antibody binding.The seropositive rate in the convalescent individuals was above 95 % at all sampling time points for both assays. There was an overall decline in IgG titers over time in both waves (p < 0.001). Pairwise comparison showed that IgG declined significantly from the first sample until approximately 7 months in both waves (p < 0.001). After that, the antibody level still declined significantly (p < 0.001), but decelerated with an altered slope remaining fairly stable from 7 months to 12 months after infection. Interestingly, the IgG titers followed a U-shaped curve with higher antibody levels among the oldest (67+) and the youngest (0– 17) age groups compared to intermediate groups (p < 0.001).Our results indicate that COVID-19 convalescent individuals are likely to be protected from reinfection up to 12 months after symptom onset and maybe even longer. We believe our results can add to the understanding of natural immunity and the expected durability of SARS-CoV-2 vaccine immune responses.

Individuals born small have an increased risk for developing type 2 diabetes. Altered food preferences in these subjects seem to play a role; however, limited evidence is available on the association between being born small-for-gestational-age (SGA) at term and food intake in adolescence. Alterations in leptin, ghrelin and dopamine levels are suggested mechanisms linking SGA with later food intake. From a large prospective Danish National Birth Cohort, we compared dietary intake of adolescents being born SGA with normal-for-gestational-age (NGA) adolescents. Intake of foods and nutrients was assessed by a validated food frequency questionnaire in a subsample of 15,607 14-year-old individuals born at term. SGA was defined by birth weight (BW) n = 1470) and NGA as BW between 10 and 90th percentile (n = 14,137) according to sex and gestational age-specific BW standard curves. Girls born SGA had a 7% (95% CI: 3–12%, P = 0.002) higher intake of added sugar and a 2–8% lower intake of dietary fibre, vegetables, polyunsaturated fatty acids, and total n−6, compared with NGA girls (P < 0.05). Adjusting for parental socio-occupational status, maternal smoking and diet in pregnancy did not substantially change the differences in dietary intake, except from dietary fibre, which were no longer statistically significant. No significant differences in dietary intake between SGA and NGA boys were found. In summary, girls born SGA had an unfavourable dietary intake compared with NGA girls. These differences persisted after controlling for potential confounders, thus supporting a fetal programming effect on dietary intake in girls born SGA at term. However, residual confounding by other factors operating early in childhood cannot be excluded.

BACKGROUND: High glycemic index (GI) and glycemic load (GL) as indicators of carbohydrate quality and quantity have been found to increase risk of metabolic outcomes in adults. Whether carbohydrate quality may influence metabolic programming already in early life is unknown. We examined the association of maternal GI and GL with offspring body mass index (BMI) in the first 7 years of life among 68,471 mother-offspring dyads from the Danish National Birth Cohort (DNBC). In a sub-cohort of offspring with clinical data (n = 1234) that included 608 dyads exposed to gestational diabetes mellitus (GDM), we also examined the relation to metabolic health at 9-16 years.METHODS: Maternal GI and GL were quantified using a mid-pregnancy food frequency questionnaire. We used birth weight and length to calculate offspring's ponderal index. Age- and sex-specific BMI z scores at 5 mo, 12 mo, and 7 y were standardized against WHO reference data. In the clinical cohort, we quantified body composition, HOMA-IR, and HOMA-B. We used multivariable mixed linear and Poisson regression to model the associations.RESULTS: Median (IQR) of GI and GL were 83 (63-111) and 241 (180-333) g/day, respectively. We found that GI (Q4 vs. Q1:1.09, 95%CI: 1.03, 1.15) and GL (Q4 vs. Q1:1.10, 95%CI: 1.05, 1.16) modestly increased the relative risk of large-for gestational age (LGA). In the clinical sub-cohort, we observed a potential increase in offspring HOMA-IR, adiposity, and metabolic syndrome z score with higher maternal GI and GI. These associations were stronger among the GDM-exposed offspring, but the CI included the null value.CONCLUSION: We found associations of GI and GL in pregnancy with offspring LGA. Potential long-term benefits to offspring exposed to GDM need to be confirmed in larger, well-powered studies.

Background Evidence from experimental studies has demonstrated that higher than normal iron concentrations can lead to pancreatic β cell dysfunction and impaired glucose metabolism. Studies on body iron stores in early pregnancy and subsequent gestational diabetes mellitus (GDM) risk are sparse. Objective Our objective was to determine whether biomarkers of body iron stores measured in early pregnancy are associated with GDM risk. Methods A case-control study of 350 GDM cases and 349 non-GDM controls was conducted in participants from the Danish National Birth Cohort. Blood was collected at a mean ± SD gestational age of 9.4 ± 3.2 wk. Plasma biomarkers of iron stores, including ferritin and soluble transferrin receptor (sTfR), were measured. Logistic regression was used to estimate the OR of GDM associated with quintiles of plasma biomarkers of body iron stores, controlling for maternal age, family history of diabetes, exercise in pregnancy, parity, and prepregnancy body mass index (BMI). Results Cases were older (mean ± SD age: 32.2 ± 4.3 compared with 29.9 ± 4.2 y) and had a higher BMI (in kg/m(2); mean ± SD: 28.7 ± 6.0 compared with 24.1 ± 4.6) than controls. Plasma concentrations of both ferritin and sTfR in early pregnancy were significantly higher in GDM cases than in controls [means ± SDs: 80.6 ± 56.0 compared with 71.8 ± 50.1 μg/L (P = 0.03) and 1.5 ± 0.7 compared with 1.4 ± 0.6 mg/L (P = 0.002) for ferritin and sTfR, respectively]. Ferritin was positively and significantly associated with GDM risk even after adjustment for major risk factors of GDM, including prepregnancy BMI. ORs across increasing quintiles of ferritin were 1.00 (reference), 1.25 (95% CI: 0.70, 2.22), 1.89 (95% CI: 1.06, 3.37), 0.82 (95% CI: 0.46, 1.48), and 2.34 (95% CI: 1.30, 4.21) (P-linear trend = 0.02). Conclusion These findings suggest that plasma ferritin measured in early pregnancy is significantly and positively associated with GDM risk.

Objective To examine the associations of gestational weight gain (GWG) and diet with low-grade inflammation in pregnancy. Methods A cross-sectional analysis of 671 pregnant women was performed, and diet was assessed in gestational week 30. GWG was recorded in weeks 30 and ∼37 (difference between the weight recorded at these time points and pre-pregnancy weight). Markers of inflammation, high-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), interleukin (IL)−6, IL-8, IL-1β, and tumor necrosis factor-α were quantified in serum from week 30. Results After adjusting for age, pre-pregnancy BMI, parity, smoking status, and education, each 1 kg increase in GWG was associated with 3% (95% CI: 1–5) higher hsCRP and 3% (95% CI: 1–4) higher SAA concentrations, which corresponded to ∼18% to 25% increase in these biomarkers among those with excessive weight gain. GWG was inversely associated with IL-8 while no associations were found for the other inflammatory markers. With respect to diet, women in the highest compared with lowest quintile of protein intake had 26% (95% CI: 3–54) higher hsCRP concentrations. This increase appeared to be driven by intake of animal protein. A similar pattern was observed for SAA. Conclusions Excessive GWG, as well as high intake of animal protein, was associated with higher concentrations of inflammatory factors.

In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data on characteristics, dietary factors and lifestyle factors were collected on several occasions during pregnancy. We analysed the association between predicted vitamin D status, based on a subsample with 25-hydroxyvitamin D (25(OH)D) biomarker measurements (n 1497) from gestation week 25, and first-time forearm fractures among offspring between birth and end of follow-up. Diagnoses were extracted from the Danish National Patient Register. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between predicted vitamin D status (based on smoking, season, dietary and supplementary vitamin D intake, tanning bed use and outdoor physical activity) in pregnancy and offspring forearm fractures. Likewise, measured 25(OH)D, tanning bed use and dietary vitamin D intake were not associated with offspring forearm fractures. In mid-pregnancy, 91 % of the women reported intake of vitamin D from dietary supplements. Offspring of women who took >10 µg/d in mid-pregnancy had a significantly increased risk for fractures compared with the reference level of zero intake (hazard ratios (HR) 1·31; 95 % CI 1·06, 1·62), but this was solely among girls (HR 1·48; 95 % CI 1·10, 2·00). Supplement use in the peri-conceptional period exhibited similar pattern, although not statistically significant. In conclusion, our data indicated no protective effect of maternal vitamin D status with respect to offspring forearm fractures.

High glycemic index (GI) and glycemic load (GL) as indicators of carbohydrate quality and quantity have been found to increase risk of metabolic outcomes in adults. Whether carbohydrate quality may influence metabolic programming already in early life is unknown. We examined the association of maternal GI and GL with offspring body mass index (BMI) in the first 7 years of life among 68,471 mother-offspring dyads from the Danish National Birth Cohort (DNBC). In a sub-cohort of offspring with clinical data (n = 1234) that included 608 dyads exposed to gestational diabetes mellitus (GDM), we also examined the relation to metabolic health at 9-16 years.Maternal GI and GL were quantified using a mid-pregnancy food frequency questionnaire. We used birth weight and length to calculate offspring's ponderal index. Age- and sex-specific BMI z scores at 5 mo, 12 mo, and 7 y were standardized against WHO reference data. In the clinical cohort, we quantified body composition, HOMA-IR, and HOMA-B. We used multivariable mixed linear and Poisson regression to model the associations.Median (IQR) of GI and GL were 83 (63-111) and 241 (180-333) g/day, respectively. We found that GI (Q4 vs. Q1:1.09, 95%CI: 1.03, 1.15) and GL (Q4 vs. Q1:1.10, 95%CI: 1.05, 1.16) modestly increased the relative risk of large-for gestational age (LGA). In the clinical sub-cohort, we observed a potential increase in offspring HOMA-IR, adiposity, and metabolic syndrome z score with higher maternal GI and GI. These associations were stronger among the GDM-exposed offspring, but the CI included the null value.We found associations of GI and GL in pregnancy with offspring LGA. Potential long-term benefits to offspring exposed to GDM need to be confirmed in larger, well-powered studies.

Objective Food frequency questionnaires are relatively inexpensive, easy and quick to administer, but the construction of a food frequency questionnaire that can capture Chinese food habits is challenging given the diverse lifestyle and eating habits in different parts of the country. The aim of this study was to assess the validity and reproducibility of a self-administered food frequency questionnaire against a 3-day dietary recall in a rural region of western China. Design Prospective cohort study. Setting Chinese maternal and child healthcare hospital. Population A total of 168 healthy pregnant women. Methods Pregnant women completed a food frequency questionnaire at 16–24 weeks gestation, and again at 29–31 weeks; during weeks 26–27 they completed a 3-day dietary recall. Results In general, mean intake was higher when assessed with food frequency questionnaires compared with dietary recall. Spearman and intra-class correlation coefficients between the two food frequency questionnaires ranged from 0.31 to 0.69 and from 0.27 to 0.79, respectively. For the second food frequency questionnaire and the dietary recall, the crude and de-attenuated Spearman correlations ranged from 0.12 to 0.55 and 0.14 to 0.58, respectively. The correlation both between the two food frequency questionnaires and between the second food frequency questionnaire and the dietary recall decreased after adjustment for energy. Ranking women, 31–57% and 1–8% were classified into the same and the opposite quartile, respectively, by both food frequency questionnaires; 30–45% and 1–11% were classified into the same and the opposite quartile respectively for the second food frequency questionnaire and dietary recall. Conclusion The food frequency questionnaire showed good reproducibility and correlations with dietary recall; it is useful for ranking study participants according to dietary intake, which is of great importance to future etiological studies in this cohort.

Fetal exposure to persistent organic pollutants (POPs) has been linked to adverse neurodevelopment, but few studies have had follow-up beyond childhood.The purpose of this study was to examine the association of maternal serum concentrations of two perfluoroalkyl acids (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS)), polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (p,p′-DDE) and hexachlorobenzene (HCB) with offspring behavioural and affective disorders and scholastic achievement in a prebirth cohort study with 20 years of follow up.Between 1988 and 1989 pregnant women (n = 965) were recruited for the prebirth Danish Fetal Origins 1988 (DaFO88) Cohort in Aarhus, Denmark. Perfluoroalkyl acids, PCBs, p,p′-DDE, and HCB were quantified in serum from week 30 of gestation (n = 876 for perfluoroalkyl acids/872 for PCBs, p,p′-DDE, HCB). Offspring were followed up through national registries until 2011. We evaluated associations between maternal serum concentrations of these POPs and offspring neurodevelopmental outcomes, defined as: first admission diagnosis or prescription of medication until age >20 for (1) ADHD; (2) depression; and (3) scholastic achievement defined as mean grade on a standardized written examination given in the 9th grade (final exams of compulsory school in Denmark).Maternal concentrations of organochlorine substances and perfluoroalkyl acids were higher than present day levels. During the follow-up period there were 27 (3.1%) cases of ADHD and 104 (11.9%) cases of depression; the mean scholastic achievement was 6.7 (SD 2.3). Overall we found no association for maternal levels of any of the measured pollutants with offspring behavioural and affective disorders or with scholastic achievement.Our analyses based on biomarkers from a cohort of over 800 pregnant women with long-term close to complete follow-up through national registries showed little evidence of a programming effect of PFOA, PFOS, PCBs, p,p′-DDE, and HCB in relation to clinically and functionally relevant offspring neurodevelopmental outcomes. Keywords: Neurodevelopmental outcomes, Persistent organic pollutants, Long-time follow-up, Attention deficit/hyperactivity disorder, Depression, Scholastic achievement

Maternal fish intake during pregnancy may influence the risk of child asthma and allergic rhinitis, yet evidence is conflicting on its association with these outcomes. We examined the associations of maternal fish intake during pregnancy with child asthma and allergic rhinitis. Mothers in the Danish National Birth Cohort (n 28 936) reported their fish intake at 12 and 30 weeks of gestation. Using multivariate logistic regression, we examined the associations of fish intake with child wheeze, asthma and rhinitis assessed at several time points: ever wheeze, recurrent wheeze (>3 episodes), ever asthma and allergic rhinitis, and current asthma, assessed at 18 months (n approximately 22 000) and 7 years (n approximately 17 000) using self-report and registry data on hospitalisations and prescribed medications. Compared with consistently high fish intake during pregnancy (fish as a sandwich or hot meal ≥ 2–3 times/week), never eating fish was associated with a higher risk of child asthma diagnosis at 18 months (OR 1·30, 95 % CI 1·05, 1·63, P= 0·02), and ever asthma by hospitalisation (OR 1·46, 95 % CI 0·99, 2·13, P= 0·05) and medication prescription (OR 1·37, 95 % CI 1·10, 1·71, P= 0·01). A dose–response was present for asthma at 18 months only (P for trend = 0·001). We found no associations with wheeze or recurrent wheeze at 18 months or with allergic rhinitis. The results suggest that high (v. no) maternal fish intake during pregnancy is protective against both early and ever asthma in 7-year-old children.

To examine the associations of gestational weight gain (GWG) and diet with low-grade inflammation in pregnancy.A cross-sectional analysis of 671 pregnant women was performed, and diet was assessed in gestational week 30. GWG was recorded in weeks 30 and ∼37 (difference between the weight recorded at these time points and pre-pregnancy weight). Markers of inflammation, high-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor-α were quantified in serum from week 30.After adjusting for age, pre-pregnancy BMI, parity, smoking status, and education, each 1 kg increase in GWG was associated with 3% (95% CI: 1-5) higher hsCRP and 3% (95% CI: 1-4) higher SAA concentrations, which corresponded to ∼18% to 25% increase in these biomarkers among those with excessive weight gain. GWG was inversely associated with IL-8 while no associations were found for the other inflammatory markers. With respect to diet, women in the highest compared with lowest quintile of protein intake had 26% (95% CI: 3-54) higher hsCRP concentrations. This increase appeared to be driven by intake of animal protein. A similar pattern was observed for SAA.Excessive GWG, as well as high intake of animal protein, was associated with higher concentrations of inflammatory factors.

ObjectiveTo develop a basis for building models that can examine the impact of organic food (OF) choices on maternal and offspring health, including identification of factors associated with OF consumption and underlying dietary patterns.DesignDietary intake was collected for the preceding month from an FFQ in mid-pregnancy and information on sociodemographic characteristics was collected from telephone interviews during pregnancy. From a question about OF consumption in the FFQ, including six food categories, an OF preference index was calculated. Latent variables that captured the variability in OF choices in relation to dietary intake were defined.SettingThe Danish National Birth Cohort (DNBC), 1996–2002.SubjectsPregnant women from DNBC (n 60 773).ResultsWe found that frequent OF use was highly associated with age, occupational status, urbanization, smoking and vegetarianism. By principal components analysis we identified two eating patterns, a ‘Western dietary pattern’ and a ‘Prudent dietary pattern’, that explained 14·2 % of the variability in data. Frequent OF users consumed a more ‘prudent’ diet compared with non-users and had significantly higher intakes of vegetables (+67 %), fibre (+13 %) and n-3 fatty acids (+11 %) and less saturated fat (−8 %).ConclusionsFrequent OF users seemed to have a healthier lifestyle than non-users. These findings highlight a major challenge in observational studies examining the impact of OF consumption on health due to potentially irremediable confounding factors.

Background The relation between maternal peanut intake during pregnancy and allergic disease development in children has been controversial. Objective We used data from the Danish National Birth Cohort to examine associations between maternal peanut and tree nut intake during pregnancy and allergic outcomes in children at 18 months and 7 years of age. Methods We estimated maternal peanut and tree nut intake (n = 61,908) using a validated midpregnancy food frequency questionnaire. At 18 months, we used parental report of childhood asthma diagnosis, wheeze symptoms, and recurrent wheeze (>3 episodes). We defined current asthma at 7 years as doctor-diagnosed asthma plus wheeze in the past 12 months and allergic rhinitis as a self-reported doctor's diagnosis. We also used alternative classifications based on registry-based International Classification of Diseases, Tenth Revision, codes and drug dispensary data. We report here odds ratios (ORs) comparing intake of 1 or more times per week versus no intake. Results We found that maternal intake of peanuts (OR, 0.79; 95% CI, 0.65-0.97) and tree nuts (OR, 0.75; 95% CI, 0.67-0.84) was inversely associated with asthma in children at 18 months of age. Compared with mothers consuming no peanuts, children whose mothers reported eating peanuts 1 or more times per week were 0.66 (95% CI, 0.44-0.98) and 0.83 (95% CI, 0.70-1.00) times as likely to have a registry-based and medication-related asthma diagnosis, respectively. Higher tree nut intake was inversely associated with a medication-related asthma diagnosis (OR, 0.81; 95% CI, 0.73-0.90) and self-reported allergic rhinitis (OR, 0.80; 95% CI, 0.64-1.01). Conclusions Our results do not suggest that women should decrease peanut and tree nut intake during pregnancy; instead, consumption of peanuts and tree nuts during pregnancy might even decrease the risk of allergic disease development in children.

Background: Sugar-sweetened soft drinks have been linked to a number of adverse health outcomes such as high weight gain. Therefore, artificially sweetened soft drinks are often promoted as an alternative. However, the safety of artificial sweeteners has been disputed, and consequences of high intakes of artificial sweeteners for pregnant women have been minimally addressed. Objective: We examined the association between intakes of sugarsweetened and artificially sweetened soft drinks and preterm delivery. Design: We conducted prospective cohort analyses of 59,334 women from the Danish National Birth Cohort (1996‐2002). Soft drink intake was assessed in midpregnancy by using a foodfrequency questionnaire. Preterm delivery (,37 wk) was the primary outcome measure. Covariate information was assessed by telephone interviews. Results: There was an association between intake of artificially sweetened carbonated and noncarbonated soft drinks and an increased risk of preterm delivery (P for trend: 0.001, both variables). In comparison with women with no intake of artificially sweetened carbonated soft drinks, the adjusted odds ratio for women who consumed 1 serving of artificially sweetened carbonated soft drinks/d was 1.38 (95% CI: 1.15, 1.65). The corresponding odds ratio for women who consumed 4 servings of artificially sweetened carbonated soft drinks/d was 1.78 (95% CI: 1.19, 2.66). The association was observed for normal-weight and overweight women. A stronger increase in risk was observed for early preterm and moderately preterm delivery than with late-preterm delivery. No association was observed for sugar-sweetened carbonated soft drinks (P for trend: 0.29) or for sugar-sweetened noncarbonated soft drinks (P for trend: 0.93). Conclusions: Daily intake of artificially sweetened soft drinks may increase the risk of preterm delivery. Further studies are needed to reject or confirm these findings. Am J Clin Nutr 2010;92:626‐ 33.

The aim of this study was to identify dietary predictors of plasma dioxin-like activity in women from the Danish National Birth Cohort. Associations between exposure and birth weight and infant development at 6 months were also explored. Diet was assessed in mid-pregnancy by a food-frequency questionnaire. One hundred nulliparous 25–35-year-old women of normal pre-pregnancy body-mass-index were chosen according to their intake of fatty fish, as fatty fish is a potential route of exposure. Intake of other foods of animal origin was also explored. Dioxin-like activity was measured in plasma using the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR-CALUX) and quantified in toxic equivalents (CALUX-TEQs). Information on infant attainment of specific milestones was obtained by maternal report in a standardized interview. The sample mean was 46 pg CALUX-TEQ/g lipid. Plasma dioxin-like activity increased by 10.7 pg CALUX-TEQ/g lipid (95% CI: 1.8; 19.7) for the highest compared to the lowest tertile of total dietary fat intake but decreased by −9.8 pg CALUX-TEQ/g lipid (95% CI: −19.4; −0.2) for fatty fish intake. The inverse association for fatty fish was explained by lower intake of high-fat food groups such as red meat, fats and oils, which were also predictors of dioxin-like activity. Plasma dioxin-like activity was not associated with birth weight, but an inverse correlation was observed with total developmental score (Spearman r =−0.23, p =0.046). Our study indicates that dietary patterns associated with high fat intake may lead to increased plasma dioxin-like activity and in utero exposure might be related to early infant development.

Background: Vitamin D is obtained from dietary sources and synthesized in the skin during exposure to ultraviolet B radiation in sunlight. During pregnancy, vitamin D is transported from mother to fetus through the placenta in the form of 25-hydroxyvitamin D [25(OH)D]. There is evidence that vitamin D influences neuronal differentiation, endocrine functions, and fetal brain growth. Animal studies indicate alterations in the offspring brain as a consequence of vitamin D deficiency during pregnancy. In humans, maternal vitamin D insufficiency has been linked to impaired child language development. Using data from a prebirth cohort with up to 22 years of follow-up, we examined the association of vitamin D status with proxies of offspring neurodevelopmental outcomes. During 1988-1989, pregnant women were recruited for the DaFO88 cohort (n = 965) in Aarhus, Denmark. Maternal concentrations of 25(OH)D were quantified in serum from week 30 of gestation via the LC-MS/MS method (n = 850). Offspring were followed up through national registries until the age of 22 years. We evaluated the association of the maternal concentration of 25(OH)D with offspring neurodevelopmental outcomes defined as first admission diagnosis or prescription of medication for (1) ADHD, (2) depression, and (3) scholastic achievement based on the mean grade on standardized written examinations in the 9th grade (final exams after 10 years of compulsory school in Denmark). Key Messages: Maternal concentrations of 25(OH)D were higher compared to current levels (median 76 nmol/l; 5th to 95th percentiles 23-152). There was a direct association between maternal vitamin D status and offspring depression (ptrend = 0.01); for ADHD there was no association. Scholastic achievement was slightly higher for offspring of mothers with a vitamin D status in the range of >50-125 nmol/l, but this nonlinear association was not statistically significant. Conclusions: Our analyses based on biomarker measurement of 25(OH)D from a cohort of 850 pregnant women combined with long-term follow-up showed no support for a beneficial fetal programming effect of vitamin D status with regard to behavioral and affective disorders and scholastic achievement.

BACKGROUND: High prenatal vitamin D status has been linked to decreased risk of atopic diseases in early childhood, but whether such relations persist until adulthood has not been explored.OBJECTIVE: We sought to examine the association between maternal 25-hydryxovitamin D (25[OH]D) concentrations and outcomes of allergic airway disease and lung function in offspring with 20 to 25 years of follow-up.METHODS: In a prospective birth cohort with 965 pregnant women enrolled in 1988-1989, maternal 25(OH)D concentrations were quantified in serum from gestational week 30 (n = 850 [88%]). Offspring were followed in nationwide registries with complete follow-up to the age of 25 years (n = 850 [100%]). Additionally, at age 20 years, outcomes of allergic airway disease and lung function were assessed in a subset of offspring by using blood samples and spirometry (n = 410 [45%]) and a questionnaire (n = 641 [70%]).RESULTS: Exposure to a high maternal 25(OH)D concentration (≥125 nmol/L) was associated with an increased risk of asthma hospitalizations in offspring (hazard ratio [HR], 1.81; 95% CI, 0.78-4.16) during 25 years of follow-up compared with the reference group (75-CONCLUSIONS: Our study does not provide support for a protective effect of a high maternal 25(OH)D concentration on outcomes of allergic airway disease and lung function at 20 to 25 years of age. In contrast, a high maternal 25(OH)D concentration might be associated with an increased risk of allergic diseases in offspring.

Objectives To elucidate the research possibilities when merging data on maternal diet from the Danish National Birth Cohort (DNBC) and the Norwegian Mother and Child Cohort Study (MoBa), through comparison of (i) the methodology used for dietary assessment and (ii) the estimated intake of selected food groups in the two cohorts. Design Qualitative and quantitative comparison of the two dietary databases. Setting Two national prospective pregnancy cohorts. Population Denmark, Norway. Methods Comparison of food intake using food frequency questionnaires (FFQs). Results The FFQs had overlapping time windows and a majority of the questions in the two FFQs were comparable. Calculation principles shared similar features, including the software used and use of global questions to calibrate intakes of different food groups. A total of 63 food groups were defined that could be compared across the two cohorts; these were further aggregated down to 31 broader groups. A comparison of food intakes (grams/d) showed 39, 74 and 141% lower daily intakes of fish, potatoes and rice, respectively, in DNBC vs. MoBa and 39, 54 and 65% higher daily intakes of milk, butter and potatoes in DNBC vs. MoBa. For most other food groups, differences in consumption data were below 20%. Conclusions The two FFQs are to a large extent compatible and substantial differences in dietary habits were observed between the two cohorts. This may strengthen studies using pooled analysis to examine diet–disease relations. This is a conclusion of great importance given the colossal and costly task involved to establish each of these two cohorts.

Importance Women with a history of gestational diabetes mellitus (GDM) are at substantially increased risk of type 2 diabetes mellitus (T2DM). The identification of important modifiable factors could help prevent T2DM in this high-risk population. Objective To examine the role of physical activity and television watching and other sedentary behaviors, and changes in these behaviors in the progression from GDM to T2DM. Design, Setting, and Participants Prospective cohort study of 4554 women from the Nurses’ Health Study II who had a history of GDM, as part of the ongoing Diabetes & Women’s Health Study. These women were followed up from 1991 to 2007. Exposures Physical activity and television watching and other sedentary behaviors were assessed in 1991, 1997, 2001, and 2005. Main Outcomes and Measure Incident T2DM identified through self-report and confirmed by supplemental questionnaires. Results We documented 635 incident T2DM cases during 59 287 person-years of follow-up. Each 5–metabolic equivalent hours per week (MET-h/wk) increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity, was related to a 9% lower risk of T2DM (adjusted relative risk [RR], 0.91; 95% CI, 0.88-0.94); this inverse association remained significant after additional adjustment for body mass index (BMI). Moreover, an increase in physical activity was associated with a lower risk of developing T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activity) had a 47% lower risk of T2DM (RR, 0.53; 95% CI, 0.38-0.75); the association remained significant after additional adjustment for BMI. The multivariable adjusted RRs (95% CIs) for T2DM associated with television watching of 0 to 5, 6 to 10, 11 to 20, and 20 or more hours per week were 1 (reference), 1.28 (1.04-1.59), 1.41 (1.11-1.79), and 1.77 (1.28-2.45), respectively ( P value for trend Conclusions and Relevance Increasing physical activity may lower the risk of progression from GDM to T2DM. These findings suggest a hopeful message to women with a history of GDM, although they are at exceptionally high risk for T2DM, promoting an active lifestyle may lower the risk.

Background: Past studies suggest that maternal vitamin D intake during pregnancy may protect against child wheeze but studies on asthma are limited. Our objective was to examine the relation between intake of vitamin D in mid-pregnancy and child asthma and allergic rhinitis at 18 months and 7 years. Methods: We examined data from 44,825 women enrolled during pregnancy in the longitudinal Danish National Birth Cohort (1996–2002). We estimated vitamin D intake from diet and supplements based on information from a validated food frequency questionnaire completed in gestational week 25. At 18 months, we evaluated child asthma using data from phone interviews. We assessed asthma and allergic rhinitis by self-report at age 7 and asthma by using records from national registries. Current asthma at age 7 was defined as lifetime asthma diagnosis and wheeze in the past 12 months. We calculated multivariable risk ratios with 95% CIs comparing highest vs. lowest quintile of vitamin D intake in relation to child allergic disease outcomes. Results: The median (5%-95%ile) intake of total vitamin D was 11.7(3.0-19.4) μg/day (68% from supplements). In multivariable analysis, mothers in the highest (vs. lowest) quintile of total vitamin D intake were less likely to have children classified with current asthma at 7 years (Q5 vs. Q1: 0.74, 95% CI: 0.56, 0.96, P = 0.02) and they were less likely to have children admitted to the hospital due to asthma (Q5 vs. Q1: 0.80, 95% CI: 0.64, 1.00, P = 0.05). We found no associations with child asthma at 18 months or with allergic rhinitis at 7 years. Conclusions: Our findings suggest a weak inverse relationship between high total vitamin D and asthma outcomes in later, but not early, childhood. The data did not suggest a clear threshold of vitamin D intake above which risk of asthma was reduced.

BackgroundMaternal supplementation with long-chain n-3 polyunsaturated fatty acids can have immunologic effects on the developing fetus through several anti-inflammatory pathways. However, there is limited knowledge of the long-term programming effects.ObjectiveIn a randomized controlled trial from 1990 with 24 years of follow-up, our aim was to determine whether supplementation with 2.7 g of long-chain n-3 polyunsaturated fatty acids in pregnancy can reduce the risk of asthma in offspring and allergic respiratory disease.MethodsThe randomized controlled trial included 533 women who were randomly assigned to receive fish oil during the third trimester of pregnancy, olive oil, or no oil in the ratio 2:1:1. The offspring were followed in a mandatory national prescription register, with complete follow-up for prescriptions related to the treatment of asthma and allergic rhinitis as primary outcomes. Furthermore, the offspring were invited to complete a questionnaire (74% participated) and attend a clinical examination (47% participated) at age 18 to 19 years.ResultsIn intention-to-treat analyses the probability of having had asthma medication prescribed was significantly reduced in the fish oil group compared with the olive oil group (hazard ratio, 0.54, 95% CI, 0.32-0.90; P = .02). The probability of having had allergic rhinitis medication prescribed was also reduced in the fish oil group compared with the olive oil group (hazard ratio, 0.70, 95% CI, 0.47-1.05; P = .09), but the difference was not statistically significant. Self-reported information collected at age 18 to 19 years supported these findings. No associations were detected with respect to lung function outcomes or allergic sensitization at 18 to 19 years of age.ConclusionMaternal supplementation with fish oil might have prophylactic potential for long-term prevention of asthma in offspring

Dairy products are important sources of micronutrients, fatty acids and probiotics which could modify the risk of child asthma and allergy development. To examine the association of dairy product intake during pregnancy with child asthma and allergic rhinitis at 18 months and 7 years in the Danish National Birth Cohort, data on milk and yoghurt consumption were collected in mid-pregnancy (25th week of gestation) using a validated FFQ (n 61 909). At 18 months, we evaluated asthma and wheeze using interview data. We assessed asthma and allergic rhinitis using a questionnaire at the age of 7 years and through registry linkages. Current asthma was defined as self-reported ever asthma diagnosis and wheeze in the past 12 months. All associations were evaluated using multivariate logistic regression. At 18 months whole milk was inversely associated with child asthma (≥5·5 times/week v. none: 0·85, 95 % CI 0·75, 0·97); the reverse was true for semi-skimmed milk (≥5·5 times/week v. none: 1·08, 95 % CI 1·02, 1·15). For yoghurt, children of women who ate low-fat yoghurt >1 serving/d had 1·21 (95 % CI 1·02, 1·42) greater odds of a medication-related ever asthma diagnosis compared with children of women reporting no intake. They were also more likely to have a registry-based ever diagnosis and report allergic rhinitis. Low-fat yoghurt intake was directly related to increased risk of both child asthma and allergic rhinitis, while whole milk appeared protective for early-life outcomes only. Nutrient components or additives specific to low-fat yoghurt may be mediating the increase in risk.

Previous studies have indicated a protective effect of long-chain n-3 polyunsaturated fatty acids (LCn3FAs) against cardiovascular disease; however, women are underrepresented in cardiovascular research. The aim of this study was to explore the association between intake of LCn3FAs and the risk of cardiovascular disease in a large prospective cohort of young women (mean age at baseline: 29.9 years [range: 15.7–46.9]). Exposure information on 48 627 women from the Danish National Birth Cohort was linked to the Danish National Patients Registry for information on events of hypertensive, cerebrovascular, and ischemic heart disease used to define a combined measure of cardiovascular diseases. Intake of fish and LCn3FAs was assessed by a food-frequency questionnaire and telephone interviews. During follow-up (1996–2008; median: 8 years), 577 events of cardiovascular disease were identified. Low LCn3FA intake was associated with an increased risk of cardiovascular disease (adjusted hazard ratio for women in lowest versus highest LCn3FA intake group: 1.91 [95% CI: 1.26–2.90]). Restricting the sample to women who had consistently reported similar frequencies of fish intake across 3 different dietary assessment occasions tended to strengthen the relationship (hazard ratio for lowest versus highest intake: 2.91 [95% CI: 1.45–5.85]). Furthermore, the observed associations were consistent in supplementary analyses where LCn3FA intake was averaged across the 3 dietary assessment occasions, and the associations were persistent for all 3 of the individual outcomes. Our findings based on a large prospective cohort of relatively young and initially healthy women indicated that little or no intake of fish and LCn3FAs was associated with an increased risk of cardiovascular disease.

Background: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD), despite the detrimental consequences the disorder can impose on mother and child. Research on alternative methods of prevention and treatment of PPD is warranted. Previous studies have suggested that long-chain n23 polyunsaturated fatty acids (PUFAs) might have a beneficial effect on depression. Objective: The objective was to explore the association between intake of fish and n23 PUFAs during pregnancy and PPD in the Danish National Birth Cohort (DNBC). Design: Exposure information from the DNBC was linked to the Danish patient and prescription registries for data on clinically identified cases of depression up to 1 y postpartum. Intake of fish and n23 PUFAs was assessed in midpregnancy with a food-frequency questionnaire. Admission to the hospital for PPD (PPD-admission) and prescription of antidepressants (PPD-prescription) were treated as separate outcomes. A total of 54,202 women were included in the present study sample. Results: Rates of depression were 0.3% (PPD-admission) and 1.6% (PPD-prescription). No association was observed between fish intake and risk of PPD-admission [crude odds ratio of 1.01 (95% CI: 0.52, 1.97) and adjusted odds ratio of 0.82 (95% CI: 0.42, 1.64)], whereas a higher risk of PPD-prescription was found for the lowest compared with the highest fish intake group [crude odds ratio of 1.61 (95% CI: 1.26, 2.06) and adjusted odds ratio of 1.46 (95% CI: 1.12, 1.90)]. No association was observed with respect to n23 PUFA intake. Conclusion: Overall, our data from a large prospective cohort linked with high-quality registers showed little evidence to support anassociationbetweenintakeoffishorn23PUFAsandPPD. Am J Clin Nutr 2009;90:149‐55.

Objective To explore the association between physical activity during pregnancy and postpartum depression (PPD) in a large, prospective cohort. Method Exposure information from the Danish National Birth Cohort, a large, prospective cohort with information on more than 100,000 pregnancies (1996-2002), was linked to the Danish Psychiatric Central Register and the Danish Register for Medicinal Product Statistics for data on clinically identified cases of depression up to 1 year postpartum. A total of 70,866 women from the Danish National Birth Cohort were included in the analyses. Duration, frequency, and type of physical activity were assessed by a telephone interview at approximately week 12 of gestation. Admission to hospital due to depression (PPD-admission) and prescription of an antidepressant (PPD-prescription) were treated as separate outcomes. Results Through linkage to national registers, we identified 157 cases of PPD-admission and 1,305 cases of PPD-prescription. Women engaging in vigorous physical activity during pregnancy had a lower risk of PPD-prescription compared to women who were not physically active (adjusted odds ratio, 0.81; 95% CI, 0.66-0.99). No association was observed between physical activity and PPD-admission; but, in women who were underweight prior to pregnancy, physical activity was associated with increased risk of PPD-admission. Conclusions Our data are compatible with a protective effect of vigorous physical activity, but not for other measures of physical activity, against postpartum depression requiring antidepressant therapy. No protective effect could be detected on PPD leading to hospitalization.

Objective To examine the association between physical activity in early pregnancy and risk of pre-eclampsia. Design Prospective cohort. Setting Denmark. Population A total of 85 139 pregnant Danish women, recruited between 1996 and 2002. Methods The authors assessed leisure time physical activity in first trimester by a telephone interview and categorised women a priori into seven groups: 0 (reference), 1–44, 45–74, 75–149, 150–269, 270–419 and 420+ minutes/week. Pre-eclampsia diagnoses were extracted from the Danish National Patient Registry. A number of potential confounders were adjusted for by logistic regression. Main outcome measures Pre-eclampsia and severe pre-eclampsia. Results The two highest physical activity levels were associated with increased risk of severe pre-eclampsia compared with the nonexercising group, with adjusted odds ratios of 1.65 (95% CI: 1.11–2.43) and 1.78 (95% CI: 1.07–2.95), whereas more moderate levels of physical activity (1–270 minutes/week) had no statistically significant association with risk of pre-eclampsia (total n = 85 139). Conclusions We were unable to document a protective effect of leisure time physical activity against pre-eclampsia. Our data even suggest that leisure time physical activity exceeding 270 minutes/week in first trimester may increase risk of severe pre-eclampsia.

Experimental studies have shown that developmental exposures to environmental chemicals may have long lasting adverse consequences for the development of the immune system. In humans such findings have mostly been explored for persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), organochlorine pesticides, andmorerecently perfluoroalkyl substances (PFAS). Developmental exposures to PCBs have, for example, been associated with both otitis media and lower respiratory infections. Evidence regarding asthma and allergic disease is less well established, partly due to lack of studies with sufficiently long follow-up time. More recently developmental exposures to PFAS have been associated with reduced immune response to vaccinations, while other immune endpoints have been minimally explored. In a cohort of 965 women who gave birth in 1988-1989 with offspring follow-up up to 20 years of age we have examined the long term consequences of in utero exposure to POPs on offspring use of asthma medication and biomarkers of allergic airway disease. Using registry based information on offspring use of asthma medication until 20 years of age, prenatal exposures to PCB-118 and hexachlorobenzene (HCB) were positively associated (p1/FVC) In line with previous findings our results suggest that early life exposures to certain PCB-congeners and organochlorine pesticides may be associated with increased risk of offspring asthma up to 20 years of age. Examining the role of these contaminations in relation to other registry based information on immune disease is currently in preparation.

BACKGROUND: Past evidence has suggested a role of artificial sweeteners in allergic disease; yet, the evidence has been inconsistent and unclear. OBJECTIVE: To examine relation of intake of artificially-sweetened beverages during pregnancy with child asthma and allergic rhinitis at 18 months and 7 years. METHODS: We analyzed data from 60,466 women enrolled during pregnancy in the prospective longitudinal Danish National Birth Cohort between 1996 and 2003. At the 25th week of gestation we administered a validated Food Frequency Questionnaire which asked in detail about intake of artificially-sweetened soft drinks. At 18 months, we evaluated child asthma using interview data. We also assessed asthma and allergic rhinitis through a questionnaire at age 7 and by using national registries. Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months. We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95% CI comparing daily vs. no intake. RESULTS: At 18 months, we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 (95% CI: 1.13, 1.33) times more likely to report a child asthma diagnosis compared to non-consumers. Similar results were found for child wheeze. Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient (1.30, 95% CI: 1.01, 1.66) and medication (1.13, 95% CI: 0.98, 1.29) registry, as well as self-reported allergic rhinitis (1.31, 95% CI: 0.98, 1.74) during the first 7 years of follow-up. We found no associations for sugar-sweetened soft drinks. CONCLUSION: Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis, while early childhood outcomes were related to non-carbonated soft drinks. These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development.

Fat-soluble vitamins A, E and K have been shown to play roles in immunity and inflammation, but studies on child allergic disease have been few and inconsistent. The aim of the present study was to examine the relationship between maternal intake of vitamins A, E and K in mid-pregnancy and child asthma and allergic rhinitis. We used data on 44 594 mother–child pairs from the Danish National Birth Cohort. Maternal intake of fat-soluble vitamins was calculated based on the information from a validated FFQ completed in mid-pregnancy. At 18 months, interviews with the mothers were conducted to evaluate doctor-diagnosed child asthma. At age 7 years, we assessed child asthma and allergic rhinitis using questions from the International Study of Asthma and Allergies in Childhood questionnaire and by national registries on hospital contacts and medication use. Current asthma was defined as asthma diagnosis and wheeze in the past 12 months by maternal report. We calculated multivariable risk ratios and 95 % CI by comparing the highestv. lowest quintile (Q) of maternal vitamin A, E and K intake in relation to child allergic disease outcomes. Maternal total vitamin K intake was directly associated with ever admitted asthma (Q5v. Q1: 1·23, 95 % CI 1·01, 1·50) and current asthma at 7 years (Q5v. Q1: 1·30, 95 % CI 0·99, 1·70). Weak inverse associations were present for maternal vitamin A and E intake during pregnancy with child allergic rhinitis. Maternal vitamin K intake during pregnancy may increase the risk of child asthma, and should be explored further on a mechanistic level. Conversely, maternal vitamin A and E intake may protect against child allergic rhinitis.

Background: Prenatal exposures to persistent organic pollutants (POPs) have been associated with asthma medication use and self-reported symptoms, but associations with lung function and allergic sensitization have been minimally explored. The aim of the study was to examine the associations between prenatal exposures to POPs and allergic sensitization and lung function in 20-year-old offspring. Methods: In a Danish cohort of 965 pregnant women established in 1988-1989, six polychlorinated biphenyl (PCB) congeners, hexachlorobenzene (HCB), and dichlorodiphenyldichloroethylene (p,p'-DDE) were quantified in archived maternal serum drawn in gestational week 30 (n=872). Among those with available maternal exposure information, at age 20, 421 offspring attended attended a clinical examination including measurements of allergic sensitization (serum-specific IgE≥0.35 kU A/L) (n = 418) and lung function [forced expiratory volume in one second (FEV 1) and forced vital capacity (FVC)] (n = 414). Results: There were no associations between maternal concentrations of POPs and offspring allergic sensitization at 20years of age. Maternal concentrations of POPs were, however, positively associated with offspring airway obstruction (FEV 1/FVC1% of predicted value