Association Between Maternal Diet During Pregnancy and the Risk of Childhood Acute Lymphoblastic Leukemia. An Overview.
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BACKGROUND: The effect of maternal habits during pregnancy has been studied to determine their association with the risk of childhood acute lymphoblastic leukemia (ALL). AIM: To synthesize current evidence on the association between maternal diet during pregnancy and the risk of childhood ALL. METHODS: Overview of Systematic reviews (SRs) published until September 2023 were searched in MEDLINE (Pubmed), EMBASE, SCOPUS, Web of Science, and LILACS databases. Effect estimates and meta-aggregate analysis results are presented according to maternal exposure subgroups: (I) alcohol; (II) animal protein; (III) coffee; (IV) fruits and vegetables consumption; and (V) folic acid supplementation. The risk of bias was assessed independently by two authors using the AMSTAR II tool. PROSPERO protocol CRD42023462391. RESULTS: Thirteen SRs were included; of these, according to the AMSTAR II tool, three were graded as high-quality, three as moderate-quality, five as low-quality, and two as critically low-quality reviews. The inclusion of meat (fish), fruits, and vegetables in the diet during pregnancy, as well as folic acid supplementation, seems to have a protective effect against the development of childhood ALL. In contrast, the daily frequency and amount of coffee consumption during pregnancy could influence the development of this type of cancer in the pediatric population. We did not find enough evidence supporting the association of alcohol as a risk factor of childhood ALL. CONCLUSION: The low certainty of the evidence found makes it impossible to establish clear associations between maternal exposure during pregnancy to any of the five nutritional factors here evaluated and the development of childhood ALL.