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. Design: 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 3 min<sup>-1</sup> × 1.73 m<sup>-2</sup>; 95% CI: 0.01, 0.12 mL min<sup>-1</sup> 1.73 m<sup>-2</sup> per gram of protein intake). This association was mainly driven by vegetable protein intake (0.22 mL × min<sup>-1</sup> × 1.73 m<sup>-2</sup>; 95% CI: 0.10, 0.35 mL min<sup>-1</sup> 1.73 m<sup>-2</sup> 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.

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Keywords Kidney development, Kidney function, Kidney health, Maternal diet, Maternal protein intake, Pediatrics
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Journal The American Journal of Clinical Nutrition
Miliku, K, Voortman, R.G, van den Hooven, E.H, Hofman, A, Franco, O.H, & Jaddoe, V.W.V. (2015). First-trimester maternal protein intake and childhood kidney outcomes: The generation R study. The American Journal of Clinical Nutrition, 102(1), 123–129. doi:10.3945/ajcn.114.102228