(P10-040-24) Association Between Low-Calorie Sweetener Consumption During Pregnancy and Child Growth: A Systematic Review and Meta-Analysis

Objectives: We aimed to systematically review and meta-analyse the association between perinatal exposure to low-calorie sweeteners (LCS) and offspring weight gain.

Methods: A systematic search of electronic databases in PubMed, Embase, CINAHL, the Cochrane Library, Scopus, Web of Science, PsycINFO, ProQuest Health and Medical, and ClinicalTrials.gov was conducted up to 21 September 2023. A random effects model with restricted maximum likelihood estimation was used for the meta-analysis. We appraised the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation tool.

Results: From 2581 records identified, eight eligible studies with a total of 57,319 participants were included. Compared with no consumption, LCS consumption during pregnancy was not associated with birth weight [standardized mean difference (SMD) (95%CI): -0.58 (-1.73, 0.57)]. Any LCS consumption during pregnancy showed a weak positive association with overweight at one year of age [Odds ratio (95%CI): 1.19 (0.81, 1.58)], and consumption ≥1 serve/day increased the odds of being overweight in one year by up to 57% compared to no consumption. There was no consistent association between LCS exposure during pregnancy and BMI z-score from birth to 7 years. The pooled effect size at birth was [SMD (95%CI): 0.00 (-0.14, 0.15)], at 6 months [SMD (95%CI): 0.05 (-0.84, 0.95)], at 1 year [SMD (95%CI): -0.04 (-0.34, 0.26)], and 7 years [SMD (95%CI): 0.10 (-0.15, 0.34)].

Conclusions: LCS consumption during pregnancy was not associated with birth weight, nor did consistently associate with child growth from birth to age seven. Frequent LCS consumption was linked with an increased risk of offspring overweight. The overall quality of the evidence is 'low' as the included studies were observational. More robust research evidence is required to better understand the effect of LCS consumption during the pregnancy on child growth.

Funding Sources: There is no funding to declare. BG is supported by the University of Adelaide research scholarship. ZL is supported by the National Health and Medical Research Council Emerging Leader-2 Fellowship (GNT#2009730).