{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:56:23Z","timestamp":1792173383230,"version":"4.4.0"},"reference-count":32,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science Foundation of Guangdong Second Provincial General Hospital","award":["YY2018-002"],"award-info":[{"award-number":["YY2018-002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The relationship between the consumption of maternal non-nutritive sweeteners (NNS) during pregnancy and the risk of obesity in offspring remains inconsistent. We aimed to systematically evaluate and clarify the relationship between NNS intake during pregnancy and weight gain in offspring based on evidence from population and clinical research. Databases including PubMed (via Medline), EMBASE, and the Cochrane Library were systematically searched for eligible human studies. The primary outcome was the differences in body mass index (BMI) z-scores between offspring at 1 year of age who were with and without NNS intake during pregnancy or between offspring with different NNS intake levels during pregnancy. A random-effects meta-analysis was conducted for data synthesis to calculate the weighted mean difference (WMD). A total of six prospective cohort studies were eligible for inclusion, among which three were used for pooled analysis of the BMI z-score. A significant increase was found in an offspring\u2019s weight at 1 year of age in the NNS group when compared with the control group: WMD in BMI z-score = 0.19 (95% CI: 0.07, 0.31), p-value = 0.002. Results from the dose-response analysis showed a linear relationship between NNS intake during pregnancy and WMD at 1 year of age: beta = 0.02 (95% CI: 0.001, 0.04) for per serving\/week increase in NNS consumption. The whole body of evidence for the review was rated as low quality. In summary, maternal NNS intake during pregnancy was found to be associated with increased weight gain in offspring based on evidence from human studies. Further well-designed and adequately powered studies are needed to confirm this relationship.<\/jats:p>","DOI":"10.3390\/nu14235098","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T02:24:46Z","timestamp":1669861486000},"page":"5098","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Consumption of Non-Nutritive Sweetener during Pregnancy and Weight Gain in Offspring: Evidence from Human Studies"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1184-1791","authenticated-orcid":false,"given":"Guowei","family":"Li","sequence":"first","affiliation":[{"name":"Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou 510317, China"},{"name":"Father Sean O\u2019Sullivan Research Centre, St. Joseph\u2019s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoting","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou 510317, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changfa","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou 510317, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Likang","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou 510317, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou 510317, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5969-2185","authenticated-orcid":false,"given":"Guiju","family":"Sun","sequence":"additional","affiliation":[{"name":"Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults","volume":"390","author":"Bentham","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1038\/nrendo.2009.195","article-title":"Nutritional programming of the metabolic syndrome","volume":"5","author":"Symonds","year":"2009","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"834","DOI":"10.3945\/ajcn.116.147934","article-title":"Mothers\u2019 intake of sugar-containing beverages during pregnancy and body composition of their children during childhood: The Generation R Study","volume":"105","author":"Jen","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Casas, R., Barquero, S.C., and Estruch, R. (2020). Impact of Sugary Food Consumption on Pregnancy: A Review. Nutrients, 12.","DOI":"10.3390\/nu12113574"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e12914","DOI":"10.1111\/ijpo.12914","article-title":"Sugar-sweetened beverages intake and the risk of obesity in children: An updated systematic review and dose-response meta-analysis","volume":"17","author":"Farhangi","year":"2022","journal-title":"Pediatr. Obes."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1001\/jamapediatrics.2016.0301","article-title":"Association between Artificially Sweetened Beverage Consumption during Pregnancy and Infant Body Mass Index","volume":"170","author":"Azad","year":"2016","journal-title":"JAMA Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1038\/s41366-021-00897-0","article-title":"Associations of maternal non-nutritive sweetener intake during pregnancy with offspring body mass index and body fat from birth to adolescence","volume":"46","author":"Plows","year":"2022","journal-title":"Int. J. Obes."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e20170031","DOI":"10.1542\/peds.2017-0031","article-title":"Beverage Intake during Pregnancy and Childhood Adiposity","volume":"140","author":"Gillman","year":"2017","journal-title":"Pediatrics"},{"key":"ref_9","unstructured":"Institute of Medicine (2007). Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth, The National Academies Press."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1038\/s41366-020-0575-x","article-title":"Nonnutritive sweetener consumption during pregnancy, adiposity, and adipocyte differentiation in offspring: Evidence from humans, mice, and cells","volume":"44","author":"Azad","year":"2020","journal-title":"Int. J. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1093\/ije\/dyx095","article-title":"Maternal consumption of artificially sweetened beverages during pregnancy, and offspring growth through 7 years of age: A prospective cohort study","volume":"46","author":"Zhu","year":"2017","journal-title":"Int. J. Epidemiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Salavati, N., Vinke, P.C., Lewis, F., Bakker, M.K., Erwich, J.J.H.M., and van der Beek, E.M. (2020). Offspring birth weight is associated with specific preconception maternal food group intake: Data from a linked population-based birth cohort. Nutrients, 12.","DOI":"10.3390\/nu12103172"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"nzz004","DOI":"10.1093\/cdn\/nzz004","article-title":"Trends in Low-Calorie Sweetener Consumption among Pregnant Women in the United States","volume":"3","author":"Sylvetsky","year":"2019","journal-title":"Curr. Dev. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.3389\/fmicb.2019.01360","article-title":"Maternal Exposure to Non-nutritive Sweeteners Impacts Progeny\u2019s Metabolism and Microbiome","volume":"10","author":"Rother","year":"2019","journal-title":"Front. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Archibald, A.J., Dolinsky, V.W., and Azad, M.B. (2018). Early-Life Exposure to Non-Nutritive Sweeteners and the Developmental Origins of Childhood Obesity: Global Evidence from Human and Rodent Studies. Nutrients, 10.","DOI":"10.3390\/nu10020194"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1017\/S002966511800263X","article-title":"Effects of consuming sugars and alternative sweeteners during pregnancy on maternal and child health: Evidence for a secondhand sugar effect","volume":"78","author":"Goran","year":"2019","journal-title":"Proc. Nutr. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajog.2020.03.034","article-title":"Consumption of non-nutritive sweeteners during pregnancy","volume":"223","author":"Palatnik","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3416","DOI":"10.1210\/en.2015-1394","article-title":"Developmental Origins of Health and Disease: Integrating Environmental Influences","volume":"156","author":"Heindel","year":"2015","journal-title":"Endocrinology"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Collison, K.S., Makhoul, N.J., Zaidi, M.Z., Saleh, S.M., Andres, B., Inglis, A., Al-Rabiah, R., and Al-Mohanna, F.A. (2012). Gender dimorphism in aspartame-induced impairment of spatial cognition and insulin sensitivity. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0031570"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1017\/S2040174415001269","article-title":"Fetal programming of overweight through the microbiome: Boys are disproportionately affected","volume":"7","author":"Kozyrskyj","year":"2016","journal-title":"J. Dev. Orig. Health Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"108943","DOI":"10.1016\/j.diabres.2021.108943","article-title":"Use of non-nutritive-sweetened soft drink and risk of gestational diabetes","volume":"178","author":"Prete","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/j.ajog.2020.08.020","article-title":"Consumption of non-nutritive sweeteners during pregnancy","volume":"223","author":"Ayoob","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1590\/1806-9282.62.02.120","article-title":"Adverse effects of the consumption of artificial sweeteners\u2014Systematic review","volume":"62","author":"Bernardo","year":"2016","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"E929","DOI":"10.1503\/cmaj.161390","article-title":"Nonnutritive sweeteners and cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials and prospective cohort studies","volume":"189","author":"Azad","year":"2017","journal-title":"CMAJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"112696","DOI":"10.1016\/j.physbeh.2019.112696","article-title":"Metabolic and behavioural effects of prenatal exposure to non-nutritive sweeteners: A systematic review and meta-analysis of rodent models","volume":"213","author":"Morahan","year":"2020","journal-title":"Physiol. Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5024","DOI":"10.1017\/S1368980021000173","article-title":"Effects of prenatal artificial sweeteners consumption on birth outcomes: A systematic review and meta-analysis","volume":"24","author":"Cai","year":"2021","journal-title":"Public Health Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Maslova, E., Str\u00f8m, M., Olsen, S.F., and Halldorsson, T.I. (2013). Consumption of artificially-sweetened soft drinks in pregnancy and risk of child asthma and allergic rhinitis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0057261"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1177\/0022034509352958","article-title":"Xylitol gum and maternal transmission of mutans streptococci","volume":"89","author":"Nakai","year":"2010","journal-title":"J. Dent. Res."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/23\/5098\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:30:59Z","timestamp":1760146259000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/23\/5098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,1]]},"references-count":32,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["nu14235098"],"URL":"https:\/\/doi.org\/10.3390\/nu14235098","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,1]]}}}