Abstract
Background: Inflammation during pregnancy has been linked to adverse maternal and infant outcomes. There is limited information available on the contribution of maternal diet to systemic inflammation and pregnancy health.Objective: The objective of this study was to examine associations of maternal prenatal dietary inflammatory index (DII), a composite measure of the inflammatory potential of diet, with markers of maternal systemic inflammation and pregnancy outcomes.Methods: We studied 1808 mother-child pairs from Project Viva, a pre–birth cohort study in Massachusetts. We calculated the DII from first- and second-trimester food-frequency questionnaires by standardizing the dietary intakes of participants to global means, which were multiplied by the inflammatory effect score and summed. We examined associations of DII with maternal plasma C-reactive protein and white blood cell count in the second trimester and the following perinatal outcomes: gestational diabetes, preeclampsia, length of gestation, fetal growth, mode of delivery, and duration of breastfeeding. We used multivariable linear and logistic regression models to analyze the strength of these associations.Results: Maternal age was (mean ± SD) 32.2 ± 5.0 y, prepregnancy body mass index (BMI; in kg/m2) was 24.9 ± 5.2, and DII was −2.56 ± 1.42 units with a range of −5.4 to 3.7. DII was positively correlated with prepregnancy BMI (Pearson's r = 0.13, P < 0.0001). Higher DII scores, reflecting more proinflammatory dietary potential, were associated with higher second-trimester plasma CRP (β: 0.08 mg/L per 1-unit increase in maternal DII; 95% CI: 0.02, 0.14) and lower birth weight for gestational age z score in infants born to obese mothers (β: −0.10 z score per 1-unit increase in maternal DII; 95% CI: −0.18, −0.02). Higher DII scores were associated with lower odds of breastfeeding for at least 1 mo (OR = 0.85; 95% CI: 0.74, 0.98).Conclusion: A proinflammatory diet during pregnancy is associated with maternal systemic inflammation and may be associated with impaired fetal growth and breastfeeding failure.
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