Abstract
Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016–March 2017. Stillbirths, preterm births, and cases of neonatal encephalopathy were excluded. We prospectively collected data on maternal diet (food frequency questionnaire) and morbidity, and analyzed umbilical cord blood for interleukin (IL)-1α, IL-1β, IL-6, IL-8 and C-reactive protein. We determined associations between nutrition and infection exposures and cord cytokine elevation (≥75% vs. <75%) using logistic regression, adjusting for confounders. One-third of mothers were underweight (BMI < 18.5 kg/m2) at enrollment. Antenatal and intrapartum infections were observed among 4.8% and 15.9% of the sample, respectively. Low pregnancy intakes of B vitamins (B1, B2, B3, B6, B9 (folate)), fat-soluble vitamins (D, E), iron, zinc, and linoleic acid (lowest vs. middle tertile) were associated with higher risk of inflammation, particularly IL-8. There was a non-significant trend of increased risk of IL-8 and IL-6 elevation with history of ante-and intrapartum infections, respectively. In Bangladesh, improving micronutrient intake and preventing pregnancy infections are targets to reduce fetal systemic inflammation and associated adverse neurodevelopmental outcomes.
Highlights
In order to identify potential modifiable pregnancy targets to reduce fetal exposure to inflammation, we aimed to investigate the association of maternal pregnancy undernutrition and infections with offspring inflammation, as measured by proinflammatory immune mediators in umbilical cord blood in a pregnancy-birth cohort in rural Bangladesh
We report on pregnancy risk factors for cord blood inflammation in the Projahnmo birth cohort, a rural Bangladeshi population typical of South Asia with a high prevalence of maternal undernutrition
We found that lower intake of B vitamins (B1, B2, B3, B6, and B9), iron, zinc, and omega-6 fatty acid in pregnancy, were associated with higher risk of inflammation in the newborn at birth
Summary
An estimated 200 million children under the age of 5 years do not reach their full potential in cognitive development, the vast majority in low-middle-income countries (LMIC) [1]. The first 1000 days from conception onward presents a critical window of opportunity to optimize child neurodevelopment [2]. Maternal undernutrition and infections are prevalent and targetable pregnancy risks in LMIC may have significant consequences for long term offspring development. There is increasing recognition of the importance of the complex “collision” of nutrition and inflammation in global child health, as evidenced by the National Institute of Child Health and Human Development
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