Abstract
Maternal inflammation during pregnancy is known to adversely impact fetal development, birth outcomes, and offspring physical and mental health. Diet and stress have been identified as important determinants of inflammation, yet their combined effects have not been examined in the context of pregnancy. The aim of this study was to examine the relationship between maternal diet with inflammatory potential and psychological stress, and to determine their interaction effect on concentrations of tumor necrosis factor (TNF)-α across pregnancy. We conducted a prospective longitudinal study of n = 202 women with three assessments during pregnancy, which included: ecological momentary assessment (EMA) of maternal stress using the perceived stress scale (PSS) short version; 24-h dietary recalls from which the dietary inflammatory index (DII) was computed; and serum measurements of TNF-α. Across pregnancy, higher perceived stress was associated with consumption of a more pro-inflammatory diet (r = 0.137; p < 0.05). In a linear regression model adjusted for covariates, DII was positively associated with TNF-α (B = 0.093, p = 0.010). The effect of the pro-inflammatory diet on concentrations of TNF-α was more pronounced in women reporting higher levels of stress (B = 0.134, p = 0.018 for DII*PSS interaction). These results highlight the need to consider nutrition and stress concurrently in the context of inflammation during pregnancy.
Highlights
Embryonic and fetal life represents a critical developmental period during which exposures to suboptimal conditions or insults can result in structural and functional changes in cells, tissues, and organ systems that independently—or through interactions with subsequent developmental conditions and environments—may confer critical long-term consequences for health and disease susceptibility [1,2,3,4,5]
dietary inflammatory index (DII) decreased with advancing gestation (p = 0.023), indicating a shift towards a more anti-inflammatory diet in later pregnancy, perceived stress scale (PSS) remained stable across pregnancy (p = 0.216), while tumor necrosis factor (TNF)-α showed the expected increased from early to late pregnancy (p = 0.054)
Results of the current study suggest that higher levels of perceived stress are significantly associated with consumption of a diet with greater inflammatory potential, and that perceived stress potentiates the effects of a pro-inflammatory diet on TNF-α levels across pregnancy
Summary
Embryonic and fetal life represents a critical developmental period during which exposures to suboptimal conditions or insults can result in structural and functional changes in cells, tissues, and organ systems that independently—or through interactions with subsequent developmental conditions and environments—may confer critical long-term consequences for health and disease susceptibility [1,2,3,4,5]. In this context, maternal inflammation during pregnancy has been established as a key mediator of the effects of a diverse range of gestational conditions. Beyond the prevalence of infections and pre-existing chronic inflammatory conditions, there is a paucity of literature investigating the role of potentially modifiable factors on the pro-inflammatory milieu during pregnancy
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