Sen Sarbattama, Rifas-Shiman Sheryl L, Shivappa Nitin, Wirth Michael D, Hébert James R, Gold Diane R, Gillman Matthew W, Oken Emily
Pediatric Newborn Medicine and
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA;
J Nutr. 2016 Apr;146(4):728-36. doi: 10.3945/jn.115.225581. Epub 2016 Mar 2.
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.
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.
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.
Maternal age was (mean ± SD) 32.2 ± 5.0 y, prepregnancy body mass index (BMI; in kg/m(2)) 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'sr= 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 agezscore in infants born to obese mothers (β: -0.10zscore 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).
A proinflammatory diet during pregnancy is associated with maternal systemic inflammation and may be associated with impaired fetal growth and breastfeeding failure.
孕期炎症与母婴不良结局相关。关于孕妇饮食对全身炎症和孕期健康的影响，现有信息有限。
本研究旨在探讨孕妇产前饮食炎症指数（DII），一种饮食炎症潜力的综合衡量指标，与孕妇全身炎症标志物及妊娠结局之间的关联。
我们对来自马萨诸塞州一项产前队列研究“活力计划”的1808对母婴进行了研究。我们通过将参与者的饮食摄入量标准化为全球均值来计算DII，该均值乘以炎症效应得分并求和，数据来自孕早期和孕中期的食物频率问卷。我们研究了DII与孕中期孕妇血浆C反应蛋白和白细胞计数以及以下围产期结局之间的关联：妊娠期糖尿病、先兆子痫、妊娠期长度、胎儿生长、分娩方式和母乳喂养持续时间。我们使用多变量线性和逻辑回归模型来分析这些关联的强度。
孕妇年龄为（均值±标准差）32.2±5.0岁，孕前体重指数（BMI；单位：kg/m²）为24.9±5.2，DII为 -2.56±1.42单位，范围为 -5.4至3.7。DII与孕前BMI呈正相关（Pearson相关系数r = 0.13，P < 0.0001）。较高的DII得分，反映出更强的促炎饮食潜力，与孕中期血浆C反应蛋白水平升高相关（每孕妇DII增加1单位，β：0.08 mg/L；95%置信区间：0.02，0.14），并且与肥胖母亲所生婴儿的出生体重相对于胎龄z评分降低相关（每孕妇DII增加1单位，β：-0.10 z评分；95%置信区间：-0.18，-0.02）。较高的DII得分与至少母乳喂养1个月的几率降低相关（比值比 = 0.85；95%置信区间：0.74，0.98）。
孕期促炎饮食与孕妇全身炎症相关，可能与胎儿生长受限和母乳喂养失败有关。
