Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan; Fukushima Medical Center for Children and Women, Fukushima, Japan.
Nutrition. 2021 May;85:111129. doi: 10.1016/j.nut.2020.111129. Epub 2021 Jan 5.
Increased risk of preterm birth (PTB) in women with endometriosis is considered to be associated with chronic inflammatory conditions. Accordingly, we hypothesized that a prepregnancy antiinflammatory diet is a potential form of preconception care for preventing PTB in women with endometriosis and conducted this study to investigate the correlation of a prepregnancy antiinflammatory diet with obstetric outcomes in this patient population.
We used singleton pregnancy data from the Japan Environment and Children's Study involving live births from 2011 to 2014. Individual meal patterns before pregnancy, derived through food frequency questionnaires, were used to calculate the Dietary Inflammatory Index. Participants were categorized according to Dietary Inflammatory Index quintiles (Q1 and Q5 were the most proinflammatory and antiinflammatory groups, respectively), and a multiple logistic regression model was used to estimate the effect of the antiinflammatory diet on PTB before 37 or 34 wk and on low birth weight (LBW) <2500 or 1500 g.
In women who did not undergo assisted reproduction, significantly reduced risk was found in the Q5 group for both PTB at <34 wk significantly decreased (adjusted odds ratio, 0.25; 95% confidence interval, 0.07-0.83) and low birth weight <1500 g (adjusted odds ratio, 0.07; 95% confidence interval, 0.01-0.60).
This study suggests a distinct effect of an antiinflammatory diet on more severe obstetric outcomes, specifically PTB before 34 wk and low birth weight <1500 g, for women with endometriosis. Preconception lifestyle can improve perinatal mortality and morbidity among these women.
子宫内膜异位症患者早产（PTB）风险增加被认为与慢性炎症状态有关。因此，我们假设孕前抗炎饮食可能是预防子宫内膜异位症患者 PTB 的一种孕前保健形式，并进行了这项研究，以调查这种孕前抗炎饮食与该患者人群产科结局的相关性。
我们使用了日本环境与儿童研究中的单胎妊娠数据，该研究涉及 2011 年至 2014 年的活产。通过食物频率问卷得出的孕前个体膳食模式用于计算饮食炎症指数。根据饮食炎症指数五分位数（Q1 和 Q5 分别为最促炎和抗炎组）对参与者进行分类，并使用多因素逻辑回归模型估计抗炎饮食对 37 周前或 34 周前 PTB 以及低出生体重（LBW）<2500 或 1500 g 的影响。
在未接受辅助生殖的女性中，Q5 组的 34 周前 PTB 风险显著降低（调整后的比值比，0.25；95%置信区间，0.07-0.83），且出生体重<1500 g 的风险也显著降低（调整后的比值比，0.07；95%置信区间，0.01-0.60）。
本研究表明，抗炎饮食对子宫内膜异位症患者更严重的产科结局，特别是 34 周前 PTB 和出生体重<1500 g ，具有明显的影响。孕前生活方式可以改善这些女性的围产期死亡率和发病率。
