Baştemur Ayşe Gülçin, Gezer İclal Sena, Kesikli Burcu, Tanaçan Atakan, Kara Özgür, Yazıhan Nuray, Şahin Dilek
Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Pathophysiology, Faculty of Medicine, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara University, Ankara, Turkey.
BMC Pregnancy Childbirth. 2025 May 14;25(1):569. doi: 10.1186/s12884-025-07674-1.
Fetal growth restriction (FGR) is characterized by the fetus's inability to reach its growth potential and affecting approximately 10% of the population. The etiology of late-onset FGR, which occurs after 32 weeks, is unclear but may be influenced by maternal weight. A proinflammatory diet can cause chronic inflammation and, Dietary Inflammatory Index (DII) was developed to evaluate of the diet's impact on inflammation. A high DII indicates a pro-inflammatory diet, known to increase serum inflammatory markers, with oxidative stress playing a key role in inflammatory diseases. The study aimed to investigate the correlation between maternal DII, total oxidant status (TOS), total antioxidant status (TAS), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) levels in FGR-diagnosed pregnant women.
This prospective-observational study included FGR-diagnosed pregnant women and healthy pregnant women with gestational ages of 32-38 weeks (n = 23 per group). Chronic diseases, hypertension, fetal anomalies, membrane ruptures, and multiple pregnancies were excluded. The DII was calculated using the BeBiS-9 program based on 3-day dietary records kept by an expert dietician. Blood samples were collected, centrifuged, and analyzed for IL-6, TNF-α, IL-10, TAS, and TOS.
The study group had significantly higher DII scores (p < 0.001), lower energy (p = 0.004), carbohydrate (p = 0.002), protein (p = 0.011), fiber (p < 0.001) intake than the control group. TNF-α levels were elevated in the FGR group (p < 0.001), while IL-6 levels were higher but not statistically significant (p = 0.06). IL-10 levels were lower in the study group (p = 0.05). TAS, TOS, and TAS/TOS levels showed no significant differences between groups. Logistic regression indicated a 62% increase in FGR probability with higher DII levels (p = 0.001, CI 1.209-2.195). Correlation analysis revealed a strong positive correlation between DII and maternal serum TNF-α (r = 0.375, p = 0.01) and a strong negative correlation between birth weight and TNF-α (r=-0.478, p < 0.001) and DII (r=-0.446, p = 0.002).
This study showed that a pro-inflammatory maternal diet increased dietary inflammatory index and increased maternal inflammatory markers, and this was more significant in fetuses with FGR than in normal weight fetuses.
胎儿生长受限（FGR）的特征是胎儿无法发挥其生长潜能，约影响10%的人群。孕32周后发生的晚发型FGR的病因尚不清楚，但可能受母体体重影响。促炎饮食可导致慢性炎症，饮食炎症指数（DII）用于评估饮食对炎症的影响。高DII表明饮食具有促炎作用，已知会增加血清炎症标志物，氧化应激在炎症性疾病中起关键作用。本研究旨在探讨诊断为FGR的孕妇的母体DII、总氧化状态（TOS）、总抗氧化状态（TAS）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）和肿瘤坏死因子-α（TNF-α）水平之间的相关性。
这项前瞻性观察性研究纳入了诊断为FGR的孕妇和孕龄32 - 38周的健康孕妇（每组n = 23）。排除慢性疾病、高血压、胎儿畸形、胎膜破裂和多胎妊娠。DII根据专家营养师记录的3天饮食记录，使用BeBiS - 9程序计算。采集血样，离心后分析IL-6、TNF-α、IL-10、TAS和TOS。
研究组的DII评分显著更高（p < 0.001），能量（p = 0.004）、碳水化合物（p = 0.002）、蛋白质（p = 0.011）、纤维（p < 0.001）摄入量低于对照组。FGR组的TNF-α水平升高（p < 0.001），而IL-6水平较高但无统计学意义（p = 0.06）。研究组的IL-10水平较低（p = 0.05）。TAS、TOS和TAS/TOS水平在两组之间无显著差异。逻辑回归表明，DII水平较高时FGR发生概率增加62%（p = 0.001，CI 1.209 - 2.195）。相关性分析显示DII与母体血清TNF-α之间存在强正相关（r = 0.375，p = 0.01），出生体重与TNF-α（r = -0.478，p < 0.001）和DII（r = -0.446，p = 0.002）之间存在强负相关。
本研究表明，促炎的母体饮食会增加饮食炎症指数并增加母体炎症标志物，这在FGR胎儿中比正常体重胎儿中更为显著。
