title: Dietary Inflammatory Potential during Pregnancy Is Associated with Lower Fetal Growth and Breastfeeding Failure: Results from Project Viva.
abstract: 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.
authors.affiliation: Pediatric Newborn Medicine and ssen2@partners.org.
authors.forename: Sarbattama
authors.initials: S
authors.lastname: Sen
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA;
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
authors.affiliation: South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; and Connecting Health Innovations, LLC, Columbia, SC.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; and Connecting Health Innovations, LLC, Columbia, SC.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wirth
authors.affiliation: South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; and Connecting Health Innovations, LLC, Columbia, SC.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.affiliation: Channing Laboratory, Brigham and Women's Hospital, Boston, MA;
authors.forename: Diane R
authors.initials: DR
authors.lastname: Gold
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA;
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA;
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding; D002097:C-Reactive Protein / Q000378:metabolism; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts; D039382:Maternal Nutritional Physiological Phenomena; D018977:Micronutrients / Q000008:administration & dosage; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients; D002097:C-Reactive Protein
keywords: breastfeeding; diet; fetal growth; inflammation; obesity; pregnancy