title: Pre-Pregnancy Body Mass Index Is Associated with Dietary Inflammatory Index and C-Reactive Protein Concentrations during Pregnancy.
abstract: There have been a limited number of studies examining the association between pre-pregnancy body mass index (BMI) and dietary inflammation during pregnancy. Our aim is to examine the association between pre-pregnancy BMI and the Dietary Inflammatory Index (DII)™ and C-reactive protein (CRP) concentrations during pregnancy. The study included 631 pregnant American women from the National Health and Nutrition Examination Survey (NHANES) cross-sectional examinations from 2003 to 2012. Pre-pregnancy BMI was calculated based on self-reported pre-pregnancy weight and measured height. The cut-offs of <18.5 (underweight), 18.5-24.9 (normal), 25.0-29.9 (overweight), and ≥30 kg/m² (obese) were used to categorize the weight status of pregnant women prior to pregnancy. The DII, a literature-based dietary index to assess the inflammatory properties of diet, was estimated based on a one-day 24-h recall. Multivariable linear and logistic regressions were performed to estimate beta coefficients and the adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) on the association of pre-pregnancy BMI categories with the DII and CRP concentrations during pregnancy. After controlling for variables including: race/ethnicity, family poverty income ratio, education, marital status, month in pregnancy, and smoking status during pregnancy; women who were obese before pregnancy (n= 136) had increased odds for being in the highest tertile of the DII and CRP concentrations compared to women with normal weight (AORs 2.40, 95% CIs 1.01-5.71; AORs 24.84, 95% CIs 6.19-99.67, respectively). These findings suggest that women with pre-pregnancy obesity had greater odds of reporting higher DII and having elevated CRP. In conclusion, high pre-pregnancy BMI was associated with increased odds of pro-inflammatory diet and elevated CRP levels during pregnancy in the USA.
authors.affiliation: Department of Nutrition & Dietetics, College of Nursing & Professional Disciplines, University of North Dakota, Grand Forks, ND 58202, USA. dayeon.shin@und.edu.
authors.forename: Dayeon
authors.initials: D
authors.lastname: Shin
authors.affiliation: Department of Biomedical Sciences, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202, USA. junguk.hur@med.und.edu.
authors.forename: Junguk
authors.initials: J
authors.lastname: Hur
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon 24289, Korea. ehcho@kangwon.ac.kr.
authors.forename: Eun-Hee
authors.initials: EH
authors.lastname: Cho
authors.affiliation: Department of Food and Nutrition, Hoseo University, Asan 31499, Korea. hkchung@hoseo.edu.
authors.forename: Hae-Kyung
authors.initials: HK
authors.lastname: Chung
authors.affiliation: Department of Epidemiology and Biostatistics, and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. shivappa@mailbox.sc.edu.|Connecting Health Innovations, LLC, Columbia, SC 29201, USA. shivappa@mailbox.sc.edu.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: Department of Epidemiology and Biostatistics, and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. wirthm@mailbox.sc.edu.|Connecting Health Innovations, LLC, Columbia, SC 29201, USA. wirthm@mailbox.sc.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wirth
authors.affiliation: Department of Epidemiology and Biostatistics, and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. jhebert@mailbox.sc.edu.|Connecting Health Innovations, LLC, Columbia, SC 29201, USA. jhebert@mailbox.sc.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.affiliation: Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA. kyungwlee@korea.kr.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D009749:Nutrition Surveys; D009765:Obesity / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D050177:Overweight / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D012307:Risk Factors; D057566:Self Report; D013851:Thinness / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: C-reactive protein; NHANES; dietary inflammatory index; pregnancy body mass index; reproductive health