Dietary Inflammatory Index during Pregnancy and Congenital Heart Defects

Abstract

The relationship between diet-related inflammation during pregnancy and congenital heart defects (CHD) is unclear. This study attempted to investigate the association between the dietary inflammation index (DII) during pregnancy, reflecting the overall inflammatory potential of the maternal diet, and CHD in Northwest China. A case-control study with 474 cases and 948 controls was performed in Xi’an City, China. Eligible women awaiting delivery were recruited, and their dietary and other information during pregnancy was collected. Logistic regression models were applied to estimate the risk of CHD in association with DII. The maternal DII ranged from −1.36 to 5.73 in cases, and 0.43 to 5.63 in controls. Pregnant women with per 1 higher DII score were at 31% higher risk of fetal CHD (OR = 1.31, 95%CI = 1.14–1.51), and the adjusted OR (95%CI) comparing the pro-inflammatory diet group with the anti-inflammatory diet group was 2.04 (1.42–2.92). The inverse association of maternal DII score with CHD risk was consistent across various subgroups of maternal characteristics. Maternal DII in pregnancy had good predictive value for CHD in offspring, with the areas under the receiver operating characteristic curve higher than 0.7. These findings suggested that avoiding a pro-inflammatory diet in pregnancy should be emphasized in the prevention of CHD.

Maternal Oxidative Balance Score during Pregnancy and Congenital Heart Defects

“…Our results was supported by previous studies on the associations of individual OBS components with CHD, such as smoking [ 5 ], alcohol drinking [ 6 ], BMI [ 7 ], physical activity [ 8 ], and antioxidant nutrients [ 12 ]. In addition, we have previously used other scoring approaches including the Global Diet Quality Score, Mediterranean Diet Score, and Dietary Inflammation Index to assess the overall dietary quality and dietary inflammatory potential with CHD risk rather than just examining one nutrient at a time [ 9 , 10 ]. The OBS approach is similar, and would extend the previous reports that only examine one exposure at a time and reflect how multiple exposures jointly influence outcomes.…”

“…Maternal OBS ranged from 6 to 34 among cases, and 5 to 37 among controls. The medians (25th percentile, 75th percentile) among cases and controls were 15 (10,21) and 21 (14,28), respectively, with the difference statistically significant (p < 0.001). Table 1 displays the baseline characteristics by tertiles of OBS.…”

“…Previous studies have shown some modifiable exposures during pregnancy in association with CHD risk, such as maternal smoking [ 5 ], alcohol drinking [ 6 ], BMI [ 7 ], physical activity [ 8 ], and dietary habits [ 9 , 10 , 11 , 12 , 13 , 14 ]. These exogenous exposures have either oxidative or antioxidative effects in maternal body, which may further influence fetal cardiovascular development through reactive oxygen species and redox-related signaling [ 15 ].…”

“…To the best of our knowledge, there has been no study specially investigating the relationship between maternal OBS in pregnancy and CHD. Prior researches have reported some indices during pregnancy for the early prediction of CHD [ 9 , 10 ]. However, no studies have evaluated the potential predictive value of maternal OBS during pregnancy on CHD.…”