Longitudinal Assessment of Relationships Between Health Behaviors and IL-6 in Overweight and Obese Pregnancy

Abstract

Background: Inflammation is a common factor in adverse pregnancy outcomes (APOs). Behavioral factors influence inflammatory markers and APOs but rarely have been investigated simultaneously in pregnancy. Our purpose was to determine how diet, physical activity, and obesity are associated with interleukin (IL)-6 in early and late pregnancy. Methods: We conducted a secondary analysis of 49 overweight/obese pregnant women. Health behavior data, including diet quality using the Dietary Inflammatory Index (DII®); physical activity (Leisure Time Physical Activity scale); body mass index (BMI); and plasma IL-6 concentrations were collected at 13–16 weeks (early pregnancy) and 34–36 weeks (late pregnancy) gestation. Multiple linear regression analyses were used to determine the amount of variance explained in early and late pregnancy IL-6 concentrations by early and late pregnancy diet, physical activity, and BMI. Results: Early diet and early BMI were the strongest predictors of early IL-6 concentrations (R2 = 0.43; p < .001) and late IL-6 concentrations (R2 = 0.30; p < .001). Late BMI predicted late IL-6 (R2 = .11; p = .02). Change in diet over pregnancy predicted late IL-6 (R2 = 0.17; p = .03). Conclusion: These findings suggest that maternal diet and BMI in early pregnancy, which likely reflects prepregnancy status, may have a greater impact on inflammatory processes than factors later in pregnancy. Future work should assess if behavioral factors before pregnancy produce similar relationships to those reported here, which may clarify the timing and type of lifestyle interventions to effectively reduce APOs.

Effect of an Antenatal Lifestyle Intervention on Dietary Inflammatory Index and Its Associations with Maternal and Fetal Outcomes: A Secondary Analysis of the PEARS Trial

“…These findings are consistent with the limited available literature. In a longitudinal study of 49 women with overweight and obesity by Wallace et al, the E-DII TM did not change from early to late pregnancy [ 3 ]. The PEARs antenatal lifestyle intervention was not designed to reduce inflammation but rather to reduce the glycaemic potential of the diet.…”

“…Evidence suggests the association between pre-pregnancy overweight and obesity and adverse maternal and foetal outcomes is mediated through inflammation [ 2 ]. Early pregnancy diet and weight may have implications for inflammation throughout pregnancy [ 3 ]. In addition, emerging evidence suggests that maternal inflammation during pregnancy may impact foetal neurodevelopment, possibly with long-term effects [ 4 , 5 ].…”

“…The unique inflammatory effect of each of these nutrients has been quantified based on evidence for relationships with inflammatory markers such as C-Reactive Protein (CRP), Tissue-Necrosis Factor-Alpha (TNF-Alpha) and Interleukin-6 (IL-6) (6). This evidence is in non-pregnant populations, but the DII ® has been validated in pregnancy cohorts [ 3 , 8 ]. A benefit of the DII ® is that it can be universally applied internationally using data from any form of dietary assessment.…”

“…Evidence suggests higher BMI is associated with DII ® in adults and children [ 1 , 21 ]. Pre-pregnancy BMI is positively associated with pregnancy DII ® and both BMI and DII ® are associated with inflammation in pregnant women with overweight and obesity [ 1 , 3 ].…”

Decreased Fatty Acid Transporter FABP1 and Increased Isoprostanes and Neuroprostanes in the Human Term Placenta: Implications for Inflammation and Birth Weight in Maternal Pre-Gestational Obesity

“…Additionally, gestational weight gain was 40 % in obese mothers, compared to lean mothers. Although several studies have shown that maternal obesity is associated with an inflammatory and pro-oxidant milieu [47,48], there are reports of healthy obese mothers with no signs of dyslipaemia [13,49]. On the other hand, irrespective of its severity, there are consistent data showing that several placental responses appear to be affected by maternal pre-gestational obesity [16,50].…”