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.

Dietary patterns and the risk of pregnancy‐associated hypertension in the Danish National Birth Cohort: a prospective longitudinal study

“…Our findings are possibly explained by the knowledge that diet is a key modifiable determinant of inflammation. 18 For instance, the presence of trans fatty acids (i.e. in margarine) in the Western diet may increase systemic inflammation and endothelial dysfunction found in PAH, 31 whereas docosahexaenoic acid and eicosapentaenoic acid (i.e.…”

“…[33][34][35][36][37][38] Another explanation for the lack of an association in the overweight/obese group could be because of the chronic inflammation and endothelial dysfunction that already exists in obesity. [18][19][20]39 It is possible that this underlying inflammation overpowers the effect of other determinants, such as diet. However, the underlying mechanism for the association between pre-pregnancy BMI and PAH remains unclear.…”

“…Pre-pregnancy BMI is a known risk factor for PAH and an inflammatory process involving increased C-reactive protein levels has been implicated in the pathogenesis. [18][19][20] Likewise, Hiozaki et al showed that women carrying female fetuses had significantly higher incidence of PAH than those carrying male fetuses. 21 Stratification would help to identify vulnerable sub-groups of the population that may require more clinical attention.…”

Obesity and recurrent miscarriage: A systematic review and meta‐analysis

“…Shin et al . found that a high BMI prior to pregnancy is associated with a pro‐inflammatory diet and high levels of CRP during pregnancy .…”

“…Shin et al . found that a high BMI prior to pregnancy is associated with a pro‐inflammatory diet and high levels of CRP during pregnancy . In order to evaluate the inflammatory potential of diet in terms of the risk of recurrent miscarriage, Vahid et al .…”