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CME Credit Offered
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Abstract Award
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Poster Session 3

(933) Association between the dietary inflammatory index and adverse pregnancy outcomes

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Presenting Author(s)

  • UB

    Ummayhany Bharmal, MBBS (she/her/hers)

    Medical College Baroda
    Medical College Baroda, Gujarat, India

    • Coauthor(s)

  • George R. Saade, MD (he/him/his)

    Professor and Chair, Associate Dean for Women's Health Obstetrics and Gynecology
    Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University
    Norfolk, Virginia, United States

    • Submitting Author(s)

  • Tetsuya Kawakita, MD, MS

    Associate Professor
    Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University
    Norfolk, VA, United States

Objective: The impact of pre-conception inflammatory load has not been adequately evaluated. We sought to determine whether a pre-conception diet that promotes inflammation, as measured by the dietary inflammatory index (DII), is associated with adverse pregnancy outcomes.

Study Design: This is a secondary analysis of data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) study, in which dietary habits were assessed for three months before conception via a food frequency questionnaire. Data was obtained through patient interviews and chart abstraction. Individuals with spontaneous abortion or missing dietary data were excluded. DII was calculated from 28 pro-and anti-inflammatory food items. Participants were classified into DII quartiles, with the highest quartile indicating the most pro-inflammatory diet. The primary outcome was a composite of adverse pregnancy outcomes including preeclampsia, preterm birth less than 37 weeks, small for gestational age less than 5th percentile, and stillbirth. Adjusted relative risks (aRR) along with the 95% confidence intervals (CI) were calculated for all outcomes, using modified Poisson regression while controlling for confounders.

Results: Of the 7,911 participants included in this analysis, 1,443 (18.2%) had an adverse pregnancy outcome. Demographics and socioeconomic factors including age, race, marital status, insurance, education, and depression varied across the groups (Table 1). Outcomes according to DII quartiles are presented in Table 2. Individuals in the highest DII quartile compared with those in the lowest quartile had an increased risk of the primary outcome (20.8% vs 17.4%, aRR: 1.17, 95% CI: 1.02-1.34) as well as stillbirth (0.9% vs. 0.3%; aRR 2.94, 95% CI: 1.04-8.32). Other secondary outcomes were not statistically significant.

Conclusion: A pro-inflammatory diet in the immediate preconception period is associated with a composite of adverse pregnancy outcomes. Investigation of pre-pregnancy nutritional interventions is warranted.