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. 2021 Oct 26;13(11):3792.
doi: 10.3390/nu13113792.

Maternal Diet, Infection, and Risk of Cord Blood Inflammation in the Bangladesh Projahnmo Pregnancy Cohort

Anne Cc Lee  1   2 , Sara Cherkerzian  1   2 , Ingrid E Olson  1 , Salahuddin Ahmed  3 , Nabidul Haque Chowdhury  3 , Rasheda Khanam  4 , Sayedur Rahman  3 , Chloe Andrews  1 , Abdullah H Baqui  4 , Wafaie Fawzi  5 , Terrie E Inder  1   2 , Stephanie Nartey  6 , Charles A Nelson  2   7   8 , Emily Oken  2   5   9 , Sarbattama Sen  1   2 , Raina Fichorova  2   6
Affiliations

Maternal Diet, Infection, and Risk of Cord Blood Inflammation in the Bangladesh Projahnmo Pregnancy Cohort

Anne Cc Lee et al. Nutrients. .

Abstract

Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016-March 2017. Stillbirths, preterm births, and cases of neonatal encephalopathy were excluded. We prospectively collected data on maternal diet (food frequency questionnaire) and morbidity, and analyzed umbilical cord blood for interleukin (IL)-1α, IL-1β, IL-6, IL-8 and C-reactive protein. We determined associations between nutrition and infection exposures and cord cytokine elevation (≥75% vs. <75%) using logistic regression, adjusting for confounders. One-third of mothers were underweight (BMI < 18.5 kg/m2) at enrollment. Antenatal and intrapartum infections were observed among 4.8% and 15.9% of the sample, respectively. Low pregnancy intakes of B vitamins (B1, B2, B3, B6, B9 (folate)), fat-soluble vitamins (D, E), iron, zinc, and linoleic acid (lowest vs. middle tertile) were associated with higher risk of inflammation, particularly IL-8. There was a non-significant trend of increased risk of IL-8 and IL-6 elevation with history of ante-and intrapartum infections, respectively. In Bangladesh, improving micronutrient intake and preventing pregnancy infections are targets to reduce fetal systemic inflammation and associated adverse neurodevelopmental outcomes.

Keywords: inflammation; micronutrient; prenatal infection; undernutrition.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Estimated average weekly consumption (grams) of food items through the course of gestation among (n = 251) pregnant women in Sylhet, Bangladesh: (a) animal source and (b) plant-based food items.
Figure 2
Figure 2
Spearman correlations between 20 nutrients in pregnant women in the Projahnmo cohort, Sylhet, Bangladesh. Unshaded cells did not meet statistical significance. Abbreviations: Vit = Vitamin, Se, selenium; Zn, Zinc; ALA, Alpha Linolenic acid; ARA, arachidonic acid; DHA, docosahexaenoic acid; DPA, docosapentaenoic acid; ETA, eicosatrienoic acid; EPA, eicosapentaenoic acid; LA, linoleic acid.
Figure 3
Figure 3
Distribution of inflammation biomarkers (natural log transformed) in Projahnmo cohort. The 75% thresholds for each cytokine are: (a) IL-1α: 0.05 pg/mg total protein; (b) IL-1β: 2.01 pg/mg total protein; (c) IL-6: 0.0046 pg/mg total protein; (d) IL-8: 3.09 pg/mg total protein; and (e) CRP: 0.04 ng/mg total protein.
Figure 3
Figure 3
Distribution of inflammation biomarkers (natural log transformed) in Projahnmo cohort. The 75% thresholds for each cytokine are: (a) IL-1α: 0.05 pg/mg total protein; (b) IL-1β: 2.01 pg/mg total protein; (c) IL-6: 0.0046 pg/mg total protein; (d) IL-8: 3.09 pg/mg total protein; and (e) CRP: 0.04 ng/mg total protein.
Figure 4
Figure 4
Association of maternal anthropometry and infections with newborn inflammation at delivery (n = 251 healthy term infants): Odds ratios are for outcome of elevation in inflammation protein above the 75% (vs. <75%). The 75% thresholds for each cytokine are: IL-1α: 0.05 pg/mg total protein; IL-1β: 2.01 pg/mg total protein; IL-6: 0.0046 pg/mg total protein; IL-8: 3.09 pg/mg total protein; and CRP: 0.04 ng/mg total protein. Analyses were adjusted for potential confounding by socioeconomic status, nulliparity, maternal education attainment (years), maternal upper arm circumference (MUAC) < 22 cm, tobacco or betel nut use, and season of initial antenatal assessment.
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