Maternal Nutrient Intake and Neonatal Cord Blood in Rural Bangladesh

Principal Investigator: Anne CC Lee

Authors: Cherkerzian S, Olson I, Andrews C, Ahmed S, Baqui A, Chowdhury N, Fawzi WW, Fichorova R, Inder TE, Khanam R, Nartey S, Nelson C, Oken E, Rahman S, Sen S, Lee AC
Lay Abstract

Background: Inflammation during pregnancy may contribute to the burden of neurodevelopmental impairment concentrated in low-income countries. Identifying modifiable pregnancy risk factors may address this issue.

Objective: To determine whether maternal nutrient intake during pregnancy is associated with pro-inflammatory markers in the offspring’s blood.

Methods: We included data from 251 mothers and their healthy, term infants from a pregnancy-birth cohort in Sylhet, Bangladesh. Health data, including maternal report of weekly food consumption, were collected during pregnancy and at delivery. Estimated levels of nutrient intake were calculated using regional food composition tables and averaged across 2 pregnancy timepoints. Umbilical cord blood was analyzed for proinflammatory markers called cytokines (interleukin (IL)-1α, IL-1β, IL-6, IL-8, and CRP). The association between nutrient intake and high cytokine levels was investigated using statistical models.

Results: Mothers who ate more foods with B vitamins (B1, B6), folate, zinc, and polyunsaturated fatty acids (PUFAs: linoleic and arachidonic acids) had less inflammation as measured by the IL-8 or IL-6 markers compared with mothers whose diets included less of these nutrients.

Conclusion: Mothers improving their diet with more B vitamins, folate, zinc, and PUFAs is a potential way to reduce fetal inflammation.

Scientific Abstract

Background: Perinatal inflammation may contribute to the burden of neurodevelopmental impairment concentrated in low-income countries. Identifying modifiable pregnancy risk factors may address this issue.

Objective: To determine associations between maternal prenatal nutrient intake and cord blood inflammatory markers in rural Bangladesh.

Methods: Health data from 251 mother-infant dyads of healthy, term infants from a pregnancy-birth cohort in Sylhet, Bangladesh, were prospectively collected during pregnancy and at delivery, including a maternal food frequency questionnaire. Relative levels of nutrient intake were calculated utilizing regional food composition tables and averaged across two pregnancy timepoints. Umbilical cord blood spots were analyzed for interleukin (IL)-1α, IL-1β, IL-6, IL-8, and CRP. Associations between nutrient intake tertiles and elevated inflammatory markers [>75% vs ≤75%] were evaluated using logistic regression models adjusted for confounding.

Results: Greater mean pregnancy intake of B vitamins (B1, B6), folate, zinc, and linoleic acid was associated with lower risk of elevated IL-8 (e.g., Vitamin B1: Adjusted Odds Ratio (aOR):0.46 [95% CI:0.21,0.99] comparing top to bottom tertiles of intake); greater intake of arachidonic acid with lower risk of elevated IL-6 (aOR:0.45 [95% CI:0.21,1.00]).

Conclusion: Improving micronutrient intake (B vitamins, folate, zinc, linoleic and arachidonic acids) is a potential target for reducing systemic fetal inflammation.

Clinical Implications
Among pregnant women in rural Bangladesh, improving diet with more B vitamins, folate, zinc, and fatty acids may reduce fetal inflammation. This dietary change can potentially address the public health burden of neurodevelopmental impairment concentrated in low-income countries.

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