The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction

Abstract Background Fetal growth restriction (FGR) is characterized by the fetus’s inability to reach its growth potential and affecting approximately 10% of the population. The etiology of late-onset FGR, which occurs after 32 weeks, is unclear but may be influenced by maternal weight. A proinflamm...

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Main Authors: Ayşe Gülçin Baştemur, İclal Sena Gezer, Burcu Kesikli, Atakan Tanaçan, Özgür Kara, Nuray Yazıhan, Dilek Şahin
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07674-1
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author Ayşe Gülçin Baştemur
İclal Sena Gezer
Burcu Kesikli
Atakan Tanaçan
Özgür Kara
Nuray Yazıhan
Dilek Şahin
author_facet Ayşe Gülçin Baştemur
İclal Sena Gezer
Burcu Kesikli
Atakan Tanaçan
Özgür Kara
Nuray Yazıhan
Dilek Şahin
author_sort Ayşe Gülçin Baştemur
collection DOAJ
description Abstract Background Fetal growth restriction (FGR) is characterized by the fetus’s inability to reach its growth potential and affecting approximately 10% of the population. The etiology of late-onset FGR, which occurs after 32 weeks, is unclear but may be influenced by maternal weight. A proinflammatory diet can cause chronic inflammation and, Dietary Inflammatory Index (DII) was developed to evaluate of the diet’s impact on inflammation. A high DII indicates a pro-inflammatory diet, known to increase serum inflammatory markers, with oxidative stress playing a key role in inflammatory diseases. The study aimed to investigate the correlation between maternal DII, total oxidant status (TOS), total antioxidant status (TAS), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) levels in FGR-diagnosed pregnant women. Methods This prospective-observational study included FGR-diagnosed pregnant women and healthy pregnant women with gestational ages of 32–38 weeks (n = 23 per group). Chronic diseases, hypertension, fetal anomalies, membrane ruptures, and multiple pregnancies were excluded. The DII was calculated using the BeBiS-9 program based on 3-day dietary records kept by an expert dietician. Blood samples were collected, centrifuged, and analyzed for IL-6, TNF-α, IL-10, TAS, and TOS. Results The study group had significantly higher DII scores (p < 0.001), lower energy (p = 0.004), carbohydrate (p = 0.002), protein (p = 0.011), fiber (p < 0.001) intake than the control group. TNF-α levels were elevated in the FGR group (p < 0.001), while IL-6 levels were higher but not statistically significant (p = 0.06). IL-10 levels were lower in the study group (p = 0.05). TAS, TOS, and TAS/TOS levels showed no significant differences between groups. Logistic regression indicated a 62% increase in FGR probability with higher DII levels (p = 0.001, CI 1.209–2.195). Correlation analysis revealed a strong positive correlation between DII and maternal serum TNF-α (r = 0.375, p = 0.01) and a strong negative correlation between birth weight and TNF-α (r=-0.478, p < 0.001) and DII (r=-0.446, p = 0.002). Conclusion This study showed that a pro-inflammatory maternal diet increased dietary inflammatory index and increased maternal inflammatory markers, and this was more significant in fetuses with FGR than in normal weight fetuses.
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spelling doaj-art-bb37794e1ef5495d80acc212fa4031882025-08-20T04:01:42ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-012511910.1186/s12884-025-07674-1The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restrictionAyşe Gülçin Baştemur0İclal Sena Gezer1Burcu Kesikli2Atakan Tanaçan3Özgür Kara4Nuray Yazıhan5Dilek Şahin6Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City HospitalDepartment of Pathophysiology, Faculty of Medicine, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Institute of Health Sciences, Ankara UniversityDepartment of Pathophysiology, Faculty of Medicine, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Institute of Health Sciences, Ankara UniversityDivision of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City HospitalDivision of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City HospitalDepartment of Pathophysiology, Faculty of Medicine, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Institute of Health Sciences, Ankara UniversityDivision of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City HospitalAbstract Background Fetal growth restriction (FGR) is characterized by the fetus’s inability to reach its growth potential and affecting approximately 10% of the population. The etiology of late-onset FGR, which occurs after 32 weeks, is unclear but may be influenced by maternal weight. A proinflammatory diet can cause chronic inflammation and, Dietary Inflammatory Index (DII) was developed to evaluate of the diet’s impact on inflammation. A high DII indicates a pro-inflammatory diet, known to increase serum inflammatory markers, with oxidative stress playing a key role in inflammatory diseases. The study aimed to investigate the correlation between maternal DII, total oxidant status (TOS), total antioxidant status (TAS), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) levels in FGR-diagnosed pregnant women. Methods This prospective-observational study included FGR-diagnosed pregnant women and healthy pregnant women with gestational ages of 32–38 weeks (n = 23 per group). Chronic diseases, hypertension, fetal anomalies, membrane ruptures, and multiple pregnancies were excluded. The DII was calculated using the BeBiS-9 program based on 3-day dietary records kept by an expert dietician. Blood samples were collected, centrifuged, and analyzed for IL-6, TNF-α, IL-10, TAS, and TOS. Results The study group had significantly higher DII scores (p < 0.001), lower energy (p = 0.004), carbohydrate (p = 0.002), protein (p = 0.011), fiber (p < 0.001) intake than the control group. TNF-α levels were elevated in the FGR group (p < 0.001), while IL-6 levels were higher but not statistically significant (p = 0.06). IL-10 levels were lower in the study group (p = 0.05). TAS, TOS, and TAS/TOS levels showed no significant differences between groups. Logistic regression indicated a 62% increase in FGR probability with higher DII levels (p = 0.001, CI 1.209–2.195). Correlation analysis revealed a strong positive correlation between DII and maternal serum TNF-α (r = 0.375, p = 0.01) and a strong negative correlation between birth weight and TNF-α (r=-0.478, p < 0.001) and DII (r=-0.446, p = 0.002). Conclusion This study showed that a pro-inflammatory maternal diet increased dietary inflammatory index and increased maternal inflammatory markers, and this was more significant in fetuses with FGR than in normal weight fetuses.https://doi.org/10.1186/s12884-025-07674-1Fetal growth restrictionDietary inflammatory indexIL-6IL-10TNF-αTotal antioxidant status
spellingShingle Ayşe Gülçin Baştemur
İclal Sena Gezer
Burcu Kesikli
Atakan Tanaçan
Özgür Kara
Nuray Yazıhan
Dilek Şahin
The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction
BMC Pregnancy and Childbirth
Fetal growth restriction
Dietary inflammatory index
IL-6
IL-10
TNF-α
Total antioxidant status
title The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction
title_full The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction
title_fullStr The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction
title_full_unstemmed The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction
title_short The influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction
title_sort influence of dietary choices investigation of the relationship dietary inflammatory index and fetal growth restriction
topic Fetal growth restriction
Dietary inflammatory index
IL-6
IL-10
TNF-α
Total antioxidant status
url https://doi.org/10.1186/s12884-025-07674-1
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