Abstract
BACKGROUND: A protective influence of maternal inflammatory status on infantile atopic eczema risk has been proposed, but few studies have investigated these potential links. We examined the associations between energy-adjusted dietary inflammatory index (E-DII) scores indicative of an inflammatory dietary pattern, maternal serum neopterin levels, a biomarker elevated in Th1 immune activation, and infantile risk of atopic eczema. METHODS: Within the UK Southampton Women's Survey, mothers' diets were recorded using questionnaires at preconception, early and late pregnancy and E-DII scores derived. 3006 deliveries of live born infants with no major congenital growth abnormalities who were assessed for atopic eczema at 6 or 12 months (ascertained using the UK Working Party Diagnostic Criteria [n = 2955 and 2871, respectively]). A sub-sample of 497 mothers had serum neopterin measured in late pregnancy. RESULTS: Unadjusted analyses showed that higher E-DII in preconception and late pregnancy was associated with a lower risk of eczema at ages 6 and 12 months. After adjusting for maternal BMI, age, parity, education, smoking during pregnancy, breastfeeding duration and sex, higher E-DII in late pregnancy was associated with reduced risks of eczema at age 6 and 12 months (OR 0.89 [95% CI 0.81, 0.99], p = 0.03 and OR 0.91 [0.82, 1.00], p = 0.05, respectively). Consistent with this, higher maternal serum neopterin was associated with a lower risk of eczema at ages 6 months (OR 0.72 [0.51, 1.01], p = 0.05) and 12 months (OR 0.71 [0.53, 0.96], p = 0.03). CONCLUSION: The findings suggest that a pro-inflammatory maternal diet and an inflammatory maternal environment during pregnancy may protect the developing infant from Th2 driven inflammation and lower the risk of infantile atopic eczema. TRIAL REGISTRATION: NCT04715945.