First–Second-Trimester Dietary Inflammatory Index and Anemia Risk in the Third Trimester: A Prospective Cohort Study
2025
Cong Huang | Zhitan Zhang | Junwei He | Zixin Zhong | Yuxin Ma | Xun Huang | Fan Xia | Hongzhuan Tan | Jing Deng | Mengshi Chen
Objectives: Dietary conditions are closely related to maternal health. This study aims to investigate the causal relationship between the first&ndash:second-trimester Dietary Inflammatory Index (DII) and developing anemia in the third trimester. Methods: This prospective cohort study comprised 545 pregnant women, with dietary data assessed via a semi-quantitative food frequency questionnaire (FFQ). Hemoglobin levels were obtained by hospital laboratory tests and used to diagnose anemia. Multivariable logistic regression models&mdash:adjusted for baseline serum iron, age, pre-pregnancy body mass index (BMI), occupation, education, history of adverse pregnancy outcomes, parity, serum iron, passive smoking exposure, and iron supplementation use during pregnancy&mdash:were employed to evaluate the relationships between the first-trimester DII, second-trimester DII, first&ndash:second-trimester average DII, and third-trimester anemia. Results: After multivariable adjustment, the first&ndash:second-trimester average DII in the pro-inflammatory diet group demonstrated a 3.73-fold elevated risk of third-trimester anemia compared to the anti-inflammatory diet group (Odds Ratio [OR] = 3.73, 95% Confidence Interval [CI]: 1.50&ndash:9.25). Conclusions: Pro-inflammatory dietary patterns during pregnancy exhibit a significant correlation with developing third-trimester anemia. This study demonstrates that reducing dietary pro-inflammatory components through prenatal nutrition programs may lower third-trimester anemia risk. Notably, this study carries potential risks of bias, including self-reporting bias in dietary data and incompletely controlled confounding factors (such as unmeasured biomarkers).
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