Dietary inflammation during pregnancy and later symptoms of offspring behavioral and emotional problems

The maternal diet is believed to influence child neurodevelopment, at least in part, through inflammation, as dietary components can have pro- or anti-inflammatory effects. We examined the association between the energy-adjusted dietary inflammatory index (E-DII) during pregnancy and offspring symptoms of behavioral and emotional problems at 5.5 and 10 years, using data from the French nationwide ELFE birth cohort. Dietary intake during pregnancy was assessed using a validated food frequency questionnaire and an E-DII score was generated. Child behavioral and emotional symptoms, (including hyperactivity-inattention, conduct, peer-relationship, and emotional problems), were evaluated by parents using the Strengths and Difficulties Questionnaire at 5.5 (n=9627) and 10 years (n=8362) for: hyperactivity-inattention, conduct, peer-relationship, and emotional problems. Children were classified into three categories based on thresholds used to identify clinically relevant symptoms: "Normal", "Borderline", and "Atypical". Multinomial logistic regression, adjusted for potential confounders was used to estimate odds ratios and 95% confidence intervals. An increasing maternal E-DII score during pregnancy was associated with higher odds of offspring classified with atypical hyperactivity-inattention and conduct problem scores at 5.5 and 10 years, atypical peer-relationship problem scores at 10-years, and atypical emotional problem scores at 10 years (differentially by sex). A more proinflammatory diet during pregnancy was consistently associated with higher odds of symptoms of externalizing problems throughout childhood and with internalizing problems at 10 years. Future research should explore the mechanisms by which prenatal exposure to maternal diet-induced inflammation may contribute to these outcomes.