Socioeconomic adversity, maternal nutrition, and the prenatal programming of child cognition and language at two years of age through maternal inflammation
A. Gogos1, S. Thomson1, K. Drummond1, L. Holland1, M. O'Hely2, S. Dawson2, W. Marx2, T. Mansell3, D. Burgner3, R. Saffery3, P. Sly2, F. Collier2, M. Tang3, C. Symeonides3, P. Vuillermin2, A.-L. Ponsonby1
1Florey Institute of Neuroscience and Mental Health, Neuroepidemiology Group, Parkville, Australia, 2Deakin University, IMPACT, Geelong, Australia, 3Murdoch Children’s Research Institute, Royal Children's Hospital, Parkville, Australia
Background: The adverse effect of socioeconomic adversity on offspring cognition may be mediated through elevated prenatal maternal inflammation, but the role of modifiable antecedents such as nutrition has not been clarified.
Aims & Objectives: We explored the impact of prenatal maternal factors, particularly nutrition, on maternal systemic inflammation and child neurodevelopmental outcomes; and whether the associations between socioeconomic adversity and child neurodevelopment were mediated through prenatal nutrition and inflammation.
Method: We used a population-derived pre-birth longitudinal cohort of 1074 mother-child pairs, the Barwon Infant Study (Victoria, Australia). Exposures: prenatal factors at 28 weeks’ gestation including maternal diet (food frequency questionnaire) and dietary patterns (principal component analysis). Main outcome measures: maternal inflammatory biomarkers (GlycA and hsCRP levels) at 28 weeks’ gestation; 2-year old offspring Bayley-III cognition and language scores.
Results: The ‘modern wholefoods’ and ‘processed’ maternal dietary patterns were associated with reduced and elevated maternal inflammation respectively (GlycA or hsCRP p<0.001), and also with higher and reduced offspring Bayley-III scores respectively (cognition p≤0.004, language p≤0.009). Associations between dietary patterns and offspring cognition/language were partially mediated by higher maternal GlycA (cognition p≤0.036, language p≤0.05), but were less evident for hsCRP. The maternal dietary patterns mediated 22% of the association between socioeconomic adversity (lower maternal education and/or household income) and poorer offspring cognition (p=0.001).
Discussion & Conclusions: Modifiable prenatal dietary patterns were associated with adverse child outcomes through their effect on maternal inflammation. Maternal diet may partially explain the association between socioeconomic adversity and child neurocognitive vulnerability. Maternal diet-by-inflammation pathways are an attractive target for intervention studies.
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