SOCIOECONOMIC ADVERSITY, MATERNAL NUTRITION, AND THE PRENATAL PROGRAMMING OF CHILD COGNITION AND LANGUAGE AT TWO YEARS OF AGE THROUGH MATERNAL INFLAMMATION

Abstract 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.