Association between the Dietary Inflammatory Index and the Risk of Cesarean Delivery
Abstract
Background: Cesarean section (CS) is one of the most important pregnancy concerns in the world. Increased inflammation is associated with increased risk factors for cesarean section. Diet plays a major role in reducing inflammation. This study aimed to investigate the relationship between dietary inflammatory index (DII) and the risk of Cesarean section in Tehranian women.
Methods: This case-control study included 390 pregnant women in Tehran, Iran between 2020 and 2021 at their initial visit to pregnancy clinics, selected by a cluster sampling method. Dietary intakes were determined using valid reliable questionnaires and DII was calculated. Weight, height, and waist circumference were also measured.
Results: The mean age of the subjects was 28.5 yr (± 5.02) and weight, body mass index (BMI) and waist circumference (WC) in the case group with a higher DII were higher. Odds ratio (OR) of cesarean section in DII quartiles was statistically significant. Confounding factors including age, BMI and total energy intake were adjusted in the first model and weight, waist circumference, physical activity and supplements in the second model and the relationship remained significant (P<0.001).
Conclusion: High scores of dietary inflammatory index, possibly through an increase in inflammatory factors, can increase the chances of having a cesarean section.
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13. Shi Y, Zhou W (2023). Interactive Effects of Dietary Inflammatory Index with BMI for the Risk of Stroke among Adults in the United States: Insight from NHANES 2011-2018. J Nutr Health Aging, 27 (4):277-284.
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15. Shivappa N, Wang R, Hébert JR, et al (2019). Association between inflammatory potential of diet and risk of lung cancer among smokers in a prospective study in Singapore. Eur J Nutr, 58 (7):2755-2766.
16. Zhao Q, Tan X, Su Z, et al (2023). The Relationship between the Dietary Inflammatory Index (DII) and Metabolic Syndrome (MetS) in Middle-Aged and Elderly Individuals in the United States. Nutrients, 15 (8):1857.
17. Therdtatha P, Shinoda A, Nakayama J (2022). Crisis of the Asian gut: associations among diet, microbiota, and metabolic diseases. Biosci Microbiota Food Health, 41 (3):83-93.
18. Chia AR, Chen LW, Lai JS, et al (2019). Maternal Dietary Patterns and Birth Outcomes: A Systematic Review and Meta-Analysis. Adv Nutr, 10 (4):685-695.
19. Borem P, de Cássia Sanchez R, Torres J, et al (2020). A Quality Improvement Initiative to Increase the Frequency of Vaginal Delivery in Brazilian Hospitals. Obstet Gynecol, 135 (2):415-425.
20. Cierny JT, Unal ER, Flood P, et al (2014). Maternal inflammatory markers and term labor performance. Am J Obstet Gynecol, 210 (5): 447.e1-6.
21. Asghari G, Rezazadeh A Fau - Hosseini-Esfahani F, et al (2012). Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran Lipid and Glucose Study. Br J Nutr, 108 (6): 1109-17.
22. Hu Y, Huang K, Sun Y, et al (2017). Placenta response of inflammation and oxidative stress in low-risk term childbirth: the implication of delivery mode. BMC Pregnancy Childbirth, 17 (1):407.
23. Kyozuka H, Murata T, Fukuda T, et al (2020). Dietary Inflammatory Index during Pregnancy and the Risk of Intrapartum Fetal Asphyxia: The Japan Environment and Children's Study. Nutrients, 12 (11):3482.
24. Philippou E, Nikiphorou E (2018). Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev, 17 (11): 1074-1077.
25. Casas R, Castro-Barquero S, Crovetto F, et al (2022). Maternal Dietary Inflammatory Index during Pregnancy Is Associated with Perinatal Outcomes: Results from the IMPACT BCN Trial. Nutrients, 14 (11):2284.
26. Namazi N, Larijani B, Azadbakht L (2018). Dietary Inflammatory Index and its Association with the Risk of Cardiovascular Diseases, Metabolic Syndrome, and Mortality: A Systematic Review and Meta-Analysis. Horm Metab Res, 50 (5): 345-358.
27. Shivappa N, Hébert JR, Rashvand S, et al (2016). Inflammatory Potential of Diet and Risk of Ulcerative Colitis in a Case-Control Study from Iran. Nutr Cancer, 68 (3): 404-9.
28. de Freitas NPA, Carvalho TR, Gonçalves CCRA, et al (2022). The Dietary Inflammatory Index as a predictor of pregnancy outcomes: Systematic review and meta-analysis. J Reprod Immunol, 152:103651.
29. Denova-Gutiérrez EA-O, Muñoz-Aguirre P, Shivappa N, et al (2018). Dietary Inflammatory Index and Type 2 Diabetes Mellitus in Adults: The Diabetes Mellitus Survey of Mexico City. Nutrients, 10 (4):385.
30. Shivappa N, Wang R, Hébert JR, et al (2019). Association between inflammatory potential of diet and risk of lung cancer among smokers in a prospective study in Singapore. Eur J Nutr, 58 (7):2755-2766.
31. Demirci-Çekiç S, Özkan G, Avan AN, et al (2022). Biomarkers of Oxidative Stress and Antioxidant Defense. J Pharm Biomed Anal, 209:114477.
32. Huang D (2018). Dietary Antioxidants and Health Promotion. Antioxidants (Basel), 7 (1):9.
33. Wood LG, Shivappa N Fau, Berthon BS, et al (2015). Dietary inflammatory index is related to asthma risk, lung function and systemic inflammation in asthma. Clin Exp Allergy, 45 (1): 177-83.
34. Siregar DAS, Rianda D, Irwinda R, et al (2020). Associations between diet quality, blood pressure, and glucose levels among pregnant women in the Asian megacity of Jakarta. PLoS One, 15 (11): e0242150.
35. Sukmawati S, Sunarno I, Arsyad MA, Idris I (2020). Vaginal and cesarean section delivery with severe preeclampsia and preeclampsia with complications. Enfermería Clínica, 30:537-540.
36. Bjorklund J, Wiberg-Itzel E, Wallstrom T (2022). Is there an increased risk of cesarean section in obese women after induction of labor? A retrospective cohort study. PLoS One, 17 (2):e0263685.
37. Hans U, Edward B (2010). Regular vitamin C supplementation during pregnancy reduces hospitalization: outcomes of a Ugandan rural cohort study. Pan Afr Med J, 5:15.
38. Changamire FT, Mwiru RS, Peterson KE, et al (2015). Effect of multivitamin supplements on weight gain during pregnancy among HIV-negative women in Tanzania. Matern Child Nutr, 11 (3):297-304.
2. Betran AP, Ye J, Moller AB, et al (2021). Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health, 6 (6): e005671.
3. Rafiei M, Saei Ghare M, Akbari M, et al (2018). Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. Int J Reprod Biomed, 16 (4):221-234.
4. Mylonas I, Friese K (2015). Indications for and Risks of Elective Cesarean Section. Dtsch Arztebl Int, 112 (29-30):489-95.
5. Latifnejad Roudsari R, Zakerihamidi M, Merghati Khoei E (2015). Socio-Cultural Beliefs, Values and Traditions Regarding Women's Preferred Mode of Birth in the North of Iran. Int J Community Based Nurs Midwifery, 3 (3):165-76.
6. Bernhardt GV, Shivappa P, Bernhardt K, et al (2022). Markers of inflammation in obese pregnant women: Adenosine deaminase and high sensitive C - reactive protein. Eur J Obstet Gynecol Reprod Biol X, 16:100167.
7. Stromsnes K, Correas AG, Lehmann J, et al (2021). Anti-Inflammatory Properties of Diet: Role in Healthy Aging. Biomedicines, 9 (8):922.
8. Hébert JR, Shivappa N, Wirth MD,et al (2019). Perspective: The Dietary Inflammatory Index (DII)-Lessons Learned, Improvements Made, and Future Directions. Adv Nutr, 10 (2):185-195.
9. Duggan MR, Butler L, Peng Z, et al (2023). Plasma proteins related to inflammatory diet predict future cognitive impairment. Mol Psychiatry, 28 (4):1599-1609.
10. Zhou N, Xie ZP, Liu Q, et al (2023). The dietary inflammatory index and its association with the prevalence of hypertension: A cross-sectional study. Front Immunol, 13:1097228.
11. Yarizadeh H, Mirzababaei A, Ghodoosi N, et al (2021). The interaction between the dietary inflammatory index and MC4R gene variants on cardiovascular risk factors. Clin Nutr, 40 (2):488-495.
12. Zuercher MD, Harvey DJ, Santiago-Torres M, et al (2023). Dietary inflammatory index and cardiovascular disease risk in Hispanic women from the Women's Health Initiative. Nutr J, 22 (1):5.
13. Shi Y, Zhou W (2023). Interactive Effects of Dietary Inflammatory Index with BMI for the Risk of Stroke among Adults in the United States: Insight from NHANES 2011-2018. J Nutr Health Aging, 27 (4):277-284.
14. Aslani Z, Qorbani M, Hébert JR, et al (2019). Association of Dietary Inflammatory Index with anthropometric indices in children and adolescents: the weight disorder survey of the Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN)-IV study. Br J Nutr, 121 (3):340-350.
15. Shivappa N, Wang R, Hébert JR, et al (2019). Association between inflammatory potential of diet and risk of lung cancer among smokers in a prospective study in Singapore. Eur J Nutr, 58 (7):2755-2766.
16. Zhao Q, Tan X, Su Z, et al (2023). The Relationship between the Dietary Inflammatory Index (DII) and Metabolic Syndrome (MetS) in Middle-Aged and Elderly Individuals in the United States. Nutrients, 15 (8):1857.
17. Therdtatha P, Shinoda A, Nakayama J (2022). Crisis of the Asian gut: associations among diet, microbiota, and metabolic diseases. Biosci Microbiota Food Health, 41 (3):83-93.
18. Chia AR, Chen LW, Lai JS, et al (2019). Maternal Dietary Patterns and Birth Outcomes: A Systematic Review and Meta-Analysis. Adv Nutr, 10 (4):685-695.
19. Borem P, de Cássia Sanchez R, Torres J, et al (2020). A Quality Improvement Initiative to Increase the Frequency of Vaginal Delivery in Brazilian Hospitals. Obstet Gynecol, 135 (2):415-425.
20. Cierny JT, Unal ER, Flood P, et al (2014). Maternal inflammatory markers and term labor performance. Am J Obstet Gynecol, 210 (5): 447.e1-6.
21. Asghari G, Rezazadeh A Fau - Hosseini-Esfahani F, et al (2012). Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran Lipid and Glucose Study. Br J Nutr, 108 (6): 1109-17.
22. Hu Y, Huang K, Sun Y, et al (2017). Placenta response of inflammation and oxidative stress in low-risk term childbirth: the implication of delivery mode. BMC Pregnancy Childbirth, 17 (1):407.
23. Kyozuka H, Murata T, Fukuda T, et al (2020). Dietary Inflammatory Index during Pregnancy and the Risk of Intrapartum Fetal Asphyxia: The Japan Environment and Children's Study. Nutrients, 12 (11):3482.
24. Philippou E, Nikiphorou E (2018). Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev, 17 (11): 1074-1077.
25. Casas R, Castro-Barquero S, Crovetto F, et al (2022). Maternal Dietary Inflammatory Index during Pregnancy Is Associated with Perinatal Outcomes: Results from the IMPACT BCN Trial. Nutrients, 14 (11):2284.
26. Namazi N, Larijani B, Azadbakht L (2018). Dietary Inflammatory Index and its Association with the Risk of Cardiovascular Diseases, Metabolic Syndrome, and Mortality: A Systematic Review and Meta-Analysis. Horm Metab Res, 50 (5): 345-358.
27. Shivappa N, Hébert JR, Rashvand S, et al (2016). Inflammatory Potential of Diet and Risk of Ulcerative Colitis in a Case-Control Study from Iran. Nutr Cancer, 68 (3): 404-9.
28. de Freitas NPA, Carvalho TR, Gonçalves CCRA, et al (2022). The Dietary Inflammatory Index as a predictor of pregnancy outcomes: Systematic review and meta-analysis. J Reprod Immunol, 152:103651.
29. Denova-Gutiérrez EA-O, Muñoz-Aguirre P, Shivappa N, et al (2018). Dietary Inflammatory Index and Type 2 Diabetes Mellitus in Adults: The Diabetes Mellitus Survey of Mexico City. Nutrients, 10 (4):385.
30. Shivappa N, Wang R, Hébert JR, et al (2019). Association between inflammatory potential of diet and risk of lung cancer among smokers in a prospective study in Singapore. Eur J Nutr, 58 (7):2755-2766.
31. Demirci-Çekiç S, Özkan G, Avan AN, et al (2022). Biomarkers of Oxidative Stress and Antioxidant Defense. J Pharm Biomed Anal, 209:114477.
32. Huang D (2018). Dietary Antioxidants and Health Promotion. Antioxidants (Basel), 7 (1):9.
33. Wood LG, Shivappa N Fau, Berthon BS, et al (2015). Dietary inflammatory index is related to asthma risk, lung function and systemic inflammation in asthma. Clin Exp Allergy, 45 (1): 177-83.
34. Siregar DAS, Rianda D, Irwinda R, et al (2020). Associations between diet quality, blood pressure, and glucose levels among pregnant women in the Asian megacity of Jakarta. PLoS One, 15 (11): e0242150.
35. Sukmawati S, Sunarno I, Arsyad MA, Idris I (2020). Vaginal and cesarean section delivery with severe preeclampsia and preeclampsia with complications. Enfermería Clínica, 30:537-540.
36. Bjorklund J, Wiberg-Itzel E, Wallstrom T (2022). Is there an increased risk of cesarean section in obese women after induction of labor? A retrospective cohort study. PLoS One, 17 (2):e0263685.
37. Hans U, Edward B (2010). Regular vitamin C supplementation during pregnancy reduces hospitalization: outcomes of a Ugandan rural cohort study. Pan Afr Med J, 5:15.
38. Changamire FT, Mwiru RS, Peterson KE, et al (2015). Effect of multivitamin supplements on weight gain during pregnancy among HIV-negative women in Tanzania. Matern Child Nutr, 11 (3):297-304.
| Files | ||
| Issue | Vol 53 No 7 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i7.16056 | |
| Keywords | ||
| Diet Inflammation Cesarean section Delivery Obstetric | ||
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How to Cite
1.
Sheikholmolooki F, Djazayeri A, Abbasi B. Association between the Dietary Inflammatory Index and the Risk of Cesarean Delivery. Iran J Public Health. 2024;53(7):1621-1628.
