Prepregnancy antiinflammatory diet in pregnant women with endometriosis: The Japan Environment and Children's Study

Objectives: Increased risk of preterm birth (PTB) in women with endometriosis is considered to be associated with chronic inflammatory conditions. Accordingly, we hypothesized that a prepregnancy antiinflammatory diet is a potential form of preconception care for preventing PTB in women with endometriosis and con-ducted this study to investigate the correlation of a prepregnancy antiinflammatory diet with obstetric out-comes in this patient population. Methods: We used singleton pregnancy data from the Japan Environment and Children's Study involving live births from 2011 to 2014. Individual meal patterns before pregnancy, derived through food frequency ques-tionnaires, were used to calculate the Dietary Inflammatory Index. Participants were categorized according to Dietary Inflammatory Index quintiles (Q1 and Q5 were the most proinflammatory and antiinflammatory groups, respectively), and a multiple logistic regression model was used to estimate the effect of the antiin-flammatory diet on PTB before 37 or 34 wk and on low birth weight (LBW) < 2500 or 1500 g. Results: In women who did not undergo assisted reproduction, significantly reduced risk was found in the Q5 group for both PTB at < 34 wk significantly decreased (adjusted odds ratio, 0.25; 95% confidence interval, 0.07-0.83) and low birth weight < 1500 g (adjusted odds ratio, 0.07; 95% confidence interval, 0.01-0.60). Conclusions: This study suggests a distinct effect of an antiinflammatory diet on more severe obstetric out-comes, specifically PTB before 34 wk and low birth weight < 1500 g, for women with endometriosis. Precon-ception lifestyle can improve perinatal mortality and morbidity among these women. (c) 2021 Elsevier Inc. All rights reserved.