# Maternal Dietary Anthocyanidin, Dietary Inflammatory Potential, and Risk of Small-for-Gestational-Age in China

## TL;DR

This study finds that higher anthocyanidin intake is linked to lower risk of small-for-gestational-age babies, especially in women with more inflammatory diets.

## Contribution

The study reveals a protective effect of anthocyanidins against SGA, modulated by dietary inflammatory potential.

## Key findings

- Higher anthocyanidin intake was associated with reduced SGA risk (OR: 0.96).
- Dietary inflammatory index (EDII) was linked to increased SGA risk (OR: 1.08).
- Anthocyanidin's protective effect was strongest in women with high EDII scores (OR: 0.67).

## Abstract

Background: The interaction between anthocyanidin intake and dietary inflammatory potential might influence small-for-gestational-age (SGA), but the available evidence has been limited. This study aims to examine the associations of anthocyanidin with SGA and whether these associations change with dietary inflammatory potential. Methods: Data were derived from 2244 pregnant women enrolled in a community-based, randomized controlled trial between 2015 and 2019 in China. Anthocyanidin intake was calculated with the use of validated food-frequency questionnaires. The energy-adjusted dietary inflammatory index (EDII) was determined by aggregating data from 33 food parameters. Infant birth outcome measurements were obtained from hospital records. Associations were assessed by generalized estimating equations with adjustment for confounding factors. Results: During 39.7 gestational weeks of follow-up, 234 SGA cases occurred. The median intake of anthocyanidin was 28.7 mg/d. Higher consumption of total anthocyanidins (OR: 0.96, 95% CI: 0.95 to 0.97), cyanidin (OR: 0.96, 95% CI: 0.95 to 0.97), and peonidin (OR: 0.96, 95% CI: 0.96 to 0.97) subclasses was associated with a reduced risk of SGA. EDII was associated with an increased risk of SGA (OR: 1.08, 95% CI: 1.03 to 1.12). In addition, we observed that higher anthocyanidin intake was inversely associated with EDII (β: −0.40, 95% CI: −0.46 to −0.34). The inverse anthocyanidin-SGA association was mostly greater among women in the highest tertile of EDII (OR: 0.67, 95% CI: 0.65 to 0.68) compared with the lowest tertile. Conclusions: Higher anthocyanidin intake was inversely associated with SGA, especially among women with higher EDII scores.