A protective influence of maternal inflammatory status on infantile atopic eczema risk has been proposed, but few studies have investigated these potential links. We examined the associations between energy-adjusted dietary inflammatory index (E-DII) scores indicative of an inflammatory dietary pattern, maternal serum neopterin levels, a biomarker elevated in Th1 immune activation, and infantile risk of atopic eczema. Within the UK Southampton Women’s Survey, mothers’ diets were recorded using questionnaires at preconception, early and late pregnancy and E-DII scores derived. Atopic eczema was ascertained using the UK Working Party Diagnostic Criteria at ages 6 and 12 months (n=2955 and 2871, respectively). A sub-sample of 497 mothers had serum neopterin measured in late pregnancy. Unadjusted analyses showed that higher E-DII in preconception and late pregnancy was associated with a lower risk of eczema at ages 6 and 12 months. After adjusting for maternal BMI, age, parity, education, smoking during pregnancy, breastfeeding duration and sex, higher E-DII in late pregnancy was associated with reduced risks of eczema at age 6 and 12 months (OR 0.89 [95%CI 0.81,0.99], p=0.03 and OR 0.91 [0.82,1.00], p=0.05, respectively). Consistent with this, higher maternal serum neopterin was associated with a lower risk of eczema at ages 6 months (OR 0.72 (0.51,1.01), p=0.05) and 12 months (OR 0.71 (0.53,0.96), p=0.03). The findings suggest that a pro-inflammatory maternal diet and an inflammatory maternal environment during pregnancy may protect the developing infant from Th2 driven inflammation and lower the risk of infantile atopic eczema.
