Maternal Insulinemic and Inflammatory Dietary Patterns and Risk of Child Neurodevelopmental Delay

Background Insulin response, inflammation, and hyperglycemia are important factors contributing to impaired neural development. However, the relationship between higher insulinemic, inflammatory, and hyperglycemia potential in the diet during pregnancy, and delayed neurodevelopment in children remains unclear. This study explored whether maternal dietary patterns promoting hyperinsulinemia, inflammation, or hyperglycemia may influence child neurodevelopmental delay risk. Methods We calculated dietary scores from initial food frequency questionnaires completed by 7,438 pregnant women participating in the Maternal and Infant Health Cohort Study in Hefei (MIH-Hefei). The food frequency questionnaire (FFQ) was used to evaluate the empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL) during mid-pregnancy. Child developmental assessment was conducted at 6–36 months postpartum. Results We documented 540 incident child neurodevelopmental delay cases over 7,438 pregnant women. Pregnant women exhibiting the high levels of hyperinsulinemic or proinflammatory components, or GI encountered an elevated risk of child neurodevelopmental delay; the hazard ratios (HRs) with 95% confidence intervals (CIs) for comparing the highest and lowest dietary indices quintiles were as follows: EDIH 1.48(1.07,2.04; P _trend = 0.017), EDIP 1.39(1.05,1.84; P _trend = 0.019) and GI 1.36(1.02,1.81; P _trend = 0.038). In sex-stratified analyses, these results remained significant only in boys. The performance of combined model of EDIH and EDIP for boys is comparable to that of the combined model of EDIH, EDIP, and GI to assess the risk of neurodevelopmental delay (AUC 0.801 vs. AUC 0.830). Both values are higher than the AUC values achieved by models using either set of indictors individually. Conclusion In this prospective cohort study, the maternal consumption of high insulinemic potential diet, high inflammatory potential diet, or high glycemic index diet is related to child neurodevelopmental delay, particularly amongst boys. Higher insulinemic and inflammatory potentials within the maternal diet could potentially forecast child neurodevelopmental delay among boys.