Inflammation and Pregnancy: How Anti-Inflammatory Nutrition Supports You and Your Baby
A Registered Dietitian’s Evidence-Based Guide to Reducing Pregnancy Complications Through Anti-Inflammatory Eating
When you find out you’re pregnant — especially if you’re 35 or older, navigating fertility challenges, or managing an existing health condition — the advice comes fast. Take your prenatal. Avoid sushi. Don’t eat deli meat. The list of restrictions grows, but the why behind nutrition often gets lost.
Here’s the part that most pregnancy nutrition guides skip entirely: inflammation plays a central role in many of the most common and most serious pregnancy complications. Preeclampsia, gestational diabetes, preterm birth, and growth restriction all have a documented inflammatory component — and the inflammatory potential of your diet during pregnancy is a measurable, modifiable risk factor.
This isn’t about perfection. It’s about understanding that the way you eat during pregnancy doesn’t just “provide nutrients to the baby.” It actively shapes the inflammatory environment in which your baby develops. And shifting that environment in an anti-inflammatory direction has real, evidence-based benefits for both of you.
Short on Time? Do These Three Things First.
1. Build meals around anti-inflammatory staples: fatty fish (low-mercury options like salmon and sardines), colorful vegetables, berries,
olive oil , legumes, and whole grains.2. Take a high-quality prenatal vitamin with adequate folate, iron, vitamin D, and omega-3s — and eat omega-3-rich foods at least twice a week.
3. Minimize ultra-processed foods, added sugars, and refined carbohydrates — these are the dietary factors most strongly linked to increased inflammation during pregnancy.
Start with these. Then come back when you’re ready.
This post may contain affiliate links to products that align with my evidence-based nutrition approach. As an Amazon Associate I earn from qualifying purchases. Full disclosure.
Why Inflammation Matters During Pregnancy
Pregnancy itself involves carefully orchestrated inflammatory responses. The first trimester requires an inflammatory environment for implantation. The second trimester shifts toward an anti-inflammatory state that supports growth. The third trimester returns to an inflammatory profile as the body prepares for labor. This is normal and necessary.
Problems arise when chronic, low-grade inflammation disrupts this pattern — tipping the balance toward excessive inflammation at the wrong times. And this is exactly what a pro-inflammatory diet can do.
A 2022 systematic review and meta-analysis examined the Dietary Inflammatory Index (DII) as a predictor of pregnancy outcomes across eight eligible studies. The findings were clear: a more pro-inflammatory diet was a significant predictor of obstetric complications, with particularly strong associations with preeclampsia, hypertensive disorders of pregnancy, and preterm birth (Freitas et al., 2022).
A larger 2023 meta-analysis in the British Journal of Nutrition, including nine studies and over 11,400 participants from five countries, found that each one-unit increase in DII score — meaning a slightly more pro-inflammatory diet — was associated with a 13% higher risk of gestational diabetes and a 24% higher risk of preeclampsia (Li et al., 2023). That 24% increase in preeclampsia risk from dietary inflammation alone is striking, because diet is something you can change.
For a deeper understanding of what the Dietary Inflammatory Index measures and how it applies to your eating patterns, I wrote a full explanation in what is the Dietary Inflammatory Index?.
Preeclampsia: The Inflammation Connection
Preeclampsia affects 2-5% of pregnancies globally and remains one of the leading causes of maternal and fetal morbidity. While it was once understood as primarily a blood pressure issue, the research increasingly identifies it as a condition driven by systemic inflammation and endothelial dysfunction.
A 2024 systematic review and meta-analysis of 25 studies found significantly elevated levels of inflammatory markers — including hs-CRP, IL-6, CRP, ferritin, and TNF-alpha — in women with preeclampsia compared to normotensive pregnancies. The pooled difference in hs-CRP alone was 3.20 mg/L higher in preeclamptic women (Addisu et al., 2024). That’s a substantial elevation in a marker that reflects whole-body inflammation.
This is where diet becomes a powerful lever. A 2025 narrative review in Frontiers in Nutrition examined the Mediterranean diet’s relationship to preeclampsia prevention across 12 studies — five observational and seven randomized controlled trials. The observational studies showed significant protective associations, with effect sizes ranging from 22-69% reduced preeclampsia risk for women with higher Mediterranean diet adherence. Among the RCTs, two reported statistically significant reductions, and four showed protective trends (Baroutis et al., 2025).
A separate 2025 review of the DASH diet and preeclampsia found that higher DASH diet adherence was associated with approximately 35-45% reduced risk of preeclampsia in observational studies. The review noted that higher intake of fruits, vegetables, whole grains, and plant-based foods was associated with lower preeclampsia risk, while diets high in processed foods, refined sugars, and saturated fats increased risk (Baroutis et al., 2025b).
What both the Mediterranean and DASH diets share is a fundamentally anti-inflammatory profile — rich in omega-3s, polyphenols, fiber, and antioxidants, while low in the processed and refined foods that drive inflammatory signaling.
Gestational Diabetes and Inflammatory Eating Patterns
Gestational diabetes mellitus (GDM) is another condition where dietary inflammation plays a documented role. The same 2023 meta-analysis that found a 24% increased preeclampsia risk also found that a more pro-inflammatory diet was associated with a 13% higher risk of gestational diabetes (Li et al., 2023).
The mechanism connects directly to how inflammation affects insulin signaling. Pro-inflammatory cytokines interfere with insulin receptor function, promoting the insulin resistance that underlies GDM. When your diet continuously triggers inflammatory responses — through excess refined carbohydrates, added sugars, processed oils, and ultra-processed foods — it compounds the insulin resistance that pregnancy itself naturally produces.
An anti-inflammatory dietary pattern addresses this from the other direction: omega-3s improve insulin sensitivity, fiber from vegetables and legumes moderates blood sugar response, and polyphenols from berries and colorful produce reduce the oxidative stress that impairs glucose metabolism.
This doesn’t mean you won’t develop GDM — genetics and other factors play a role. But it means that the dietary environment you create gives your body the best possible chance of managing glucose effectively.
What an Anti-Inflammatory Pregnancy Diet Looks Like
The good news: anti-inflammatory eating during pregnancy isn’t a special or restrictive diet. It’s a pattern of eating that’s rich in the nutrients your body and baby need while naturally minimizing the compounds that drive inflammation.
Fatty fish (low-mercury options). Salmon, sardines, anchovies, and herring provide EPA and DHA — omega-3 fatty acids that are critical for fetal brain and eye development and that also reduce maternal inflammation. Aim for two to three servings per week. If fish isn’t appealing (thanks, first-trimester nausea), a prenatal omega-3 supplement helps bridge the gap.
Colorful vegetables and fruits. Every color represents different anti-inflammatory compounds: the anthocyanins in berries, the carotenoids in sweet potatoes and carrots, the sulforaphane in broccoli, the lycopene in tomatoes. Aim for variety, not perfection. Whatever you can eat counts.
Legumes and whole grains. Lentils, chickpeas, black beans, quinoa, oats, and brown rice provide fiber that feeds beneficial gut bacteria, stabilizes blood sugar, and supports the anti-inflammatory gut environment that protects against pregnancy complications.
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Nuts and seeds. Walnuts provide plant-based omega-3s. Ground flaxseed delivers fiber, lignans, and alpha-linolenic acid. For a deep dive on flaxseed’s anti-inflammatory properties, see my post on ground flaxseed for menopause — the benefits apply well beyond menopause.
Fermented foods. Yogurt, kefir, and other fermented foods support the gut microbiome, which plays a direct role in immune regulation during pregnancy. A healthy gut barrier reduces the systemic inflammation that contributes to pregnancy complications. More on this in best fermented foods for menopause.
What to minimize. Ultra-processed foods, excess added sugars, refined carbohydrates, and processed oils (soybean oil, corn oil, safflower oil in packaged foods). These are the dietary components most consistently associated with higher DII scores and increased pregnancy complication risk.
The Nutrients That Need Extra Attention
Beyond the anti-inflammatory dietary pattern, certain nutrients deserve specific attention during pregnancy.
Folate prevents neural tube defects and supports DNA synthesis. Most prenatals provide adequate folic acid or methylfolate — but food sources (leafy greens, legumes, citrus) are still important.
Iron needs nearly double during pregnancy. Heme iron from animal sources (red meat, poultry) is more easily absorbed, but plant-based iron from legumes, spinach, and fortified grains counts too — pair with vitamin C foods to enhance absorption.
Vitamin D supports immune regulation, bone development, and has anti-inflammatory properties. Many women are insufficient, especially in northern climates. Ask your provider to check your levels.
Choline is critical for fetal brain development and is not always included in prenatal vitamins. Eggs are the richest dietary source — two eggs provide roughly half the daily target.
Omega-3 DHA is specifically needed for fetal brain and retinal development. If you’re not eating fatty fish regularly, supplement with a prenatal DHA — look for at least 200-300 mg DHA daily. A reliable option is Nordic Naturals Prenatal DHA.
For a broader look at nutrient needs that shift in your 40s and beyond, see my guide to nutrient deficiencies in women over 40.
Managing First-Trimester Nausea While Still Eating Well
Let’s be realistic: the first trimester can make anti-inflammatory eating feel impossible. If you’re surviving on crackers and ginger ale, you’re not failing — you’re getting through it.
A few strategies that help: eat small amounts frequently rather than waiting for hunger (which can trigger nausea). Cold foods are often better tolerated than hot. Bland isn’t forever — this phase typically improves by the second trimester. Ginger — in tea, candies, or supplements — has evidence for reducing nausea. And whatever anti-inflammatory foods you can eat count: a handful of berries, a cup of yogurt, some avocado on toast. Even ground flaxseed stirred into applesauce.
The second and third trimesters are when most women find it easier to eat a wider variety of anti-inflammatory foods. Give yourself grace during the hard part.
A Note for Women Over 35
If you’re pregnant after 35 — and especially after 40 — the inflammation conversation is particularly relevant. Age-related increases in baseline inflammation can compound the inflammatory challenges of pregnancy itself. This doesn’t mean you’re at a disadvantage — it means the anti-inflammatory dietary approach may offer you even greater relative benefit.
The research on Mediterranean diet adherence and preeclampsia protection is encouraging at every age, and the dietary patterns that reduce pregnancy complication risk are the same ones that support your long-term health beyond pregnancy: omega-3s, fiber, polyphenols, adequate protein, and minimal ultra-processed food.
You’re not too old. You’re not too late. And you have more influence over your pregnancy’s inflammatory environment than you’ve probably been told.
The Bottom Line
Pregnancy nutrition isn’t just about checking boxes on a nutrient list. It’s about creating an anti-inflammatory environment that protects you from complications and supports your baby’s development. The evidence linking dietary inflammation to preeclampsia, gestational diabetes, and preterm birth is strong — and the protective effects of anti-inflammatory eating patterns are documented across multiple large studies.
You don’t have to eat perfectly. You don’t have to stress about every meal (stress is inflammatory too). But you can make meaningful shifts — more fish, more vegetables, more
You’re building a human. Feed both of you well.
What’s the one thing you’ll try this week?
This content is for educational purposes and is not a substitute for personalized medical or prenatal advice. Always work closely with your OB-GYN, midwife, or healthcare provider throughout your pregnancy. Need help communicating your nutritional goals? I wrote a guide on how to talk to your doctor about anti-inflammatory nutrition.
References (click to expand)
Addisu, D., et al. (2024). Inflammatory markers and their association with preeclampsia among pregnant women: A systematic review and meta-analysis. *Heliyon*, 10(12), e32841. https://doi.org/10.1016/j.heliyon.2024.e32841
Freitas, N. P. A., Carvalho, T. R., Gonçalves, C. C. R. A., Silva, P. H. A., Romão, L. G. M., Kwak-Kim, J., & Cavalcante, M. B. (2022). The Dietary Inflammatory Index as a predictor of pregnancy outcomes: Systematic review and meta-analysis. *Journal of Reproductive Immunology*, 152, 103651. https://doi.org/10.1016/j.jri.2022.103651
Baroutis, D., et al. (2025). Mediterranean diet in preeclampsia prevention: Mechanisms of action and clinical evidence. *Frontiers in Nutrition*, 12, 1626022. https://doi.org/10.3389/fnut.2025.1626022
Baroutis, D., et al. (2025b). DASH diet and preeclampsia prevention: A literature review. *Nutrients*, 17(12), 2025. https://doi.org/10.3390/nu17122025
Bharmal, U., et al. (2025). Association between the dietary inflammatory index and adverse pregnancy outcomes. *American Journal of Obstetrics & Gynecology MFM*, 7(3), 101609. https://doi.org/10.1016/j.ajogmf.2025.101609
Li, H., et al. (2023). Association of dietary inflammatory index with risk of gestational diabetes mellitus and preeclampsia: A systematic review and meta-analysis. *British Journal of Nutrition*, 131(1), 54–62. https://doi.org/10.1017/S0007114523001678
Shapiro, A. L., et al. (2017). Maternal inflammatory diet and adverse pregnancy outcomes: Circulating cytokines and genomic imprinting as potential regulators? *Placenta*, 60, 14–18. https://doi.org/10.1016/j.placenta.2017.10.002
