Huang Jonathan Y, Arnold Dodie, Qiu Chun-Fang, Miller Raymond S, Williams Michelle A, Enquobahrie Daniel A
1 Department of Epidemiology, University of Washington , Seattle, Washington.
J Womens Health (Larchmt). 2014 Jul;23(7):588-95. doi: 10.1089/jwh.2013.4598. Epub 2014 Jun 11.
Abstract Objective: To evaluate associations between early pregnancy 25-hydroxyvitamin D (25[OH]D) concentrations and antepartum depression and anxiety symptoms and potential modifiers thereof.
In a pregnancy cohort (N=498), we examined cross-sectional associations of early pregnancy (mean=15.4 weeks gestation) serum 25[OH]D concentrations and depression and anxiety symptoms. Symptoms were measured using Depression, Anxiety, and Stress Scales (DASS-21) and Patient Health Questionnaire Depression Module (PHQ-9) instruments. Regression models were fit and effect modification by prepregnancy body mass index and leisure-time physical activity (LTPA) were assessed using interaction terms and stratified analyses.
Mean 25[OH]D concentration was 34.4 ng/mL. Approximately 12% had "moderate" anxiety (score ≥ 10) and depression (score ≥ 10) symptoms by DASS-21 Anxiety and PHQ-9 instruments, respectively. A 1 ng/mL lower 25[OH]D was associated with 0.043 and 0.040 higher DASS-21 Anxiety and PHQ-9 Scores (p-values=0.052 and 0.029, respectively). Participants in the lowest quartile of 25[OH]D (<28.9 ng/mL) had 1.11 higher PHQ-9 scores than those in the highest quartile (≥ 39.5 ng/mL, p<0.05). However, associations were attenuated and statistically insignificant in fully adjusted models. Inverse associations of 25[OH]D with depression symptoms were significant among participants who reported no LTPA, but not among women who reported any LTPA (interaction p=0.018).
Our study provides modest evidence for inverse cross-sectional associations of early pregnancy maternal vitamin D concentrations with antepartum depression symptoms. We also observed that these associations may be modified by physical activity.
摘要 目的:评估孕早期25-羟维生素D(25[OH]D)浓度与产前抑郁和焦虑症状之间的关联及其潜在调节因素。
在一个妊娠队列(N = 498)中,我们研究了孕早期(平均妊娠15.4周)血清25[OH]D浓度与抑郁和焦虑症状的横断面关联。症状使用抑郁、焦虑和压力量表(DASS - 21)以及患者健康问卷抑郁模块(PHQ - 9)工具进行测量。拟合回归模型,并使用交互项和分层分析评估孕前体重指数和休闲时间身体活动(LTPA)对效应的修饰作用。
25[OH]D的平均浓度为34.4 ng/mL。分别使用DASS - 21焦虑量表和PHQ - 9工具时,约12%的人有“中度”焦虑(得分≥10)和抑郁(得分≥10)症状。25[OH]D每降低1 ng/mL,DASS - 21焦虑量表得分和PHQ - 9得分分别升高0.043和0.040(p值分别为0.052和0.029)。25[OH]D处于最低四分位数(<28.9 ng/mL)的参与者的PHQ - 9得分比最高四分位数(≥39.5 ng/mL)的参与者高1.11(p<0.05)。然而,在完全调整模型中,关联减弱且无统计学意义。在报告无LTPA的参与者中,25[OH]D与抑郁症状的负相关显著,但在报告有任何LTPA的女性中不显著(交互p = 0.018)。
我们的研究为孕早期母体维生素D浓度与产前抑郁症状的反向横断面关联提供了适度证据。我们还观察到这些关联可能受身体活动的修饰。