J Acad Nutr Diet. 2020 Jun;120(6):972-984. doi: 10.1016/j.jand.2019.12.011. Epub 2020 Feb 13.
Maternal nutrition during pregnancy has a significant effect on the health of the offspring and mother, highlighting the need for identifying factors that may affect diet during pregnancy. Research in nonpregnant and pregnant populations suggest depression may play a role.
To investigate the relationship between prenatal depression and diet quality during pregnancy overall and by race/ethnicity and to explore the relationships between prenatal depression and the 12 Healthy Eating Index 2010 dietary components.
A cross-sectional secondary analysis of a cohort study of Kaiser Permanente Northern California women entering prenatal care between October 2011 and April 2013.
PARTICIPANTS/SETTING: Participants included 1,160 adult pregnant women.
Poor diet quality was defined as a Healthy Eating Index 2010 score in the lowest quartile.
Logistic regression was used to assess the relationship between prenatal depression (defined as a depression diagnosis, Patient Health Questionnaire score of 10 or greater or antidepressant medication dispensing between the last menstrual period and completion of the food frequency questionnaire) and poor diet quality overall and by race/ethnicity. Relationships between prenatal depression and each of the 12 Healthy Eating Index 2010 dietary components were assessed using t-tests and linear regression analyses.
One hundred fifty-nine (14%) participants had prenatal depression. Women with prenatal depression had nearly two times the odds of poor diet quality (odds ratio 1.80, 95% CI 1.23 to 2.60) compared with women without prenatal depression, after adjusting for potential confounders. Differences emerged by race/ethnicity; after adjusting for potential confounders the adjusted odds of poor diet quality were significant only among Hispanic women. Hispanic women with prenatal depression had an increased odds of poor diet quality compared with Hispanic women without prenatal depression (odds ratio 2.66, 95% CI 1.15 to 6.06). Women with prenatal depression had a higher consumption of empty calories (from solid fats, alcohol, and added sugars; threshold for counting alcohol >13 g/1,000 kcal) (P=0.01) and lower consumption of greens and beans (P<0.05), total fruit (P<0.01), and whole fruit (P<0.01), compared with women without prenatal depression. Except for empty calories, these findings remained after adjusting for potential confounders.
Study findings suggest that women with prenatal depression are at a higher risk of poor diet quality compared with women without prenatal depression, and the relationship is stronger among Hispanic women. Nutrition counseling interventions for women with depression should consider the use of culturally sensitive materials and target limiting empty calories from solid fats, alcohol, and added sugars and encourage eating more greens, beans, and fruit.
孕期母体营养对后代和母亲的健康有重大影响，这凸显出有必要确定可能影响孕期饮食的因素。非孕妇和孕妇群体的研究表明，抑郁可能在此方面发挥作用。
调查孕期抑郁与孕期整体饮食质量的关系，以及这种关系在不同种族/民族之间的差异，并探讨孕期抑郁与 12 项健康饮食指数 2010 饮食成分的关系。
对 Kaiser Permanente 北加利福尼亚州于 2011 年 10 月至 2013 年 4 月期间进入产前护理的女性进行的队列研究的二次分析。
参与者/设置：参与者包括 1160 名成年孕妇。
不良饮食质量定义为健康饮食指数 2010 评分处于最低四分位数。
使用逻辑回归评估孕期抑郁（定义为在末次月经至完成食物频率问卷期间出现抑郁诊断、患者健康问卷评分≥10 分或使用抗抑郁药物）与整体及不同种族/民族间不良饮食质量的关系。使用 t 检验和线性回归分析评估孕期抑郁与 12 项健康饮食指数 2010 饮食成分中的每一项的关系。
159 名（14%）参与者有孕期抑郁。调整潜在混杂因素后，与无孕期抑郁的女性相比，有孕期抑郁的女性不良饮食质量的比值比为 1.80（95%CI 1.23 至 2.60）。不同种族/民族之间存在差异；调整潜在混杂因素后，仅在西班牙裔女性中，调整后的不良饮食质量比值比有统计学意义。与无孕期抑郁的西班牙裔女性相比，有孕期抑郁的西班牙裔女性不良饮食质量的比值比增加（比值比 2.66，95%CI 1.15 至 6.06）。与无孕期抑郁的女性相比，有孕期抑郁的女性摄入更多的空卡路里（来自固体脂肪、酒精和添加糖；计算酒精的阈值>13 g/1000 kcal）（P=0.01），且绿叶蔬菜和豆类（P<0.05）、总水果（P<0.01）和全水果（P<0.01）的摄入量较低。除空卡路里外，这些发现在调整潜在混杂因素后仍然存在。
研究结果表明，与无孕期抑郁的女性相比，有孕期抑郁的女性不良饮食质量的风险更高，这种关系在西班牙裔女性中更强。针对抑郁女性的营养咨询干预措施应考虑使用文化敏感的材料，并限制固体脂肪、酒精和添加糖中的空卡路里，鼓励多吃绿叶蔬菜、豆类和水果。
