Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Guangzhou, Guangdong Province, China; Provincial Key Clinical Specialty of Woman and Child Health, No.9 Jinsui Road, Guangzhou, Guangdong Province, China.
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Guangzhou, Guangdong Province, China.
Clin Nutr. 2021 May;40(5):3485-3494. doi: 10.1016/j.clnu.2020.11.038. Epub 2020 Dec 8.
BACKGROUND & AIMS: Maternal depression has been reported to be harmful to maternal and child health, and nutrition-mental health interactions may play a key role, but evidence from longitudinal studies throughout pregnancy remains insufficient. This study aimed to investigate the association of maternal dietary patterns with depressive symptoms throughout pregnancy.
This study was based in the Born in Guangzhou Cohort Study. Dietary patterns were defined by cluster analysis based on validated food frequency questionnaires in mid-pregnancy. A healthy diet score was also developed based on predefined criteria of existing dietary guidelines. Depressive symptoms were measured by Self-rating Depression Scale (SDS) in both early and late pregnancy, with SDS scores ≥53 defined as having depressive symptoms. Associations of dietary patterns with SDS scores were examined by linear-mixed models; associations of dietary patterns with the odds of having depressive symptoms were examined by mixed-effects logistic models. The associations of the healthy diet score with both dietary patterns and depressive symptoms were also explored.
Six dietary patterns were identified in 17,430 pregnant women, namely 'Varied' (n = 3902, 22.4%), 'Vegetables' (n = 3269, 18.8%), 'Meats' (n = 2951, 16.9%), 'Cereals' (n = 2719, 15.6%), 'Milk' (n = 2377, 13.6%), and 'Fruits' (n = 2212, 12.7%). There were 19.3% and 15.7% of participants with depressive symptoms in early and late pregnancy, respectively. Compared with the 'Varied' pattern, all other patterns were associated with lower SDS scores during pregnancy except for 'Cereals' ('Vegetables': adjusted β [aβ] -0.78, 95% CI -1.16, -0.40; 'Meats': aβ -0.48, 95% CI -0.87, -0.09; 'Milk': aβ -0.52, 95% CI -0.94, -0.10; 'Fruits': aβ -0.85, 95% CI -1.27, -0.42). The 'Vegetables' (adjusted OR [aOR] 0.79, 95% CI 0.67, 0.93), 'Milk' (aOR 0.76, 95% CI 0.63, 0.91), and 'Fruits' (aOR 0.77, 95% CI 0.64, 0.93) patterns were associated with lower odds of having depressive symptoms during pregnancy than the 'Varied' pattern. Results for the healthy diet score revealed the healthiness of the 'Vegetables', 'Fruits', and 'Milk' patterns and supported an inverse association between healthy dietary patterns and depressive symptoms throughout pregnancy.
Diets rich in vegetables, fruits, nuts, and dairy products had an inverse association with depressive symptoms throughout pregnancy. Our findings add support to the existing dietary guidelines that healthy diets might also have potential benefits to maternal mental health.
已有研究表明，母亲的抑郁会对母婴健康造成危害，营养-心理健康的相互作用可能起着关键作用，但整个孕期的纵向研究证据仍然不足。本研究旨在调查整个孕期的孕妇膳食模式与抑郁症状之间的关系。
本研究基于广州出生队列研究。基于孕中期验证后的食物频率问卷，采用聚类分析方法来定义膳食模式。还根据现有膳食指南的既定标准制定了健康饮食评分。在孕早期和孕晚期均通过自评抑郁量表（SDS）来衡量抑郁症状，SDS 得分≥53 定义为有抑郁症状。采用线性混合模型检验膳食模式与 SDS 得分的相关性；采用混合效应逻辑回归模型检验膳食模式与抑郁症状发生的比值比（OR）的相关性。还探讨了健康饮食评分与膳食模式和抑郁症状之间的关系。
在 17430 名孕妇中识别出 6 种膳食模式，分别是“多样化”（n=3902，22.4%）、“蔬菜”（n=3269，18.8%）、“肉类”（n=2951，16.9%）、“谷物”（n=2719，15.6%）、“奶类”（n=2377，13.6%）和“水果”（n=2212，12.7%）。在孕早期和孕晚期分别有 19.3%和 15.7%的参与者有抑郁症状。与“多样化”模式相比，除“谷物”模式外，其他模式在孕期均与较低的 SDS 得分相关，除“谷物”模式外（“蔬菜”：调整后的 β [aβ]值为-0.78，95%CI：-1.16，-0.40；“肉类”：aβ值为-0.48，95%CI：-0.87，-0.09；“奶类”：aβ值为-0.52，95%CI：-0.94，-0.10；“水果”：aβ值为-0.85，95%CI：-1.27，-0.42）。“蔬菜”（调整后的 OR [aOR]值为 0.79，95%CI：0.67，0.93）、“奶类”（aOR 值为 0.76，95%CI：0.63，0.91）和“水果”（aOR 值为 0.77，95%CI：0.64，0.93）模式与孕期发生抑郁症状的几率较低有关。健康饮食评分的结果表明“蔬菜”、“水果”和“奶类”模式的健康程度，并支持健康饮食模式与整个孕期抑郁症状之间存在反比关系。
富含蔬菜、水果、坚果和乳制品的饮食与整个孕期的抑郁症状呈负相关。我们的研究结果为现有的饮食指南提供了更多支持，即健康饮食可能对产妇的心理健康也有潜在益处。
