Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States.
Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States.
J Nutr. 2023 Oct;153(10):3041-3048. doi: 10.1016/j.tjnut.2023.08.022. Epub 2023 Aug 19.
Prenatal depression affects ∼12% of pregnant women in the United States and is associated with an increased risk of adverse birth outcomes and maternal mortality. Adherence to a healthy dietary pattern may reduce and/or protect against depressive symptoms.
To investigate the relationship between adherence to a Mediterranean diet and depressive symptoms among pregnant women in the United States.
We used data from the National Health and Nutrition Examination Survey (2005-2018, N = 540) and included pregnant women aged 18-44 y with a positive urine pregnancy test. The Mediterranean diet score (aMED) was calculated from 1 24-h recall; aMED typically ranges from 0-9, but in these analyses, it ranged from 0-8 because alcohol was not included. The aMED score was dichotomized as high (>3) compared with low (≤3). The Patient Health Questionnaire-9 (PHQ-9), which measures depressive symptoms, was dichotomized as lower compared with higher (PHQ-9 score ≥10), based on the clinical cutoff for patient referral. Our primary model employed logistic regression to investigate the association between aMED adherence and high depressive symptoms when controlling for socio-demographics (age, racial/ethnicity, education, poverty, and relationship status), total calories, and prepregnancy body mass index (kg/m). We also modeled the PHQ-9 score as a continuous variable using a random-effects model.
About 5% of pregnant women had moderate to severe depressive symptoms, and 45% were highly adherent to a Mediterranean diet. Higher adherence to a Mediterranean diet was associated with lower odds of depressive symptoms (odds ratio: 0.31, 95% confidence interval: 0.10, 0.98). Results were not significant for the continuous PHQ-9 score (β: -0.30; 95% confidence interval: -0.90, 0.30).
Adherence to a Mediterranean diet may have the potential to lower depressive symptoms among pregnant women; however, these results should be interpreted with caution. Nevertheless, considering the public health significance of promoting mental wellness among pregnant women, this relationship merits further examination using experimental designs.
产前抑郁症影响了美国约 12%的孕妇，与不良生育结局和产妇死亡率的风险增加有关。遵循健康的饮食模式可能会减轻和/或预防抑郁症状。
研究美国孕妇对地中海饮食的依从性与抑郁症状之间的关系。
我们使用了来自全国健康和营养检查调查（2005-2018 年，N=540）的数据，纳入了尿妊娠试验阳性的 18-44 岁孕妇。地中海饮食评分（aMED）是根据 1 次 24 小时回顾得出的；aMED 通常在 0-9 之间，但在这些分析中，由于不包括酒精，其范围在 0-8 之间。aMED 评分分为高（>3）和低（≤3）两类。基于患者转诊的临床临界值，患者健康问卷-9（PHQ-9）将抑郁症状分为低（PHQ-9 评分<10）和高（PHQ-9 评分≥10）两类。我们的主要模型采用逻辑回归来调查在控制社会人口统计学因素（年龄、种族/民族、教育、贫困和关系状况）、总卡路里和孕前体重指数（kg/m）后，aMED 依从性与高抑郁症状之间的关系。我们还使用随机效应模型将 PHQ-9 评分作为连续变量进行建模。
约 5%的孕妇有中度至重度抑郁症状，45%的孕妇高度依从地中海饮食。较高的地中海饮食依从性与较低的抑郁症状几率相关（比值比：0.31，95%置信区间：0.10，0.98）。对于连续的 PHQ-9 评分，结果不显著（β：-0.30；95%置信区间：-0.90，0.30）。
地中海饮食的依从性可能有降低孕妇抑郁症状的潜力；然而，这些结果应谨慎解释。尽管如此，考虑到促进孕妇心理健康的公共卫生意义，这种关系值得进一步通过实验设计进行研究。
