Zhang Zhitan, Huang Cong, Zhang Hua, Huang Xun, Zhong Zixin, Xia Fan, He Junwei, Ma Yuxin, Liu Chang, Tan Hongzhuan, Deng Jing, Chen Mengshi, Lei Xianyang
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha 410013, China.
Qingdao Huangdao District Market Supervision Administration, No. 627 Binhai Avenue, Qingdao West Coast New District, Qingdao 266427, China.
Nutrients. 2025 Apr 24;17(9):1434. doi: 10.3390/nu17091434.
The aim of this study was to assess the association between the Dietary Inflammatory Index (DII) and depression in mid-pregnancy and the mediating effect of sleep quality according to the Edinburgh Postnatal Depression Scale (EPDS).
This was a cross-sectional study conducted in 2017-2019 at a maternal and child health centre in Hunan Province. After applying the inclusion and exclusion criteria, 749 pregnant women were finally included in this study. A multifactorial logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the mid-pregnancy DII on mid-pregnancy depression. Restricted cubic spline plot regression was used to analyse the nonlinearity of the association between DII and depression. Mediation effects models were used to analyse the mediating role of sleep quality.
The average age of the 749 pregnant women was 29.42 ± 4.22 years. The mean mid-pregnancy DII was 0.21 ± 1.48 and the overall presenting rate of mid-pregnancy depression was 9.35%. In the final model adjusted for covariates such as maternal age, race, mid-pregnancy body mass index (BMI), occupation, literacy, and mean monthly income, the risk of depression in mid-pregnancy DII Q3 was 3.51 times higher than the mid-pregnancy DII Q4 [OR = 3.51, 95% CI = (1.45 to 8.53)]. A high DII in mid-pregnancy was a risk factor for depression in mid-pregnancy ( < 0.05). Restricted cubic spline plot regression analyses showed that the association between mid-pregnancy DII and depression could not be considered nonlinear. Sleep quality may play a mediating role between DII and depression in pregnant women in mid-pregnancy (25.26% of the total effect).
A high DII is a risk factor for mid-pregnancy depression. The Dietary Inflammatory Index can influence depression not only directly but also indirectly through the mediating effect of sleep quality on mid-pregnancy depression.
本研究旨在评估孕期中期饮食炎症指数（DII）与抑郁症之间的关联，以及根据爱丁堡产后抑郁量表（EPDS）评估睡眠质量的中介作用。
这是一项于2017 - 2019年在湖南省一家妇幼保健中心开展的横断面研究。应用纳入和排除标准后，最终749名孕妇被纳入本研究。采用多因素逻辑回归模型估计孕期中期DII对孕期中期抑郁症的比值比（OR）和95%置信区间（95%CI）。使用受限立方样条图回归分析DII与抑郁症之间关联的非线性。中介效应模型用于分析睡眠质量的中介作用。
749名孕妇的平均年龄为29.42±4.22岁。孕期中期DII的平均值为0.21±1.48，孕期中期抑郁症的总体发生率为9.35%。在对孕妇年龄、种族、孕期中期体重指数（BMI）、职业、文化程度和月平均收入等协变量进行调整的最终模型中，孕期中期DII Q3组的抑郁风险比孕期中期DII Q4组高3.51倍[OR = 3.51，95%CI =（1.45至8.53）]。孕期中期高DII是孕期中期抑郁症的一个危险因素（<0.05）。受限立方样条图回归分析表明，孕期中期DII与抑郁症之间的关联不能被认为是非线性的。睡眠质量可能在孕期中期孕妇的DII与抑郁症之间起中介作用（占总效应的25.26%）。
高DII是孕期中期抑郁症的一个危险因素。饮食炎症指数不仅可以直接影响抑郁症，还可以通过睡眠质量对孕期中期抑郁症的中介作用间接影响抑郁症。
Zotero 插件