Longitudinal association of maternal dietary patterns with antenatal depression: Evidence from the Chinese Pregnant Women Cohort Study.

Background: Limited evidence to show the longitudinal associations between maternal dietary patterns and antenatal depression (AD) from cohort studies across the entire gestation period.

Methods: Data came from the Chinese Pregnant Women Cohort Study. The qualitative food frequency questionnaire (Q-FFQ) and Edinburgh Postnatal Depression Scale (EPDS) were used to collect diet and depression data. Dietary patterns were derived by using factor analysis. Generalized estimating equation models were used to analyze the association between diet and AD.

Results: A total of 4139 participants finishing 3-wave of follow-up were finally included. Four constant diets were identified, namely plant-based, animal-protein, vitamin-rich and oily-fatty patterns. The prevalence of depression was 23.89%, 21.12% and 22.42% for the first, second and third trimesters. There were reverse associations of plant-based pattern (OR:0.85, 95%CI:0.75-0.97), animal-protein pattern (OR:0.85, 95%CI:0.74-0.99) and vitamin-rich pattern (OR:0.58, 95%CI:0.50-0.67) with AD, while a positive association between oily-fatty pattern and AD (OR:1.47, 95%CI:1.29-1.68). Except for the plant-based pattern, other patterns had linear trend relationships with AD (P < 0.05). Moreover, a 1-SD increase in vitamin-rich pattern scores was associated with a 20% lower AD risk (OR:0.80, 95%CI:0.76-0.84), while a 1-SD increase in oily-fatty pattern scores was associated with a 19% higher risk (OR:1.19, 95%CI:1.13-1.24). Interactions between dietary patterns and lifestyle habits were observed.

Limitations: The self-reported Q-FFQ and EPDS may cause recall bias.

Conclusions: There are longitudinal associations between maternal dietary patterns and antenatal depression. Our findings are expected to provide evidence for a dietary therapy strategy to improve or prevent depression during pregnancy.