Abstract
Background
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.
Objective
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.
Design
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.
Main outcome measures
Poor diet quality was defined as a Healthy Eating Index 2010 score in the lowest quartile.
Statistical analyses performed
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.
Results
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.
Conclusions
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.
Keywords
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Biography
L. A. Avalos is a research scientist II, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
M. Hedderson is a research scientist II, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
B. Caan is a research scientist III, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
D.-K. Li is a research scientist III, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
N. Nance is a consulting data analyst, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
Y. Zhu is a research scientist I, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
C. Quesenberry is an associate director, Division of Research, Kaiser Permanente, Oakland, CA.
Biography
R. J. Hyde is a data scientist, Facebook, Menlo Park, CA; at the time of the study, she was a consulting data analyst, Division of Research, Kaiser Permanente, Oakland, CA.
Article info
Publication history
Published online: February 13, 2020
Accepted:
December 16,
2019
Received:
May 9,
2019
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study was supported by a career development award to L. A. Avalos (K01MH103444) by the National Institute of Mental Health. Y. Zhu was also supported by National Institutes of Health grants 5K12HD52163 and K01DK120807. This study was also partially funded by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under R40MC21515.
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© 2020 by the Academy of Nutrition and Dietetics.
