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Airaksinen V, Ruohomäki A, Hantunen S, Keski-Nisula L, Luojus MK, Pekkanen J, Tuomainen TP, Heinonen S, Pasanen M, Lehto SM. Longitudinal Analyses of Diet Quality and Maternal Depressive Symptoms During Pregnancy: The Kuopio Birth Cohort Study. J Acad Nutr Diet 2023; 123:77-86.e4. [PMID: 35605960 DOI: 10.1016/j.jand.2022.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Depression and diet quality appear to be associated in the general population. Nevertheless, little is known about their relationship among pregnant females. OBJECTIVE The aims of this study were first, to investigate longitudinally whether or not diet quality is associated with depressive symptoms during pregnancy; second, to examine whether or not variation in diet quality during pregnancy predicts variation in depressive symptoms; and third, to explore how individual dietary components are associated with depressive symptoms. DESIGN A longitudinal secondary analysis of the Kuopio Birth Cohort Study in eastern Finland was conducted. Data were collected from pregnant females during the first and third trimesters of pregnancy. PARTICIPANTS/SETTING The participants were 1,362 pregnant females who entered the study between 2012 and 2017. MAIN OUTCOME MEASURES Depressive symptoms, as measured with the Edinburgh Postnatal Depressive Scale during the first and third trimesters of pregnancy were used as continuous variables. STATISTICAL ANALYSES PERFORMED The main analyses consisted of linear mixed model analyses adjusted for potential confounders to longitudinally assess the association between diet quality as measured by the Healthy Eating Index-2015, calculated using data from a food frequency questionnaire completed during the first trimester and third trimester, and depressive symptoms during the study period. An exploratory set of linear mixed models was also used to longitudinally assess the associations between selected individual food frequency questionnaire food groups and depressive symptoms. RESULTS Descriptive analyses revealed that 12.3% of the participants had clinically relevant levels of depressive symptoms (ie, Edinburgh Postnatal Depressive Scale score ≥10) during either the first or third trimester. Longitudinal modeling suggested that depressive symptoms in pregnant females tend to remain stable throughout pregnancy. Females with a poorer quality diet already displayed higher levels of depressive symptoms during the first trimester of pregnancy (β = -.038 ± .016; P = 0.022). Variation in diet quality did not predict variation in depressive symptoms over the course of pregnancy (β = -9.741 × 10-5 ± .001; P = 0.869). CONCLUSIONS Females entering pregnancy with a poorer quality diet also displayed higher levels of depressive symptoms compared with females with a higher quality diet at the beginning of pregnancy, and this association remained constant throughout pregnancy. Further research is needed to assess the direction and the potential causality of the observed associations between diet quality and depressive symptoms.
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Affiliation(s)
- Ville Airaksinen
- Department of Psychiatry, University of Helsinki, Helsinki, Finland; Institute of Clinical Medicine, Department of Psychiatry, University of Eastern Finland, Kuopio, Finland.
| | - Aleksi Ruohomäki
- Institute of Clinical Medicine, Department of Psychiatry, University of Eastern Finland, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Maria Katariina Luojus
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Juha Pekkanen
- Environment Health Unit, National Institute for Health and Welfare, Kuopio, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland
| | - Markku Pasanen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Soili Marianne Lehto
- Department of Psychiatry, University of Helsinki, Helsinki, Finland; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health Services, R&D Department, Akershus University Hospital, Lørenskog, Norway
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Ruohomäki A, Toffol E, Airaksinen V, Backman K, Voutilainen R, Hantunen S, Tuomainen TP, Lampi J, Kokki H, Luoma I, Kumpulainen K, Heinonen S, Keski-Nisula L, Pekkanen J, Pasanen M, Lehto SM. The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months: A prospective cohort study. J Psychiatr Res 2021; 136:388-397. [PMID: 33640540 DOI: 10.1016/j.jpsychires.2021.02.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
The infants of mothers with elevated depressive symptoms (EDS) postpartum appear to be at increased risk of somatic health problems during their first 12 months of life in low- and lower-middle-income countries. However, in higher-income countries, knowledge of this association is scarce. We sought to examine whether maternal reports of infant health problems, adherence to vaccination schedules and analgesic supply to the infant during the first 12 months of life differ between mothers with and without postpartum EDS. Altogether, 969 women who were enrolled in the Kuopio Birth Cohort study (www.kubico.fi) during 2012-2017 were included in this investigation. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale during pregnancy (1st and/or 3rd trimester) and at eight weeks postpartum. Infant health data were collected as a part of a 12-month online follow-up questionnaire for mothers and were based on self-reports of either maternal observations or physician-determined diagnoses. Postpartum EDS were associated with a 2- to 5-fold increased likelihood of abnormal crying and paroxysmal wheezing (based on parental observations), as well as gastroesophageal reflux and food allergy (based on physician-determined diagnoses). Mothers with postpartum EDS also supplied their infants with analgesic medication for longer periods. Adherence to vaccination schedules was similar between the examined groups. In conclusion, infants of mothers with postpartum EDS may be more likely to experience health problems or to be perceived by their mother as having health problems, and thus receive more medications.
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Affiliation(s)
- Aleksi Ruohomäki
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland.
| | - Elena Toffol
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland
| | - Ville Airaksinen
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Katri Backman
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Raimo Voutilainen
- Institute of Clinical Medicine / Pediatrics, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Jussi Lampi
- Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Hannu Kokki
- Institute of Clinical Medicine / Anaesthesiology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Ilona Luoma
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Department of Child Psychiatry, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland
| | - Kirsti Kumpulainen
- Institute of Clinical Medicine / Child Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, University of Helsinki, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Obstetrics and Gynaecology, Helsinki University Hospital, P.O. Box 140, FI, 00029, Helsinki, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, P.O. Box 100, FI, 70029, Kuopio, Finland; Institute of Clinical Medicine / Obstetrics and Gynaecology, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Juha Pekkanen
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, P.O. Box 20, FI, 00014, Helsinki, Finland; Department of Health Security, National Institute for Health and Welfare, P.O. Box 95, FI, 70701, Kuopio, Finland
| | - Markku Pasanen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, P.O. Box 1627, FI, 70211, Kuopio, Finland; Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, FI, 00014, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, FI, 00014, Helsinki, Finland
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