Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort

• Published in: Comprehensive psychiatry Vol. 103; p. 152210
• Main Authors: van Lee, Linde, Chia, Airu, Phua, Desiree, Colega, Marjorelee, Padmapriya, Natarajan, Bernard, Jonathan Y., Cai, Shirong, Tham, Elaine K.H., Teoh, Oon Hoe, Goh, Daniel, Gooley, Joshua J., Gluckman, Peter D., Yap, Fabian, Shek, Lynette P.C., Godfrey, Keith M., Tan, Kok Hian, Chong, Yap-Seng, Müller-Riemenschneider, Falk, Broekman, Birit, Meaney, Michael, Chen, Helen, Chong, Mary F.F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2020; Elsevier Limited; Elsevier
• Subjects: Behavior; Depression - epidemiology; Depression, Postpartum - diagnosis; Depression, Postpartum - epidemiology; Depressive Disorder; Diet; Exercise; Female; Food; Fruits; Health care; Humans; Life Style; Lifestyle Behaviours; Lifestyles; Mental depression; Nutrition research; Perinatal care; Perinatal Depression; Physical Activity; Postpartum depression; Pregnancy; Questionnaires; Risk Factors; Singapore - epidemiology; Sleep; Sleep Quality; Smoking; Social support; Vitamin D; Womens health; Singapore; Pregnancy; Diet; Sleep Quality; Lifestyle Behaviours; Perinatal Depression; Physical Activity; Smoking
• ISSN: 0010-440X; 1532-8384; 1532-8384
• DOI: 10.1016/j.comppsych.2020.152210

Studies have identified lifestyle risk factors for perinatal depression, but none have examined the cumulative effect of these risk factors in pregnant women. We considered the following six factors during pregnancy: poor diet quality (Healthy eating index for Singapore pregnant women<median), poor sleep quality (global Pittsburgh sleep quality index score > 5), physical inactivity (<600 MET-minutes/week), vitamin D insufficiency (<50 nmol/l), smoking before or during pregnancy, and the perceived need for social support. Probable depression was assessed using the Edinburgh postnatal depression scale during pregnancy (>15) and at three months postpartum (≥13). Prevalence risk ratios were calculated with Poisson regressions while adjusting for potential confounders. Of 535 pregnant women, 207 (39%) had zero or one risk factor, 146 (27%) had two, 119 (22%) had three, 48 (9%) had four, and 15 (3%) had ≥5 risk factors at 26–28 weeks' gestation. These six lifestyle habits contributed to 32% of the variance in depressive symptoms during pregnancy. The prevalence of being probably depressed was 6.4 (95% CI 2.1, 19.8; ptrend < 0.001) for expecting women who had ≥4 risk factors compared to women who had ≤1 risk factor. No association was observed between the number of risk factors and depressive symptoms at 3 months postpartum (ptrend = 0.746). Pregnant women with ≥4 lifestyle risk factors showed a higher prevalence of depression during pregnancy, while no associations were observed for postpartum depression. This cohort is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2 •The cumulative effect of lifestyle factors on perinatal depression is unexplored.•Six lifestyle factors contributed 32% of the variance in prenatal depressive symptoms.•Pregnant women with ≥4 risk factors showed a higher risk of prenatal depression.•No association observed between prenatal risk factors and postnatal depression.