Dietary patterns during pregnancy and the risk of postpartum depression: the mother-child 'Rhea' cohort in Crete, Greece

Objective: To identify and describe dietary patterns in a cohort of pregnant women, and investigate whether dietary patterns during pregnancy are related to postpartum depression (PPD). Design: The study uses data from the prospective mother-child cohort 'Rhea' study. Pregnant women completed an FFQ in mid-pregnancy and the Edinburg Postpartum Depression Scale (EPDS) at 8-10 weeks postpartum. Dietary patterns during pregnancy ('health conscious', 'Western') were identified using principal component analysis. Associations between dietary patterns categorized in tertiles and PPD symptoms were investigated by multivariable regression models after adjusting for confounders. Setting: Heraklion, Crete, Greece, 2007-2010. Subjects: A total of 529 women, participating in the 'Rhea' cohort. Results: High adherence to a 'health conscious' diet, characterized by vegetables, fruit, pulses, nuts, dairy products, fish and olive oil, was associated with lower EPDS scores (highest v. lowest tertile: beta-coefficient = -1.75, P = 0.02). Women in the second (relative risk (RR) = 0.52, 95% CI 0.30, 0.92) or third tertile (RR = 0.51, 95% CI 0.25, 1.05) of the 'health conscious' dietary pattern were about 50% less likely to have high levels of PPD symptoms (EPDS >= 13) compared with those in the lowest tertile. Conclusions: This is the first prospective study showing that a healthy diet during pregnancy is associated with reduced risk for PPD. Additional longitudinal studies and trials are needed to confirm these findings.