Association of Maternal depression with diet: A systematic review

This review was conducted to explore the bi-directional association of maternal depression with diet. This link is hypothesized because the mental health of pregnant women may adversely affect their nutritional intake; or inversely, that poor nutritional intake during pregnancy may cause mental health issues. Seven electronic databases were searched to retrieve relevant peer-reviewed articles published during 2000-2018. Primary research studies published in English that evaluated the relationship between maternal antenatal and postnatal depression with dietary intake were selected. We screened 1585 articles, of which 13 met the inclusion criteria. These included five cohort studies (including two birth cohorts) and eight cross-sectional studies representing a total of 12,742 participants altogether. Studies were divided into five groups depending on whether they analyzed all nutrients, micronutrients, dietary patterns, dietary behavior or intake of fish and vegetables. The studies exploring the association of depression with dietary patterns found a protective association of "Health Conscious", "Healthy" and "Brazilian" diet patterns with maternal depression. The group of studies which analyzed all nutrients, found an inverse relationship of the "Healthy Eating Index" with maternal depression. Deficiency of calcium, iron, and folate were also associated with maternal depression. Prenatal and early postpartum eating attitudes and BMI were found as predictors of depressive symptoms in the late post-partum period in a diet behavior study. It is important to identify modifiable lifestyle risk factors which may contribute to maternal depression. A limitations of our review is the absence of meta-analysis which was not possible due to heterogeneity of the studies.