Depressive Symptoms Associated with Decreased Choline Intake in Lactating Mothers of Preterm Infants

Background/Objectives: Adequate choline intake is critical across the peripartum period for optimal maternal-offspring health. Maternal depressive symptoms are associated with poor dietary quality, but the relationship between postpartum depression and choline intake in lactating mothers of preterm infants, a period of heightened intake requirements, has not been previously explored. Methods: Lactating mothers of hospitalized preterm infants (born ≤36 weeks gestational age) completed depression screening with the Edinburgh Postnatal Depression Scale (EPDS) and a dietary choline intake survey. Mann-Whitney U tests compared maternal choline intake based on EPDS screen status (low-risk or at-risk for depression). Multivariable linear regression assessed the relationship between maternal depressive symptoms and choline intake. Results: EPDS screens were at-risk in 18 (42%) of the 43 participants. Median choline intake across the cohort was <50% of recommended dietary intake (median [IQR] 221 [147, 308] mg), with lower intake in mothers with at-risk EPDS screens compared to low-risk screens (median [IQR] score: 156 [105, 218] mg vs. 298 [196, 357] mg, p < 0.01). In multivariable linear regression, EPDS score was negatively associated with maternal choline intake (β [95% CI] = -0.13 [-0.26, -0.01], p = 0.03). Conclusions: Dietary choline intake is low among lactating mothers of preterm infants, particularly those with postpartum depressive symptoms.