Table 1 Characteristics of the studies included in the systematic review (n = 10)
From: Systematic review of the association between dietary patterns and perinatal anxiety and depression
Study characteristics | Participant characteristics | Exposure | Outcomes | Main results | Quality | |||
|---|---|---|---|---|---|---|---|---|
Study ID | Study design and Country | N / age | Gestational age during the selection period | Time assessed/ Dietary survey/ Methods of identification of dietary patterns/ identified dietary patterns | Time assessed/ Outcome/ Tool (Prevalence) | Associations between dietary patterns and depression and anxiety | NOS score | Global rating |
Paskulin et al. (2017) [26] | Cross-sectional/ Brazil | 712 / 24.6 ± 3.4 years | 16 to 36 weeks | Pregnancy/ FFQ/ Cluster analysis/ Restricted, varied, and common-Brazilian pattern | Pregnancy/ Depression – PRIME-MD (21.6%) Anxiety – PRIME-MD (19.8%) | Common-Brazilian pattern (+) depression (RP = 1.62; 95% IC = 1.15, 2.30, p < 0.01). There was no statistically significant association between the restricted (western) and varied and anxiety during pregnancy. | 7 | Good |
Baskin et al. (2017) [27] | Cohort / Australia | 167 / 30.6 ± 4.3 years | 10 to 16 weeks | Pregnancy/ FFQ/ Factor analysis/ Healthy, and unhealthy patterns | Pregnancy and post-partum/ Depressive symptoms–EPDS (28%) | Unhealthy pattern identified in 32.89 (SD = 0.89) week of gestation: (+) Depressive symptoms in 16.70 (SD = 0.91) week of gestation = (β = 0.17, 95% CI = 0.32, 0.02, p < 0.05) and in 32.89 (SD = 0.89)) week of gestation = (β = 0.19, 95% CI = 0.04, 0.34, p < 0.05). There was no statistically significant association between healthy pattern with pregnancy and postpartum depressive symptoms, and between unhealthy pattern and postpartum depressive symptoms. | 8 | Good |
Vilela et al. (2015) [28] | Cohort / Brazil | 207 / 20 to 40 years | 5 to 13 weeks | 6 months prior to pregnancy/ FFQ/ Factor analysis/ common-Brazilian, healthy, and processed (western) patterns | Second and third pregnancy trimesters and at postpartum/ Anxiety/ STAI (second trimester: 40.4%, third trimester: 40.5% and postpartum: 37.2%. | Common-Brazilian pattern: (−) postpartum anxiety (β = − 1200, 95% CI = − 2.220, − 0.181, P < 0.02). Healthy pattern: (−) postpartum anxiety (β = − 1290, 95% CI = − 2438, − 0,134, P < 0.03). There was no statistically significant association between common-Brazilian and healthy patterns and anxiety in pregnancy, and the processed (western) pattern and pregnancy and postpartum anxiety. | 8 | Good |
Vilela et al. (2014) [29] | Cohort / Brazil | 248 / 26.7 years | 5 to 13 weeks | 6 months prior to pregnancy/ FFQ/ Factor analysis/ common-Brazilian, healthy, and processed (western) patterns. | Pregnancy/ Depressive symptoms –EPDS (not reported) | Healthy pattern: (−) Depressive symptoms (β = − 0.723, 95% CI: − 1.277, − 0.169, P = 0.011). There was no statistically significant association between common-Brazilian and processed (western) patterns and depressive symptoms in pregnancy. | 8 | Good |
Vaz et al. (2013) [30] | Cross-sectional/ United Kingdom | 9.530 / < 25 years: 2.078 ≥25 years: 7.452 | 32nd week of gestation | Pregnancy/ FFQ/ Factor analysis/ Health-conscious, traditional, processed, confectionery, and vegetarian patterns. | Pregnancy/ Anxiety/ CCEI/ < 25 years: 21.9%; ≥25 years: 14.6%. | Health conscious pattern: (−) anxiety (OR = 0.77; 95% CI = 0.65, 0.93, P < 0.01). Traditional pattern: (−) anxiety (OR = 0.84; 95% IC = 0.73, 0.97, P < 0,01). Confectionery pattern: (+) anxiety (OR = 1.24; 95% CI = 1:06, 1:45, P < 0.01), not in the model adjusted for maternal intake of n-3 PUFA fatty acids. Vegetarian Pattern: (+) anxiety (OR = 1.25; 95% CI: 1.08, 1.44, P < 0.01). There was no statistically significant association between processed pattern and anxiety in pregnancy. | 7 | Good |
Okubo et al. (2011) [31] | Cohort / Japan | 865 / 29.9 ± 4.0 years | 20th week of gestation | Pregnancy/ Food history/ Factor analysis/ Healthy, western, and Japanese patterns. | Postpartum/ Depressive symptoms –EPDS (14%) | There was no statistically significant association between healthy, western and Japanese patterns and postpartum depressive symptoms. | 7 | Good |
Chatzil et al. (2011) [32] | Cohort / Greece | 529 / no presented | 6th month | Pregnancy/ FFQ/ Factor analysis/ Western, and health conscious. | Postpartum/ depressive symptoms –EPDS (14%) | Health conscious pattern: (−) depressive symptoms –third tertile versus lowest tertile of the ‘health conscious’ dietary pattern (RR = 0.51, 95% CI 0.25, 1.05). There was no statistically significant association between western pattern and postpartum depressive symptoms. | 7 | Good |
Maracy et al. (2014) [33] | Cross-sectional/ Iran | 770 | 10 days to 3 months postpartum | Evaluated in postpartum but referring to gestation / FFQ/ Factor analysis/ Mixed, semi-healthy and fruits, and vegetables patterns. | Postpartum/ Depressive symptoms– EPDS/ 34.6% | Semi-healthy dietary pattern: (−) Depressive symptoms (OR = 0.60, 95%CI: 0.38, 0.94; P = 0.05). Fruit and vegetable pattern: (−) Depressive symptoms (OR = 0.52, 95%CI: 0.32, 0.84; P = 0.004). There was no statistically significant association between mixed pattern with postpartum depressive symptoms. | 7 | Good |
Teo et al. (2018) [34] | Cohort / Singapure | 490 / 31.4 ± 4.8 | 26 to 28 weeks | Evaluated in postpartum (3 weeks post-delivery)/ 3-day food diaries/ Factor analisys/ Traditional-Chinese-Confinement, Traditional-Indian-Confinement, The Eat-Out diet, and Soup-Vegetables-Fruits. | Three months postpartum/ Depression and anxiety/ EPDS and STAI | Traditional-Indian-Confinement diet (depressive symptoms) = − 0.62 EPDS scores per SD increase in TIC score; 95% CI = − 1.16, − 0.09), p = 0.02. There was no statistically significant association between Traditional-Chinese-Confinement, The Eat-Out diet, and Soup-Vegetables-Fruits with depression. Soup-Vegetables-Fruits (−) anxiety (− 1.49 STAI-state subscale scores per SD increase in SVF score; 95% CI = − 2.56, − 0.42), p = 0.006). There was no statistically significant association between Traditional-Chinese-Confinement, Traditional-Indian-Confinement, The Eat-Out diet with anxiety. | 8 | Good |
Miyakea et al. (2018) [35] | Cross-sectional/Japan | 1744/ 31.2 ± 4.3 | 5 to 39 weeks | Pregnancy/ DHQ/ Factor analysis/ Healthy, Japanese, and Westernpattern | Pregnancy/ Depressive symptoms/CES-D scale/ 19.2% | Japanese pattern (−) Depressive symptoms (third vs first quartile – PRs = 0.76; 95% CIs = 0.58–0.998, P for trend = 0.008 and fourth vs first quartile – PRs = 0.72; 95% CIs = 0.55–0.94, P for trend = 0.008). Healthy pattern (−) Depressive symptoms (second vs first quartile – PRs = 0.70; 95% CIs = 0.55–0.89; P < 0.0001; third vs first quartile – PRs = 0.48; 95% CIs = 0.36–0.64; P < 0.0001, and fourth vs first quartile – PRs = 0.56; 95% CIs = 0.43–0.73; P < 0.0001). There was no statistically significant association between the western patternand depressive symptomsduring pregnancy. | 5 | Good |