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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
  1. Abbreviations: 95%CI, 95% confidence interval, CCEI Crown-Crisp Experiential Index, CES-D Center for Epidemiologic Studies Depression Scale, DHQ Diet History Questionnaire, EPDS Edinburgh Postnatal Depression Scale, FFQ Food frequency questionnaire, NOS Newcastle-Ottawa Scale, OR Odds ratio, PR Prevalence ratio, PRIME-MD Primary Care Evaluation of Mental Disorders, STAI State-Trait Anxiety Inventory