title: Dietary patterns during pregnancy and the risk of postpartum depression: the mother-child 'Rhea' cohort in Crete, Greece.
abstract: 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).
  
  
  METHODS
  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.
  
  
  METHODS
  Heraklion, Crete, Greece, 2007-2010.
  
  
  METHODS
  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: β-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.
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece. lchatzi@med.uoc.gr
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Melaki
authors.forename: Katerina
authors.initials: K
authors.lastname: Sarri
authors.forename: Ioanna
authors.initials: I
authors.lastname: Apostolaki
authors.forename: Theano
authors.initials: T
authors.lastname: Roumeliotaki
authors.forename: Vaggelis
authors.initials: V
authors.lastname: Georgiou
authors.forename: Maria
authors.initials: M
authors.lastname: Vassilaki
authors.forename: Antonis
authors.initials: A
authors.lastname: Koutis
authors.forename: Panos
authors.initials: P
authors.lastname: Bitsios
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000328:Adult; D000818:Animals; D003611:Dairy Products; D019052:Depression, Postpartum / Q000453:epidemiology*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D005518:Food Preferences; D005638:Fruit; D006115:Greece; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008137:Longitudinal Studies; D008460:Meat; D015999:Multivariate Analysis; D000069463:Olive Oil; D010349:Patient Compliance; D010938:Plant Oils; D011247:Pregnancy; D011248:Pregnancy Complications; D039401:Prenatal Nutritional Physiological Phenomena; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables; D055815:Young Adult
chemical_list: D000069463:Olive Oil; D010938:Plant Oils