title: Association of serum vitamin D with symptoms of depression and anxiety in early pregnancy.
abstract: Abstract Objective: To evaluate associations between early pregnancy 25-hydroxyvitamin D (25[OH]D) concentrations and antepartum depression and anxiety symptoms and potential modifiers thereof.
  
  
  METHODS
  In a pregnancy cohort (N=498), we examined cross-sectional associations of early pregnancy (mean=15.4 weeks gestation) serum 25[OH]D concentrations and depression and anxiety symptoms. Symptoms were measured using Depression, Anxiety, and Stress Scales (DASS-21) and Patient Health Questionnaire Depression Module (PHQ-9) instruments. Regression models were fit and effect modification by prepregnancy body mass index and leisure-time physical activity (LTPA) were assessed using interaction terms and stratified analyses.
  
  
  CONCLUSIONS
  Mean 25[OH]D concentration was 34.4 ng/mL. Approximately 12% had "moderate" anxiety (score ≥ 10) and depression (score ≥ 10) symptoms by DASS-21 Anxiety and PHQ-9 instruments, respectively. A 1 ng/mL lower 25[OH]D was associated with 0.043 and 0.040 higher DASS-21 Anxiety and PHQ-9 Scores (p-values=0.052 and 0.029, respectively). Participants in the lowest quartile of 25[OH]D (<28.9 ng/mL) had 1.11 higher PHQ-9 scores than those in the highest quartile (≥ 39.5 ng/mL, p<0.05). However, associations were attenuated and statistically insignificant in fully adjusted models. Inverse associations of 25[OH]D with depression symptoms were significant among participants who reported no LTPA, but not among women who reported any LTPA (interaction p=0.018).
  
  
  CONCLUSIONS
  Our study provides modest evidence for inverse cross-sectional associations of early pregnancy maternal vitamin D concentrations with antepartum depression symptoms. We also observed that these associations may be modified by physical activity.
authors.affiliation: 1 Department of Epidemiology, University of Washington , Seattle, Washington.
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Huang
authors.forename: Dodie
authors.initials: D
authors.lastname: Arnold
authors.forename: Chun-Fang
authors.initials: CF
authors.lastname: Qiu
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Miller
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Enquobahrie
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood / Q000523:psychology*; D015992:Body Mass Index; D002112:Calcifediol / Q000097:blood; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000523:psychology; D005260:Female; D006801:Humans; D007899:Leisure Activities; D009043:Motor Activity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000523:psychology*; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D057566:Self Report; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology / Q000523:psychology; D014861:Washington / Q000453:epidemiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002112:Calcifediol