title: HDL-cholesterol concentrations are inversely associated with Edinburgh Postnatal Depression Scale scores during pregnancy: results from a Brazilian cohort study.
abstract: Serum lipids have been associated with depression in the adult population; however, this association during pregnancy remains unclear. The aim of this study was to evaluate the association between serum lipids and depressive symptom scores during pregnancy. A prospective cohort of 238 pregnant women was followed at the 5th-13th, 20th-26th and 30th-36th weeks of gestation. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Serum concentrations (mg/dL) of triglycerides, total cholesterol, and low- and high-density lipoproteins (LDL-c; HDL-c) were the main exposures. Marital status (married/single), physical activity (active or very active/low or very low active), unplanned pregnancy (no/yes), pre-pregnancy BMI (<25/≥ 25 kg/m(2)), generalized anxiety disorder (no/yes) and current suicidal ideation (no/yes) were considered as potential confounders. Analyses were performed using linear mixed-effects models. The results showed that the EPDS mean score (95%CI) decreased with time during pregnancy trimesters [1st: 8.89 (95%CI = 8.28-9.51), 2nd: 7.32 (95%CI = 6.67-7.97) and 3rd: 7.08 (95%CI = 6.41-7.74)]. Suicidal ideation frequency at baseline was 18%. HDL-c concentrations were inversely associated with changes in EPDS score (β = -0.080, 95%CI = -0.157 to -0.002), while low or very low active women (β = 1.288, 95%CI = 0.630-1.946), with single marital status (β = 1.348, 95%CI = 0.163-2.534), unplanned pregnancy (β = 1.922, 95%CI = 0.714-3.131), generalized anxiety disorder (β = 2.139, 95%CI = 0.410-3.868) and current suicidal ideation (β = 1.927, 95%CI = 0.596-3.258) tended to have higher EPDS scores. No relationship was observed between other lipids and EPDS scores. HDL-c concentration was inversely associated with changes in depressive symptom scores during pregnancy after adjusting for socio-economic, demographic, behavioral, nutritional, biochemical and mental health disorders.
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil.
authors.forename: Marcella Martins Alves
authors.initials: MM
authors.lastname: Teofilo
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil.
authors.forename: Dayana Rodrigues
authors.initials: DR
authors.lastname: Farias
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil.
authors.forename: Thatiana de Jesus Pereira
authors.initials: Tde J
authors.lastname: Pinto
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil.
authors.forename: Ana Amélia Freitas
authors.initials: AA
authors.lastname: Vilela
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Pelotas Federal University, Rio Grande do Sul, RS, Brazil.
authors.forename: Juliana dos Santos
authors.initials: Jdos S
authors.lastname: Vaz
authors.affiliation: Panic and Respiration Laboratory, Institute of Psychiatry, Rio de Janeiro Federal University, National Institute for Translational Medicine (INCT-TM, CNPq), Rio de Janeiro, Brazil.
authors.forename: Antonio Egidio
authors.initials: AE
authors.lastname: Nardi
authors.affiliation: Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil. Electronic address: gilberto.kac@gmail.com.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Kac
mesh_terms: D000328:Adult; D001938:Brazil; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D013223:Statistics as Topic; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D002784:Cholesterol
keywords: Cohort studies; Depression; Lipids; Mental health; Pregnancy