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Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort

Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort
Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort

Background: Studies have identified lifestyle risk factors for perinatal depression, but none have examined the cumulative effect of these risk factors in pregnant women. Methods: We considered the following six factors during pregnancy: poor diet quality (Healthy eating index for Singapore pregnant women<median), poor sleep quality (global Pittsburgh sleep quality index score > 5), physical inactivity (<600 MET-minutes/week), vitamin D insufficiency (<50 nmol/l), smoking before or during pregnancy, and the perceived need for social support. Probable depression was assessed using the Edinburgh postnatal depression scale during pregnancy (>15) and at three months postpartum (≥13). Prevalence risk ratios were calculated with Poisson regressions while adjusting for potential confounders. Results: Of 535 pregnant women, 207 (39%) had zero or one risk factor, 146 (27%) had two, 119 (22%) had three, 48 (9%) had four, and 15 (3%) had ≥5 risk factors at 26–28 weeks' gestation. These six lifestyle habits contributed to 32% of the variance in depressive symptoms during pregnancy. The prevalence of being probably depressed was 6.4 (95% CI 2.1, 19.8; p trend < 0.001) for expecting women who had ≥4 risk factors compared to women who had ≤1 risk factor. No association was observed between the number of risk factors and depressive symptoms at 3 months postpartum (p trend = 0.746). Conclusion: Pregnant women with ≥4 lifestyle risk factors showed a higher prevalence of depression during pregnancy, while no associations were observed for postpartum depression. Clinical trial registration: This cohort is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2

Diet, Lifestyle Behaviours, Perinatal Depression, Physical Activity, Pregnancy, Sleep Quality, Smoking
0010-440X
van Lee, Linde
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Chia, Airu
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Phua, Desiree
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Colega, Marjorelee T.
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Padmapriya, Natarajan
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Bernard, Jonathan Y.
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Cai, Shirong
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Tham, Elaine KH
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Teoh, Oon Hoe
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Goh, Daniel Y.T.
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Gooley, Joshua J.
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Gluckman, Peter D.
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Yap, Fabian
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Shek, Lynette P.
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Godfrey, Keith
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Tan, Kok Hian
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Chong, Yap-Seng
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Müller-Riemenschneider, Falk
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Broekman, Birit
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Meaney, Michael
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Chen, Helen
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Chong, Mary Foong-Fong
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van Lee, Linde
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Chia, Airu
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Phua, Desiree
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Colega, Marjorelee T.
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Padmapriya, Natarajan
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Bernard, Jonathan Y.
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Cai, Shirong
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Tham, Elaine KH
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Teoh, Oon Hoe
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Goh, Daniel Y.T.
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Gooley, Joshua J.
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Gluckman, Peter D.
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Yap, Fabian
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Shek, Lynette P.
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Godfrey, Keith
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Tan, Kok Hian
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Chong, Yap-Seng
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Müller-Riemenschneider, Falk
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Broekman, Birit
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Meaney, Michael
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Chen, Helen
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Chong, Mary Foong-Fong
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van Lee, Linde, Chia, Airu, Phua, Desiree, Colega, Marjorelee T., Padmapriya, Natarajan, Bernard, Jonathan Y., Cai, Shirong, Tham, Elaine KH, Teoh, Oon Hoe, Goh, Daniel Y.T., Gooley, Joshua J., Gluckman, Peter D., Yap, Fabian, Shek, Lynette P., Godfrey, Keith, Tan, Kok Hian, Chong, Yap-Seng, Müller-Riemenschneider, Falk, Broekman, Birit, Meaney, Michael, Chen, Helen and Chong, Mary Foong-Fong (2020) Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort. Comprehensive Psychiatry, 103, [152210]. (doi:10.1016/j.comppsych.2020.152210).

Record type: Article

Abstract

Background: Studies have identified lifestyle risk factors for perinatal depression, but none have examined the cumulative effect of these risk factors in pregnant women. Methods: We considered the following six factors during pregnancy: poor diet quality (Healthy eating index for Singapore pregnant women<median), poor sleep quality (global Pittsburgh sleep quality index score > 5), physical inactivity (<600 MET-minutes/week), vitamin D insufficiency (<50 nmol/l), smoking before or during pregnancy, and the perceived need for social support. Probable depression was assessed using the Edinburgh postnatal depression scale during pregnancy (>15) and at three months postpartum (≥13). Prevalence risk ratios were calculated with Poisson regressions while adjusting for potential confounders. Results: Of 535 pregnant women, 207 (39%) had zero or one risk factor, 146 (27%) had two, 119 (22%) had three, 48 (9%) had four, and 15 (3%) had ≥5 risk factors at 26–28 weeks' gestation. These six lifestyle habits contributed to 32% of the variance in depressive symptoms during pregnancy. The prevalence of being probably depressed was 6.4 (95% CI 2.1, 19.8; p trend < 0.001) for expecting women who had ≥4 risk factors compared to women who had ≤1 risk factor. No association was observed between the number of risk factors and depressive symptoms at 3 months postpartum (p trend = 0.746). Conclusion: Pregnant women with ≥4 lifestyle risk factors showed a higher prevalence of depression during pregnancy, while no associations were observed for postpartum depression. Clinical trial registration: This cohort is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2

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Accepted/In Press date: 30 September 2020
Published date: November 2020
Additional Information: Funding Information: This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore- NMRC/TCR/004-NUS/2008 ; NMRC/TCR/012-NUHS/2014 . Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. Publisher Copyright: © 2020 The Authors
Keywords: Diet, Lifestyle Behaviours, Perinatal Depression, Physical Activity, Pregnancy, Sleep Quality, Smoking

Identifiers

Local EPrints ID: 444319
URI: http://eprints.soton.ac.uk/id/eprint/444319
ISSN: 0010-440X
PURE UUID: 0c43a99a-193a-43eb-b65e-3642a983de2e
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 12 Oct 2020 16:32
Last modified: 17 Mar 2024 02:38

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Contributors

Author: Linde van Lee
Author: Airu Chia
Author: Desiree Phua
Author: Marjorelee T. Colega
Author: Natarajan Padmapriya
Author: Jonathan Y. Bernard
Author: Shirong Cai
Author: Elaine KH Tham
Author: Oon Hoe Teoh
Author: Daniel Y.T. Goh
Author: Joshua J. Gooley
Author: Peter D. Gluckman
Author: Fabian Yap
Author: Lynette P. Shek
Author: Keith Godfrey ORCID iD
Author: Kok Hian Tan
Author: Yap-Seng Chong
Author: Falk Müller-Riemenschneider
Author: Birit Broekman
Author: Michael Meaney
Author: Helen Chen
Author: Mary Foong-Fong Chong

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