An exploratory factor analysis of nutritional biomarkers associated with major depression in pregnancy.
An exploratory factor analysis of nutritional biomarkers associated with major depression in pregnancy.
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DOI：
10.1017/s1368980011002904
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发表时间：
2012-06
影响因子：
3.2
通讯作者：
Newby, P. K.
中科院分区：
文献类型：
--
作者：
Bodnar, Lisa M.;Wisner, Katherine L.;Luther, James F.;Powers, Robert W.;Evans, Rhobert W.;Gallaher, Marcia J.;Newby, P. K.
怀孕期间的重度抑郁症（MDD）会增加孕产妇和婴儿不良结局的风险。母亲营养状况可能是产前抑郁症的一个可改变的危险因素。我们评估了妊娠中期营养生物标志物模式与 MDD 之间的关联。前瞻性队列研究 美国宾夕法尼亚州匹兹堡 妊娠 ≤20 周入组的女性在 20、30 和 36 周研究访视时通过 DSM-IV 结构化临床访谈诊断为 MDD。共有 135 名女性贡献了 345 人次访问。入组时抽取非空腹血，检测红细胞必需脂肪酸、血浆叶酸、同型半胱氨酸和抗坏血酸；血清 25-羟基维生素 D、视黄醇、维生素 E、类胡萝卜素、铁蛋白和可溶性转铁蛋白受体。营养生物标志物进入主成分分析。出现了三个因素：因素 1，必需脂肪酸；因素2，微量营养素；和因子 3，类胡萝卜素。 MDD 在 21.5% 的女性中普遍存在。在纵向多变量逻辑模型中，在就业、教育或孕前 BMI 调整之前或之后，必需脂肪酸或微量营养素模式与 MDD 之间没有关联。在未经调整的分析中，类胡萝卜素因子得分处于中三分位数和上三分位数的女性在怀孕期间患 MDD 的可能性比处于下三分位数的女性低 60%，但在调整混杂因素后，这种关联不再具有统计显着性。虽然使用营养生物标志物得出了有意义的模式，但在多变量调整分析中并未观察到与 MDD 的显着关联。需要更大、更多样化的样本来了解怀孕期间的营养与抑郁之间的关系。
Major depressive disorder (MDD) during pregnancy increases the risk of adverse maternal and infant outcomes. Maternal nutritional status may be a modifiable risk factor for antenatal depression. We evaluated the association between patterns in mid-pregnancy nutritional biomarkers and MDD. Prospective cohort study Pittsburgh, Pennsylvania, USA Women who enrolled at ≤20 weeks gestation had a diagnosis of MDD made with the Structured Clinical Interview for DSM-IV at 20-, 30-, and 36-week study visits. A total of 135 women contributed 345 person-visits. Non-fasting blood drawn at enrollment was assayed for red cell essential fatty acids, plasma folate, homocysteine, and ascorbic acid; serum 25-hydroxyvitamin D, retinol, vitamin E, carotenoids, ferritin, and soluble transferrin receptors. Nutritional biomarkers were entered into principal components analysis. Three factors emerged: Factor 1, Essential Fatty Acids; Factor 2, Micronutrients; and Factor 3, Carotenoids. MDD was prevalent in 21.5% of women. In longitudinal multivariable logistic models, there was no association between the Essential Fatty Acid or Micronutrient patterns and MDD either before or after adjustment for employment, education, or prepregnancy BMI. In unadjusted analysis, women with Carotenoid factor scores in the middle and upper tertiles were 60% less likely than women in the bottom tertile to have MDD during pregnancy, but after adjustment for confounders, the associations were no longer statistically significant. While meaningful patterns were derived using nutritional biomarkers, significant associations with MDD were not observed in multivariable adjusted analyses. Larger, more diverse samples are needed to understand nutrition-depression relationships during pregnancy.