Dose-response associations of maternal prenatal noise exposure duration with antepartum depression status.

BACKGROUND: Antepartum depression has been reported to be associated with the intensity of maternal prenatal noise exposure; however, the association between noise exposure duration and the development of antepartum depression has not been established. This study aimed to determine the total and trimester-specific association of prenatal noise exposure duration with the development of antepartum depression. METHODS: From May 2018 to June 2021, we recruited 2,166 pregnant women from Shengjing Hospital, northeast China. We used a standardized questionnaire to assess women's prenatal noise exposure and used the Edinburgh Postnatal Depression Scale to assess pregnant women's antepartum depression during the 1st -, 2nd -, and 3rd - trimesters. We calculated a cumulative noise exposure score ranging from 0 to 3, with a higher score reflecting higher frequency and longer duration of noise exposure during pregnancy. RESULTS: Women who were exposed to noise for ≥ 15 min per day had an increased risk of antepartum depression compared with women who were not exposed to noise during pregnancy [odds ratio (OR) = 1.83, 95%CI:1.18, 2.83]. Noise exposure in a specific trimester was associated with higher risk of depression in the same trimester and subsequent trimesters. We observed increases in antepartum depression risk with increasing cumulative noise exposure scores (P for trend < 0.05 for all). Pregnant women with the highest scores had the highest risk of antepartum depression during the first (OR = 1.30, 95%CI:1.02, 1.65), second (OR = 1.75, 95%CI:1.23, 2.50) trimesters. Women with a cumulative noise exposure score of 2 had the highest risk of antepartum depression during the third trimester (OR = 1.79, 95%CI:1.14, 2.80), as well as during the whole pregnancy (OR = 1.94, 95%CI:1.14, 3.30). CONCLUSIONS: Maternal prenatal noise exposure duration was positively associated with antepartum depression risk in a dose-response manner. It is necessary to develop strategies by which pregnant women can avoid excessive exposure to noise to prevent antepartum depression.

Sweet foods dietary pattern enhances negative associations of perceived indoor air quality during pregnancy with postpartum depression.

Postpartum depression (PPD) is possibly caused by indoor air pollution and may be modified by maternal diet during pregnancy. Using the data from a prospective cohort study, we examined the interaction between indoor air quality and maternal dietary patterns on PPD development. A perceived indoor air quality (PIAQ) score was used to assess indoor air pollution. A higher PIAQ score indicated a worse indoor air quality. Women with higher PIAQ scores were at increased risk for PPD (tertile 3 vs. tertile 1, odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.37-3.29). Compared with a lower adherence to a "sweet foods pattern" (OR = 1.20, 95% CI = 0.66-2.18), a higher adherence to a "sweet foods pattern" enhanced the hazardous associations of the PIAQ on PPD (OR = 3.09, 95% CI = 1.81-5.27, adjusted p for interaction = 0.044). Higher adherence to a "whole grain-seafood pattern" and lower adherence to a "traditional pattern" also increased the risk for PPD, although the p values for the interaction were not significant. Our findings provide further evidence of the link between diet during pregnancy, air pollution, and PPD, and it can be used to develop PPD prevention strategies.

Trimester-specific association of perceived indoor air quality with antenatal depression: China Medical University Birth Cohort Study.

Antenatal depression is associated with adverse birth and long-term outcomes for mothers and children. Pregnant women spend 90% of time indoors; however, the association between indoor air quality and risk of antenatal depression has not been established. In this study, we aim to determine the total and trimester-specific association of perceived indoor air quality (PIAQ) with antenatal depression. A total of 2166 pregnant women were enrolled during the first trimester and evaluated during the second and third trimesters in the China Medical University Birth Cohort Study, a prospective pre-birth cohort study in northeastern China. PIAQ scores were obtained during each of three trimesters, which a higher score indicated a worse indoor air quality. Antenatal depression was screened using an Edinburgh Postnatal Depression Scale (EPDS) and defined as an EPDS score ≥ 9. Prevalence of antenatal depression was 26.7%, 20.6%, and 20.9% during the first, second, and third trimesters, respectively. A higher PIAQ score was positively associated with a depression score throughout pregnancy (ß = 0.27, 95% CI = 0.15-0.39). Trimester-specific adverse PIAQ exposure was associated with a higher depression score in the same trimester, but not with a higher score in a subsequent trimester. A dose-response pattern and incremental increases in risk of depression were observed with calculated adverse PIAQ exposures across all three trimesters, with the highest risk (OR = 3.24; 95% CI = 2.28-4.78) among women with adverse PIAQ across all three trimesters. The hazardous association between adverse PIAQ exposure and risk of depression were less pronounced among women with higher physical activity levels (P for interaction < 0.001). The results of present study provided important evidence that pregnant women's mental health was linked to indoor air quality during pregnancy. These findings could be helpful in the development of guidelines to prevent antenatal depression by improving indoor air quality.

Trimester-specific associations of maternal dietary patterns with preterm birth: China Medical University birth cohort study.

The trimester-specific associations of maternal dietary patterns with preterm birth (PTB) are unclear. In a prospective prebirth cohort study, we aimed to examine the critical time window of maternal prenatal dietary patterns and the risk of PTB. We assessed prenatal dietary intake among 1500 pregnant women with validated food frequency questionnaires during the 1st, 2nd and 3rd trimester, respectively. We used logistic regression models and generalized estimating equation models to examine the trimester-specific associations and longitudinal associations between maternal dietary patterns in relation to risk of PTB and PTB subtypes. The incidence rate of PTB was 11.9% (179 out of 1500 pregnant women) in the present study. We observed that maternal adherence to a fish-seafood pattern in the 1st trimester was associated with higher risk of PTB [tertile 3 (T3) vs. tertile 1 (T1): OR = 2.29, 95% CI: 1.32-3.96] and iatrogenic preterm birth (IPTB) (T3 vs. T1: OR = 2.26, 95% CI: 1.21-4.20), while a fish-seafood pattern in the 2nd trimester was associated with lower risk of PTB (T3 vs. T1: OR = 0.49, 95% CI: 0.25-0.93). Maternal adherence to a dairy-egg pattern in the 2nd or 3rd trimester was associated with higher risks of PTB and IPTB. No dietary patterns were associated with spontaneous preterm birth. Our findings provide new evidence that specific dietary patterns during different trimesters may have different and even inverse health effects on pregnant women. This supports the necessity of guiding the maternal diet according to different periods of pregnancy to prevent PTB.

The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The "Born in Shenyang" Cohort.

The reported associations of maternal dietary patterns during pregnancy with gestational weight gain are inconsistent, especially among the less studied Asian Chinese populations. In a prospective pre-birth cohort study conducted in northern China, we determined the associations between maternal dietary patterns and the probability of excess gestational weight gain (EGWG) among 1026 pregnant women. We used 3-day food diaries to assess maternal diet and performed principal component analysis to identify dietary patterns. Maternal adherence to a traditional pattern, which was characterized by a higher intake of tubers, vegetables, fruits, red meat, and rice, was associated with a higher probability of EGWG (quartile 3 vs. quartile 1, odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.10−2.38). This risk association was more pronounced among women who were overweight/obese before pregnancy (quartile 4 vs. quartile 1, OR = 5.17, 95% CI = 1.45−18.46; p for interaction < 0.01). Maternal adherence to a high protein pattern, which was characterized by a higher intake of fried foods, beans and bean products, dairy products, and fruits, was associated with a lower risk of EGWG (quartile 3 vs. quartile 1, OR = 0.56, 95% CI, 0.39−0.81). The protective association was more pronounced among non-overweight/obese women (p for interaction < 0.01). These findings may help to develop interventions and better define target populations for EGWG prevention.

Associations of Dietary Patterns during Pregnancy with Gestational Hypertension: The "Born in Shenyang" Cohort Study.

The literature on maternal dietary patterns and gestational hypertension (GH) risk is largely ambiguous. We investigated the associations of maternal dietary patterns with GH risk among 1092 pregnant women in a Chinese pre-birth cohort. We used both three-day food diaries (TFD) and food frequency questionnaires (FFQ) to assess the diets of pregnant women. Principal components analysis with varimax rotation was used to identify dietary patterns from the TFD and FFQ, respectively. In total, 14.5% of the participants were diagnosed with GH. Maternal adherence to a "Wheaten food−coarse cereals pattern (TFD)" was associated with a lower risk of GH (quartile 3 [Q3] vs. Q1, odds ratio [OR] = 0.53, 95%CI: 0.31, 0.90). Maternal adherence to a "Sweet food−seafood pattern (TFD)" was associated with lower systolic blood pressure (Q4 vs. Q1, ß = −2.57, 95%CI: −4.19, −0.96), and mean arterial pressure (Q4 vs. Q1, ß = −1.54, 95%CI: −2.70, −0.38). The protective associations of the "Sweet food-seafood (TFD)" and "Fish−seafood pattern (FFQ)" with the risk of GH were more pronounced among women who were overweight/obese before pregnancy (p for interaction < 0.05 for all). The findings may help to develop interventions and better identify target populations for hypertension prevention during pregnancy.

Association of Maternal Dietary Patterns during Pregnancy and Offspring Weight Status across Infancy: Results from a Prospective Birth Cohort in China.

Literature on maternal dietary patterns during pregnancy and offspring weight status have been largely equivocal. We aimed to investigate the association of maternal dietary patterns with infant weight status among 937 mother-infant dyads in a Chinese birth cohort. We assessed maternal diet during pregnancy using food frequency questionnaires (FFQ) and three-day food diaries (TFD) and examined infants' body weight and length at birth, 1, 3, 6, 8 and 12 months. Maternal adherence to the "protein-rich pattern (FFQ)" was associated with lower infant body mass index z-scores (BMIZ) at birth, 3 and 6 months and lower odds of overweight and obesity (OwOb) across infancy (quartile 3 (Q3) vs. quartile 1 (Q1): odds ratio (OR): 0.50, (95% confidence interval: 0.27, 0.93)). Maternal adherence to the "vegetable-fruit-rice pattern (FFQ)" was associated with higher BMIZ at birth, 3 and 6 months and higher odds of OwOb across infancy (Q3 vs. Q1: OR: 1.79, (1.03, 3.12)). Maternal adherence to the "fried food-bean-dairy pattern (TFD)" was associated with lower BMIZ at 3, 6, 8 and 12 months and lower odds of OwOb (Q3 vs. Q1: OR: 0.54, (0.31, 0.95)). The study results may help to develop interventions and to better define target populations for childhood obesity prevention.