Associations of maternal stress and/or depressive symptoms with diet quality during pregnancy: a narrative review

Abstract

Background Pregnancy can be a stressful time for many women; however, it is unclear if higher stress and depressive symptoms are associated with poorer diet quality during pregnancy. Objective The aims for this narrative review were to (1) synthesize findings of original, peer-reviewed studies that examined associations of stress and/or depressive symptoms with diet quality during pregnancy; (2) review the measurement tools used to assess stress, depressive symptoms, and diet quality; (3) identify current gaps in the extant literature; and (4) offer recommendations for future research. Methods A search strategy was used to identify peer-reviewed manuscripts published between January 1997 and October 2018, using the following databases: PubMed, CINAHL Complete, PsycINFO, Academic Search Complete, and Psychology & Behavioral Sciences Collection. The search was updated December 2019. Two reviewers independently assessed title, abstract, and full-text of the studies that met the inclusion criteria. Data were extracted and a quality assessment was conducted. Results Twenty-seven observational studies were identified in this review (21 cross-sectional and 6 longitudinal). In 22 studies, higher stress and/or depressive symptoms were associated with poorer diet quality or unhealthy dietary patterns; 5 studies found no association. Findings are mixed and inconclusive regarding the relationship among stress, depressive symptoms, and food groups related to diet quality and frequency of fast-food consumption. Conclusions The current data suggest stress and depressive symptoms may be a barrier to proper diet quality during pregnancy; however, variability in the assessment tools, timing of assessments, and use of covariates likely contribute to the inconsistency in study findings. Gaps in the literature include limited use of longitudinal study designs, limited use of comprehensive diet-quality indices, underrepresentation of minority women, and lack of multilevel theoretical frameworks. Studies should address these factors to better assess associations of stress and/or depressive symptoms with diet quality during pregnancy.

Dietary Quality and Sociodemographic and Health Behavior Characteristics Among Pregnant Women Participating in the New York University Children's Health and Environment Study

“…We also found that reporting moderate to severe depressive symptoms during pregnancy was associated with lower dietary quality. Our findings for depressive symptoms are consistent with previous, though limited, literature suggesting that maternal mental health, including depression and anxiety, is associated with unhealthy dietary intakes (using various dietary assessments) (52,53). This is of concern because both poor maternal mental health and poor dietary intakes increase the risk of adverse birth outcomes, such as preterm birth and low birth weight (54,55), and later childhood health outcomes (56,57).…”

Prenatal Depression, Breastfeeding, and Infant Gut Microbiota

“…To maintain a healthy pregnancy, adequate nutrition is needed to nourish both mother and fetus. A narrative review by Boutté et al (2021) confirmed that worldwide, women with depression or stress during pregnancy eat an unhealthy diet, high on fat, and low in fruits and vegetables. Aspects of the prenatal diet related to fat consumption have been associated with changes to pregnancy and infant gut microbiota (Chu et al, 2016;Mandal et al, 2016).…”

Obesogenic Programming Effects during Lactation: A Narrative Review and Conceptual Model Focusing on Underlying Mechanisms and Promising Future Research Avenues

“…Maternal stress may also be linked to child obesity [37][38][39], but the mechanisms explaining this link are largely unknown. We propose two main pathways that may explain this link during lactation (see Figure 1), that is, one physiological pathway (i.e., through human milk composition) [40,41] and one behavioral one (i.e., through maternal lifestyle and weightrelated parenting) [42,43] affecting child weight-related behaviors [44]. Future research may examine whether and how intervention on maternal stress may impact human milk components and child weight outcomes through lactation-specific pathways (i.e., child satiety and eating characteristics, child gut microbiota, and flavor exposure).…”