Public Health Nutrition

Special groups

Dietary patterns during pregnancy and the risk of postpartum depression: the mother–child ‘Rhea’ cohort in Crete, Greece

Leda Chatzia1 c1, Vasiliki Melakia1, Katerina Sarria1, Ioanna Apostolakia1, Theano Roumeliotakia1, Vaggelis Georgioua1, Maria Vassilakia1, Antonis Koutisa1, Panos Bitsiosa2 and Manolis Kogevinasa3a4a5

a1 Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion 71003, Crete, Greece

a2 Faculty of Medicine, Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, Greece

a3 Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain

a4 CIBER, Epidemiologia y Salud Publica, Barcelona, Spain

a5 National School of Public Health, Athens, Greece


Objective To identify and describe dietary patterns in a cohort of pregnant women, and investigate whether dietary patterns during pregnancy are related to postpartum depression (PPD).

Design The study uses data from the prospective mother–child cohort ‘Rhea’ study. Pregnant women completed an FFQ in mid-pregnancy and the Edinburg Postpartum Depression Scale (EPDS) at 8–10 weeks postpartum. Dietary patterns during pregnancy (‘health conscious’, ‘Western’) were identified using principal component analysis. Associations between dietary patterns categorized in tertiles and PPD symptoms were investigated by multivariable regression models after adjusting for confounders.

Setting Heraklion, Crete, Greece, 2007–2010.

Subjects A total of 529 women, participating in the ‘Rhea’ cohort.

Results High adherence to a ‘health conscious’ diet, characterized by vegetables, fruit, pulses, nuts, dairy products, fish and olive oil, was associated with lower EPDS scores (highest v. lowest tertile: β-coefficient = −1·75, P = 0·02). Women in the second (relative risk (RR) = 0·52, 95 % CI 0·30, 0·92) or third tertile (RR = 0·51, 95 % CI 0·25, 1·05) of the ‘health conscious’ dietary pattern were about 50 % less likely to have high levels of PPD symptoms (EPDS ≥ 13) compared with those in the lowest tertile.

Conclusions This is the first prospective study showing that a healthy diet during pregnancy is associated with reduced risk for PPD. Additional longitudinal studies and trials are needed to confirm these findings.

(Received August 18 2010)

(Accepted November 23 2010)

(Online publication April 11 2011)


c1 Corresponding author: Email