Abstract
Objective: We examined cross-sectional associations between mid-pregnancy food intake indicators and prenatal depressive symptomatology. Methods This secondary analysis of the Comparison of Two Screening Strategies for Gestational Diabetes (GDM2) trial (N = 716) examined five domains of mid-pregnancy food intake (direct timing, energy timing, meal/snack structure, meal energy distribution, and diet quality) derived from 24 h dietary recalls. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). Generalized linear models examined associations between food intake indicators and both total and high (EPDS ≥ 13) depressive symptoms. Results: The mean (SD) EPDS score was 6.3 (4.9); a total of 12.4% (n = 89) of subjects had high depressive symptoms. Eating frequency (exp(B) = 1.084 [1.021, 1.151], p = 0.008), snack frequency (exp(B) = 1.063 [1.004, 1.126], p = 0.037), nighttime snacking frequency (exp(B) = 1.060 [1.003, 0.121], p = 0.040), and total daily energy intake (exp(B) = 1.058 [1.002, 1.118], p = 0.044) were positively associated with total depressive symptoms. Energy intake from breakfast (PR = 1.178 [1.029, 1.349], p = 0.017) was associated with higher prevalence of high depressive symptoms. Energy intake from dinner (PR = 0.809 [0.695, 0.943], p = 0.007), a later timing of the first eating episode (PR = 0.830 [0.699, 0.986], p = 0.034) and the first energy quartile (PR = 0.837 [0.702, 0.998], p = 0.048) were associated with lower prevalence of high depressive symptoms. Conclusions: These findings extend the prior chrononutrition–depression literature to the prenatal period, implicating eating frequency, energy intake, and meal energy timing and distribution in depressive symptomatology during pregnancy, and warrant further longitudinal investigation.