Postpartum depression (PPD) affects as many as 1 in 7 women in America (APA, 2017). PPD impairs maternal-child attachment and influences the child’s development later in life (Grace, Evindar & Stewart, 2003). Known risk factors for PPD include low income, low social support and high incidence of stressful life events (Leung, Letourneu, Giesbrecht, Ntanda & Hart, 2017). There is no current evidence that PPD is more prevalent in one race or ethnicity over another (Liu, Phan, Yasur & Doan, 2017). However, it has been shown that African American women are at a higher risk of both depressive symptoms and a lower diet quality (Kay et al., 2017; Liu et al., 2017). Lower diet quality has been shown to be associated with an increased risk of depressive symptoms in non-pregnant adults (Molendijk, Molero, Sanchez-Pedreno, Van der Does & Martinez-Gonzalez, 2017). Few studies have examined the association of diet quality and PPD in African American women. Therefore, the purpose of this study is to examine the relationship of diet quality and postpartum depressive symptoms in African American Women.
Methods
This study is a secondary analysis of an ongoing cross-sectional study conducted in the Atlanta-Metro area with a socioeconomically diverse sample of African American mothers (n=46). The parent study examined the relationship between diet, gut microbiome and cardiometabolic risk factors. Women were recruited between 8 and 10 months postpartum. In-person interviews were conducted and depressive symptom and diet quality data were collected using paper and online questionnaires. Dietary data was collected using a modified Block-Bodnar Food Frequency Questionnaire (FFQ) and scored using the Alternative Healthy Eating Index (AHEI). The Block-Bodnar FFQ assesses intake of nutrients and probiotics from both the diet and supplements in women of reproductive age within the previous 3-month period. The AHEI scores diets based on its adherence to current recommended dietary guidelines and provides a score ranging from 2.5 to 87.5, with 87.5 being the best diet quality score attainable. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a 10-item questionnaire where participants rate how often they experience depressive symptoms and provides a score between 0 and 30. Data will be analyzed using descriptive statistics, bivariate correlations and multiple regression.
Results
Preliminary analyses were completed using SPSS software. Of the 46 participants, age ranged from 20 years to 37 years with a mean of 26.59 (SD = 4.87). Concerning education, 15.2% had some high school education but no diploma, 32.6% completed High School or GED, 28.3% completed some college and 23.9% completed a college degree program. Marital status varied, 30.4% were married or in a partnered relationship and 69.6% were single or separated. Depressive symptom scores measured with the Edinburgh Postnatal Depression Scale ranged from 0 to 21 with a mean score of 6.35 (SD=4.72). Additional analysis will include description of diet quality as well as regression analysis to examine the relationship between the diet quality and depressive symptom scores.
Conclusion
Information on the relationship between diet quality and depressive symptoms is very limited (George, Milani, Hanss-Nuss, & Freeland-Graves, 2005; Teo et al., 2018) but has important clinical implications for postpartum mothers. The findings from this study will add to our knowledge about this important relationship that impacts both mothers and their children. Understanding factors that are related to PPD allow clinicians to screen for depressive symptoms and provide interventions. One promising area is the examination of diet quality, since multiple opportunities exist to intervene and improve the diet of mothers. With additional research, nursing interventions can be developed and tested to help decrease the likelihood a mother suffers from this debilitating condition.
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