Mom's Depression, Poor Diet Affect Kids' Cognitive Function

Megan Brooks

October 11, 2013

Depression during pregnancy may contribute to poor eating habits among women, which can have a negative impact on their child's cognitive function later in life, new research suggests.

Investigators at King's College London in the United Kingdom found that women who had symptoms of depression during pregnancy were more likely to have unhealthy diets and that the children of these mothers had lower scores on tests for cognitive functioning at age 8 years.

"Interventions aimed at the well-being of children of depressed mothers might consider targeting the nutrition environment during pregnancy, as this may help to alleviate maternal depression symptoms and reduce risk for atypical fetal development," lead author Edward D. Barker, PhD, Department of Psychology, Institute of Psychiatry, King's College London, told Medscape Medical News.

The study was published online October 10 in the British Journal of Psychiatry.

Higher Depressive Symptoms, Lower Levels of Nutrition

Until now, little was known about how maternal depression and unhealthy nutrition during pregnancy may developmentally interact to negatively affect child cognitive function, Dr. Barker and colleagues note.

To investigate, they studied 6979 mother-child pairs participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom.

Maternal symptoms of depression were assessed 5 times between 18 weeks' gestation and when the child was 33 months old. The women completed a food questionnaire to assess their eating habits at 32 weeks' gestation and again when their child was 47 months old. The children's cognitive function was assessed at age 8 years.

The researchers defined a healthy diet as one with nutrient-rich foods, with limited intake of salt, solid fats, and added sugar. An unhealthy diet was defined as being high in saturated fat, trans fat, salt, and added sugar.

"During gestation, higher depressive symptoms were related to lower levels of healthy nutrition and higher levels of unhealthy nutrition, each of which in turn was prospectively associated with reduced cognitive function," the researchers write.

They note that the results were "robust" to postnatal depression symptoms and nutrition, as well as a range of potential prenatal and postnatal factors, such as poverty, teenage mother, low maternal education, and substance use.

They note that the bias-corrected confidence intervals (CIs) (via 10,000 bootstraps) for the indirect pathway of maternal depression symptoms relating to reduced cognitive function via unhealthy nutrition did not cross zero (b = -0.010; 95% CI, -0.015 to -0.006), "which suggests that symptoms of depression in pregnancy can affect child development via a more unhealthy nutritional environment."

"Fresh Insights"

A recent study led by Felice Jacka, PhD, from Deakin University and University of Melbourne, Australia, showed a link between poor prenatal diet and behavioral problems in children, as reported by Medscape Medical News earlier this week.

Dr. Jacka told Medscape Medical News that this new study "is another supportive and important piece of evidence. It is concordant with our findings recently, although they have looked at cognitive function in children and we looked at mental health symptoms."

Dr. Barker and colleagues believe their findings "may provide fresh insights about how depressed mood can lead to altered dietary intake during pregnancy and open new avenues for increasing the effectiveness of prenatal interventions."

"Helping women adopt a healthier diet during pregnancy could be highly effective in reducing the association between reduced cognitive functions in children and prenatal maternal depression," Dr. Barker said in a statement.

The study is not without limitations. It is correlational in nature; hence, no causative relationship has been identified, the researchers note. In addition, the investigators note that the effect sizes for the prospective association of maternal depression and unhealthy diet were "not large, and should therefore not be interpreted as deterministic of a child's cognitive function."

Other limitations include reliance on maternal reports and a sample that includes relatively low numbers of individuals from ethnic minority groups. The present results will need replication with more ethnically diverse samples, the researchers say. Also, the study did not assess the actual biological mechanisms (eg, DNA methylation) that might explain the prenatal association with postnatal child cognitive function, they note.

This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health. The UK Medical Research Council, the Wellcome Trust, and the University of Bristol provide core support for ALSPAC. The authors and Dr. Jacka have disclosed no relevant financial relationships.

Br J Psychiatry. Published online October 10, 2013. Abstract


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