Maternal and Child Health Journal

, Volume 18, Issue 1, pp 161–170 | Cite as

Nutritional Factors Associated with Antenatal Depressive Symptoms in the Early Stage of Pregnancy Among Urban South Indian Women

  • Ammu Lukose
  • Asha Ramthal
  • Tinku Thomas
  • Ronald Bosch
  • Anura V. Kurpad
  • Christopher Duggan
  • Krishnamachari SrinivasanEmail author


Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m2. 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.


Antenatal depression Pregnancy Nutritional status South India 



This data was presented in part at the Experimental Biology meeting 2011. We thank the women for participating in this study. We are grateful to Dr. B Nirmala in helping us obtain all the clearances to conduct the study at Hosahalli Referral Hospital. We thank the doctors, nurses and the technical staff at the hospital for their support. We acknowledge Dr. S Muthayya for her assistance during the initial part of the study. We thank Ms. P.Vijaya, Ms.S.Surekha, Ms. S.Sridevi, Ms.K.R.Shilpa, Ms.C.Darshini, Ms.P.K.Preethi and Ms.R.Poornima for technical support. This research was financially supported by the Indian Council of Medical Research, India (ICMR: 5/7/192/06-RHN) and National Institute of Health, USA (NICHD: HD052143and NICHD K24 HD058795).

Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ammu Lukose
    • 1
  • Asha Ramthal
    • 1
  • Tinku Thomas
    • 1
  • Ronald Bosch
    • 2
  • Anura V. Kurpad
    • 1
  • Christopher Duggan
    • 2
  • Krishnamachari Srinivasan
    • 1
    Email author
  1. 1.Division of Nutrition, Mother and Child UnitSt. John’s Research InstituteBangaloreIndia
  2. 2.Department of NutritionHarvard School of Public HealthBostonUSA

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