HDL-cholesterol concentrations are inversely associated with Edinburgh Postnatal Depression Scale scores during pregnancy: Results from a Brazilian cohort study

• EPDS mean score significantly decreased over pregnancy trimesters.
• HDL-c concentrations were inversely associated with changes in EPDS score.
• For each mg/dl of HDL-c, there was a −0.080 unit decrease in the EPDS score.
• Changes in EPDS score were associated with social, behavioral, and mental problems.

Serum lipids have been associated with depression in the adult population; however, this association during pregnancy remains unclear. The aim of this study was to evaluate the association between serum lipids and depressive symptom scores during pregnancy. A prospective cohort of 238 pregnant women was followed at the 5th–13th, 20th–26th and 30th–36th weeks of gestation. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Serum concentrations (mg/dL) of triglycerides, total cholesterol, and low- and high-density lipoproteins (LDL-c; HDL-c) were the main exposures. Marital status (married/single), physical activity (active or very active/low or very low active), unplanned pregnancy (no/yes), pre-pregnancy BMI (<25/≥25 kg/m2), generalized anxiety disorder (no/yes) and current suicidal ideation (no/yes) were considered as potential confounders. Analyses were performed using linear mixed-effects models. The results showed that the EPDS mean score (95%CI) decreased with time during pregnancy trimesters [1st: 8.89 (95%CI = 8.28–9.51), 2nd: 7.32 (95%CI = 6.67–7.97) and 3rd: 7.08 (95%CI = 6.41–7.74)]. Suicidal ideation frequency at baseline was 18%. HDL-c concentrations were inversely associated with changes in EPDS score (β = −0.080, 95%CI = −0.157 to −0.002), while low or very low active women (β = 1.288, 95%CI = 0.630–1.946), with single marital status (β = 1.348, 95%CI = 0.163–2.534), unplanned pregnancy (β = 1.922, 95%CI = 0.714–3.131), generalized anxiety disorder (β = 2.139, 95%CI = 0.410–3.868) and current suicidal ideation (β = 1.927, 95%CI = 0.596–3.258) tended to have higher EPDS scores. No relationship was observed between other lipids and EPDS scores. HDL-c concentration was inversely associated with changes in depressive symptom scores during pregnancy after adjusting for socio-economic, demographic, behavioral, nutritional, biochemical and mental health disorders.