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Background There are few researches about the association between nutrient supplementation and depressive symptom in pregnancy in large prospective cohort studies. Methods In Chinese Pregnant Women Cohort Study (CPWCS), twenty-four hospitals distributed in 15 provinces in China were selected as centre sites. Related information were collected in the first, second and third trimester respectively. Nutrient supplements include folic acid, vitamin D, calcium, iron, docosahexaenoic acid (DHA), dietary fiber, and probiotics. Edinburgh postnatal depression scale (EPDS) was used to assess the mood of depression. Univariable and multivariable Generalized Estimating Equation were applied to analyze the association of nutrient supplementation and depressive symptom in pregnancy. Results A total of 5759 pregnant women were included in our study. Results showed that 93.3%(5374/5759), 92.8%(5189/5591) and 94.2%(4056/4307) women supplemented one or more nutrients in the first, second and third trimester separately. The detection rates of antenatal depression was 30.77%(1772/5759), 28.13%(1573/5591) and 28.44%(1225/4307) separately. Multivariable analyses suggested that supplementing one or more nutrients was significantly associated with depression (OR = 0.812, p = 0.013). When analyzed separately, depression was negatively related to vitamin D (OR = 0.850, p = 0.001), calcium (OR = 0.880, p = 0.006), and DHA (OR = 0.903, p = 0.040), but not associated with supplement of folic acid, dietary fiber, iron, or probiotics. Conclusions Depressive symptom is highly prevalent among Chinese pregnant women, and supplement of vitamin D, calcium, and DHA are preventive factors of depressive symptom in pregnancy. Key message About a third of Chinese pregnant women have depressive symptom, and supplement of vitamin D, calcium, and DHA are preventive factors of depressive symptom in pregnancy.

382Association between nutrient supplementation and depressive symptom in Pregnancy: a multicenter prospective cohort study