Plastic Container Use Mediating the Association Between Food Delivery and Maternal Depressive Symptoms: A Nationwide Cohort Study

Abstract

1. Introduction

South Korea’s food delivery culture has rapidly expanded due to its convenience and speed. This trend has altered eating patterns and increased reliance on single-use plastic containers and wraps, raising daily exposure to endocrine-disrupting chemicals that may affect maternal depression. 

1. Objective

This study examined whether frequent food delivery increases plastic usage and its association with depressive symptoms in pregnant women.

1. Method

 A nationwide cohort of pregnant women recruited between 2015 and 2020 was analyzed. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) with a cutoff of 16. Delivery food consumption (≥1/<1 per week) and plastic containers usage (Yes/No) were measured via self-administered questionnaires. Causal mediation analysis with 5,000 bootstrap simulations examined whether plastic containers usage mediated the impact of delivery food consumption on depressive symptoms. Logistic regression models were used to estimate odds ratios (ORs). All models were adjusted for maternal age, education, income, gestational week, and BMI. Analyses were conducted using R.

1. Results

Among the 4,986 participants, 783 (15.7%) reported depressive symptoms. Participants who consumed delivered foods more than once a week had greater odds of reporting depressive symptoms (OR = 1.60, 95% CI: 1.32–1.94, p < 0.0001). Frequent delivery food consumption was significantly associated with greater plastic container use (OR = 2.33, 95% CI: 1.96–2.77, p < 0.0001). Mediation analysis demonstrated that plastic container use partially mediated the effect of delivery food consumption on depressive symptoms. The Estimated Average Causal Mediation Effect (ACME) was 0.0089 (95% CI: 0.0037–0.0142, p < 0.0001), and 10.4% of the total effect was mediated through delivery food consumption.

1. Conclusion

Frequent delivery food consumption increased plastic container use, partially mediating a higher risk of depressive symptoms. These findings highlight how modern consumption habits influence maternal mental health and suggest the need to reduce reliance on delivery services and unnecessary plastic exposure during pregnancy.

1. Keywords

Food Delivery, Plastic Container, Depressive Symptoms, Pregnancy, Maternal Mental Health