Consumption of the omega-3 fatty acid docosahexaenoic acid (DHA) during pregnancy decreases the risk of developing postpartum depression (PPD) symptoms, new research suggests.
In a small randomized study presented at the recently held Experimental Biology Annual Meeting in Washington, DC, pregnant women taking fish oil capsules containing DHA showed consistent 6-point lower mean depression scores after pregnancy across numerous time points than did those receiving placebo.
|Dr. Michelle Price Judge|
"Based on previous literature, this was in line with what we had hoped for and what we hypothesized. Still, we were excited to see our expectations hold up after testing," lead study author Michelle Price Judge, PhD, RD, assistant professor in residence at the University of Connecticut School of Nursing in Storrs, told Medscape Medical News.
The investigators note that although the study population was too small to discern whether fish oil consumption resulted in a lower incidence of diagnosable PPD, the treated group showed significantly fewer symptoms common to PPD, including anxiety and loss of self.
"The findings show that we really need to encourage women to enhance their intake of omega-3 fatty acids during pregnancy to recommended levels," said Dr. Judge.
"I would also feel comfortable encouraging these women to speak to their physician about taking prenatal supplements that contain omega-3, especially during the third trimester."
Important in Mood Regulation
Dr. Judge reported that in an earlier study, she found that consumption of DHA by pregnant women gave their infants a developmental advantage up to 9 months after birth.
"That one had some exciting results pointing to the importance of maternal dietary intake of fish oil during pregnancy in infant neurodevelopment, including visual acuity and problem solving," she said.
"I was interested then in extending this research a little further to see if there was a beneficial impact of consuming fish oil during pregnancy for mother as well."
According to her presentation, 25% of new mothers are affected by PPD.
"In uncomplicated pregnancies, long-chain polyunsaturated fatty acids are preferentially transferred across the placenta. There's an acceleration of transfer of DHA to the developing fetus during the third trimester, depleting maternal stores and placing mother at an additional risk," explained Dr. Judge.
"When you look at low DHA levels in animal studies, you see that this ties in to dopamine and serotonin production, which can impact the regulation of mood."
For this study, 42 pregnant women were enrolled and randomized to receive either corn oil placebo capsules (n = 22; mean age, 28 years) or fish oil capsules containing 300 mg of DHA (n = 20; mean age, 27 years) for 5 days a week between the 24th and 40th weeks of pregnancy.
The researchers note that this DHA amount is equivalent to what a woman would consume after eating a half serving of salmon.
"It is noteworthy that dietary DHA intake during pregnancy has been estimated to be 50 to 70 mg of DHA daily, a mere fraction of the 200 to 300 mg daily that is considered optimal during pregnancy by most experts," they write.
"This is just a real problem — women in the US and Canada who are pregnant aren't consuming enough omega-3," added Dr. Judge.
The Postpartum Depression Screening Scale (PDSS) was used to assess PPD symptoms at 2 weeks, 3 weeks, 3 months, and 6 months after giving birth.
Lower Depressive Symptoms
Results showed a significantly lower PDSS composite score for the DHA-treated group (46.03) than for those treated with placebo (52.11; P = .02). Compared with the placebo group, the intervention group also had a 6-point lower mean score at all checkpoints evaluated.
In addition, those receiving DHA had significantly lower PDSS domain scores for anxiety/insecurity (P = .03), emotional lability (P = .04), and "sense of loss of self" (P =.02).
"These domain scores gives us a better picture of how specifically our intervention group benefitted from supplementation," explained Dr. Judge.
Although the scores were also lower for the DHA group for disturbances in sleeping/eating, mental confusion, guilt/shame, and suicidal thoughts, they were not statistically significant.
Finally, the women receiving the fish oil capsules had significantly higher red blood cell DHA weight percent at the 6-week postpartum timepoint (3.72% vs 2.7%, P = .001).
"DHA consumption during pregnancy — at levels that are reasonably attained from foods — has the potential to decrease symptoms of PPD," summarize the investigators.
"These results offer a basis for guidelines for...pregnant women and for community-based efforts to increase awareness of the value of DHA/fish consumption for maternal mental health," they add.
Dr. Judge concluded that further studies with a much larger study population are now needed "before we can come up with firm conclusions."
The study was funded by the Patrick and Catherine Weldon Donaghue Medical Research Foundation, Nestec Ltd, the University of Connecticut School of Nursing, and the Louisiana State University AgCenter and Pennington Biomedical Research Center. Dr. Judge has disclosed no relevant financial relationships.
Experimental Biology 2011 Annual Meeting: Abstract 349.7. Presented April 12, 2011.
康乃狄克大學護理學院駐校助理教授Michelle Price Judge博士表示，根據之前的文獻，這與我們所假設的一致，不過，我們依舊相當興奮看到這樣的結果。
這項研究中，42名孕婦隨機分派接受玉米油安慰劑膠囊(n = 22人；平均年紀28歲)或含300mgDHA的魚油膠囊(n = 20人；平均年紀27歲)，在懷孕第24-40週之間、每週5天。
研究人員指出，這個DHA含量相當於吃半份鮭魚所含的量。值得注意的是，懷孕期間飲食攝取DHA量估計為每天50-70 mg的DHA，只佔多數專家建議的懷孕期間適當攝取量、每天200-300 mg的一小部份。
在產後第2週、第3週、第3個月、第6個月時以產後憂鬱篩檢量表(PDSS)評估產後憂鬱症症狀；結果顯示，DHA治療組的PDSS綜合分數(46.03)顯著低於安慰劑組的分數(52.11；P = .02)，相較於安慰劑組，治療組在各個檢測時間點所評估的平均分數都低了6分；此外，服用DHA者在焦慮/不安全感(P = .03)、情緒不穩定(P = .04)和「失去自治力感覺」(P =.02).等PDSS領域分數也顯著較低。
最後，服用魚油膠囊婦女的紅血球DHA重量百分比在產後6週時明顯較重(3.72% vs 2.7%，P = .001)。
研究人員總結指出，懷孕時攝取DHA — 從食物中合理獲得需要量— 可減少產後憂鬱症症狀；這些結果提供的基本指引是，對於孕婦和社區，應更暸解攝取DHA/魚肉對於母親心智健康的重要性。