Abstract
Taiwanese women may practice traditional confinement after childbirth, and no study has investigated the nutritional status and the effects of postpartum depression on such women. The aim of this study was to investigate the association between nutritional status and postpartum depression at 6–8 weeks postpartum. A cross-sectional study was conducted on postpartum women who returned to the obstetrics and gynecology clinic for routine examination from January 2016 to September 2017. A total of 344 women received assessments based on the Edinburgh Postnatal Depression Scale (EPDS). An EPDS score of ≥10 indicated the presence of postpartum depressive symptoms (PPDS). A total of 97 women without such symptoms and 23 with PPDS completed nutritional parameter analyses and questionnaires. The results showed that the prevalence of postpartum depression (PPD) was 8.4%. The proportion was 70% for those who practiced confinement at home, significantly higher than for those in the non-PPDS group (45%). The overall psychological stress score was significantly higher and the postpartum care satisfaction score was significantly lower in those with PPDS compared to those without. In terms of nutritional biomarkers, the plasma riboflavin levels in the PPDS group were significantly lower than those in their symptomless counterparts (13.9%). The vitamin D insufficiency and deficiency rates in the non-PPD and PPDS groups were 35%, 41%, 48%, 26%, respectively. However, compared with those in the non-PPDS group, those with PPDS had significantly higher ratios of Σn-6/Σn-3, C20:3n-6/C18:3n-6, and C20:4n-6/(C20:5n-3 + C22:6n-3) (by 8.2%, 79.7%, and 8.8%, respectively), whereas they had lower ratios of C22:6n-3/C22:5n-6 (by 15.5%). Higher plasma riboflavin and erythrocyte C16:1n-9, C24:1n-9, C18:3n-6, and C20:5n-3 levels and lower Σn-6 fatty acid and C22:5n-6 levels decreased the risk of PPD after type of confinement, overall mental stress scores, and postpartum care satisfaction scores were adjusted for the logistic regression analysis. In conclusion, the plasma riboflavin level and erythrocyte fatty acid composition are potentially major contributors to PPD development.
Highlights
Postpartum depression (PPD) is a debilitating mental disorder with a prevalence of between 3.5%and 63.3% in Asian countries [1]
Higher plasma riboflavin and erythrocyte C16:1n-9, C24:1n-9, C18:3n-6, and C20:5n-3 levels and lower Σn-6 fatty acid and C22:5n-6 levels decreased the risk of postpartum depression (PPD) after type of confinement, overall mental stress scores, and postpartum care satisfaction scores were adjusted for the logistic regression analysis
We found that total n-3 polyunsaturated fatty acids (PUFA) significantly decreased PPD symptoms (PPDS) risk, but no significant difference was observed after the covariates were adjusted
Summary
Postpartum depression (PPD) is a debilitating mental disorder with a prevalence of between 3.5%and 63.3% in Asian countries [1]. Postpartum depression (PPD) is a debilitating mental disorder with a prevalence of between 3.5%. PPD in women can manifest as sleep disorder, mood swings, sadness and crying, fear of injury, loss of appetite, serious concerns about their child, a lack of interest in daily activities, and even suicide and death [4]. The risk factors of PPD are complicated; they include psychiatric (e.g., a previous history of depression and anxiety), obstetric (e.g., postpartum complications), biological (e.g., young age, glucose metabolism disorders), hormonal (e.g., oxytocin and estrogen imbalances), social (e.g., a lack of familial support or financial support), and lifestyle (e.g., food intake patterns, sleep status, exercise, and physical activity) factors [5,6,7,8,9,10].
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