Effect of fish oil omega-3 fatty acids on reduction of depressive symptoms among HIV-seropositive pregnant women: a randomized, double-blind controlled trial

Rose Okoyo Opiyo,Wambui Kogi-Makau,Reuben Kamau Koigi,Dorington Ogoyi,Anne Obondo,Peter Suwirakwenda Nyasulu

doi:10.1186/s12991-018-0220-4

Rose Okoyo Opiyo, Wambui Kogi-Makau + Show 4 more

Open Access

https://doi.org/10.1186/s12991-018-0220-4

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Abstract

BackgroundGlobally, it is known that HIV-infected pregnant women are prone to depressive symptoms. Research evidences also suggest that nutrient deficiencies may enhance the depressive illness, and that fish oil omega-3 fatty acids may alleviate the depressive symptoms. The aim of this study was to assess the effect of fish oil omega-3 eicosapentaenoic acid-rich supplements on depressive symptoms among HIV-seropositive pregnant women.Trial designA randomized double-blinded controlled trial with two parallel groups was conducted. The intervention group received fish oil omega-3 of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) per day for 8 weeks, while the control group received soybean oil for a similar period.MethodParticipants were HIV-seropositive pregnant women who were enrolled in prevention of mother-to-child transmission programs and attending antenatal clinics at selected Nairobi city county’s health facilities. Recruitment was done from health records of HIV-infected pregnant women. Data analysis followed per-protocol analysis. Participants who completed the 8-week trial were included in the analysis of covariance statistical model with omega-3 as main effect. The covariates in the change in BDI-II depressive symptom score outcome were baseline characteristics and nutrient adequacy.Results282 participants were recruited 109 randomized to fish oil, and 107 to soybean oil. Completion rate was 86/109 (78.9%) and 96/107 (89.7%) respectively. At the end of week-8 of follow up most participants in both arms had mild depressive symptoms 82/86 (95.3%) in the Fish oil group and 94/96 (97.9%) in the Soybean oil group. The difference in effect between the intervention and control group was not statistically significant (1.01 (95% CI − 0.58 to 2.60), p = 0.21).ConclusionFish oil omega-3 with a daily dosage of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) appears to provide no added benefit in reduction of the symptoms of depression in HIV-infected pregnant women.Trial Registration Clinical Trial Registry: NCT01614249. Registered on June 5, 2012. https://clinicaltrials.gov/ct2/show/NCT01614249

Highlights

During pregnancy, women may experience at least one episode of minor or major depression referred to as perinatal or maternal depression
At the end of week-8 of follow up most participants in both arms had mild depressive symptoms 82/86 (95.3%) in the Fish oil group and 94/96 (97.9%) in the Soybean oil group
The null hypothesis of this study was that there is no difference in the magnitude of change in Beck Depression Inventory Second Edition (BDI-II) scores between HIVseropositive pregnant women with depressive symptoms taking fish oil omega-3 eicosapentaenoic acid (EPA)-rich supplements and the control group taking soybean oil soft gels

Summary

Introduction

Women may experience at least one episode of minor or major depression referred to as perinatal or maternal depression. It is known that human immunodeficiency virus (HIV)-infected pregnant women are prone to depression [5,6,7,8]. The depression symptoms in HIVinfected pregnant women may be due to the effects of pregnancy, HIV infection or a combination of both pregnancy and HIV infection. These research evidences suggest that depression in HIV-infected pregnant women is a public health problem. It is known that HIV-infected pregnant women are prone to depressive symptoms. Research evidences suggest that nutrient deficiencies may enhance the depressive illness, and that fish oil omega-3 fatty acids may alleviate the depressive symptoms. The aim of this study was to assess the effect of fish oil omega-3 eicosa‐ pentaenoic acid-rich supplements on depressive symptoms among HIV-seropositive pregnant women.

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