Imbalance between Omega-6 and Omega-3 Polyunsaturated Fatty Acids in Early Pregnancy Is Predictive of Postpartum Depression in a Belgian Cohort.

Hoge Hoge,Degée Degée,Tabar Tabar,Castronovo Castronovo,Guillaume Guillaume,Nisolle Nisolle,Donneau Donneau,Dardenne Dardenne,Timmermans Timmermans

doi:10.3390/nu11040876

Abstract

While studies revealed that the omega-3 polyunsaturated fatty acids (n-3 PUFA) and their mediators would be able to regulate several biological processes involved into the development of postpartum depression (PPD), evidence from observational studies remains mixed. The aim of the present study was to investigate the association between maternal erythrocyte n-3 PUFA, measured in early pregnancy, and the risk of PPD. A Belgian cohort of 72 healthy women was screened. Erythrocyte fatty acids were analysed using gas chromatography. PPD was assessed using the Bromley Postnatal Depression Scale by phone interview one year after delivery. We observed a significant negative association between docosahexaenoic acid (DHA) levels and the risk of postpartum depression in the adjusted model (p = 0.034). Higher n-6/n-3 and arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratios were significantly associated with an increased odds of PPD (p = 0.013 and p = 0.043, respectively). Women with an omega-3 index <5% had a 5-fold increased risk of depressive episode than did those with an omega-3 index ≥5% (OR 5.22 (95% CI 1.24–21.88)). A low n-3 PUFA status, alone and combined with high n-6 PUFA status, in early pregnancy was associated with a greater risk of PPD. Management of maternal n-3 PUFA deficiency can be a simple, safe and cost-effective strategy for the prevention of this major public health issue.

Highlights

Maternal mental health problems are increasingly recognized as major public health concerns, due to high prevalence rates worldwide and poor outcomes affecting mothers and new-borns and other family members [1]
We previously demonstrated that n-3 long-chain polyunsaturated fatty acids (LCPUFA) deficiency could occur as soon as the early stages of pregnancy [41]
We found that lower n-3 PUFA content, alone and combined with higher n-6 PUFA content, in maternal erythrocytes at early stages of pregnancy is associated with higher risk of depressive symptoms during the first year after childbirth

Summary

Introduction

Maternal mental health problems are increasingly recognized as major public health concerns, due to high prevalence rates worldwide and poor outcomes affecting mothers and new-borns and other family members [1]. Postpartum depression (PPD) is the most common complication related to childbearing; approximatively 10 to 20% of mothers experience a depressive episode following delivery in developed countries [2,3]. Beyond maternal suffering [4,5], PPD affects the mother-baby interaction in a negative way [6,7]. This situation is likely to have short and long-term adverse consequences on several aspects of the child development, including emotional, cognitive. The effectiveness of antidepressants has been questioned for a few years, and data concerning the prevention of postpartum depression remains very limited [10,11,12]. The benefit-risk ratio associated with depression treatment remains to be further evaluated in pregnant and lactating women [13]

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