Levels of n-3 and n-6 Fatty Acids in Maternal Erythrocytes during Pregnancy and in Human Milk and Its Association with Perinatal Mental Health

Corinne Urech,Simone R B M Eussen,Johannes Bitzer,Bernd Stahl,Judith Alder,Günter Boehm,Nana Bartke,Irene Hoesli

doi:10.3390/nu12092773

Abstract

Omega-3 long-chain polyunsaturated fatty acid (n-3 FA) status may be associated with mood disorders. Here, we evaluated the potential association between antenatal depression/anxiety and n-3/n-6 FA in (a) maternal erythrocytes and (b) human milk. In addition, we explored associations between n-3/n-6 FA in erythrocytes and in human milk and postpartum depression, while controlling for antenatal depression. Twenty-seven pregnant women diagnosed with a current major depressive disorder (MDD; n = 9), anxiety disorder (AD; n = 10) or a mixed anxiety-depression disorder (MADD; n = 8), and 40 healthy controls were included. n-3/n-6 FA were determined in maternal erythrocytes in gestational week 32 and in human milk in postpartum week 1. In the first week postpartum, the Edinburgh-Postnatal-Depression-Questionnaire was used to assess postpartum depression. Results show that women with M(A)DD had significantly lower erythrocyte levels of total n-3 FA, EPA, DHA and DGLA, and significantly higher n-6 DPA, and n-6:n-3, AA:EPA and n-6 DPA:DHA ratios compared to healthy controls. No significant associations between antenatal depression or anxiety and n-3/n-6 FA in human milk were found. After controlling for antenatal mental health, n-3/n-6 FA in maternal erythrocytes or in human milk were not significantly associated with postpartum depression. In conclusion, antenatal depression, alone or with an anxiety disorder, was associated with lower n-3 FA levels and higher n-6:n-3 FA ratios in maternal erythrocytes during gestation. This study provides some insights into the associations between n-3/n-6 FA levels during pregnancy and lactation and perinatal mental health.

Highlights

The prevalence rates of depression and anxiety disorders in women during pregnancy are high, with estimates ranging from 7% to 20% for antenatal depression [1,2,3,4,5,6,7,8] and 9% to 21% for antenatal anxiety disorders [9]
We considered antenatal mental health in the association of n-3/n-6 FA levels and postpartum depression. This exploratory case-control study found that lower levels of total and specific n-3 FA and higher n-6:n-3 FA ratios (i.e., n-6:n-3 ratio, AA:EPA ratio and n-6 DPA:docosahexaenoic acid (DHA) ratio) in erythrocytes at 32 weeks of gestation were associated with antenatal depression
These associations were not observed for antenatal anxiety, nor between antenatal anxiety and/or depression and n-3/n-6 FA in human milk collected during the first week of life

Summary

Introduction

The prevalence rates of depression and anxiety disorders in women during pregnancy are high, with estimates ranging from 7% to 20% for antenatal depression [1,2,3,4,5,6,7,8] and 9% to 21% for antenatal anxiety disorders [9]. Maternal mental health problems during pregnancy have a significant impact on both mother and child. Antenatal mental health has direct detrimental effects on the mother and child, but it is one of the strongest predictors for developing postpartum depression [13]. Besides a history of (antenatal) depression and anxiety, the risk factors for postpartum depression are: stressful life events, poor marital relationships, lack of social support, low socioeconomic status, unplanned or unwanted pregnancies and biological factors, such as hormone levels [17]. Postpartum depression can interfere with normal mother–infant interaction and constitutes a risk factor for poor child development: infants of depressed mothers are more likely to have low social competence and cognitive deficits [5,10,18]

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