Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study.

Jennifer Anne Williams,Ellen L Mozurkewich,Ellen L Mozurkewich,Sheila M Marcus,Delia M Vazquez,Chelsea M Clinton,Julie L Chilimigras,Lucy J Allbaugh,Vivian C Romero,Vivian C Romero,Anjel M Vahratian,Susan E Hamilton,Ronald M Schrader

doi:10.1186/s12884-016-0988-7

Abstract

BackgroundVitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy.MethodsThis study was a secondary analysis of a randomized trial designed to assess whether prenatal omega-3 fatty acid supplementation would prevent depressive symptoms. Pregnant women from Michigan who were at risk for depression based on Edinburgh Postnatal Depression Scale Score or history of depression were enrolled. Participants completed the Beck Depression Inventory (BDI) and Mini International Neuropsychiatric Interview at 12–20 weeks, 26–28 weeks, 34–36 weeks, and 6–8 weeks postpartum. Vitamin D levels were measured at 12–20 weeks (N = 117) and 34–36 weeks (N = 112). Complete datasets were available on 105 subjects. Using regression analyses, we evaluated the relationship between vitamin D levels with BDI scores as well as with MINI diagnoses of major depressive disorder and generalized anxiety disorder. Our primary outcome measure was the association of maternal vitamin D levels with BDI scores during early and late pregnancy and postpartum.ResultsWe found that vitamin D levels at 12–20 weeks were inversely associated with BDI scores both at 12—20 and at 34–36 weeks’ gestation (P < 0.05, both). For every one unit increase in vitamin D in early pregnancy, the average decrease in the mean BDI score was .14 units. Vitamin D levels were not associated with diagnoses of major depressive disorder or generalized anxiety disorder.ConclusionsIn women at risk for depression, early pregnancy low vitamin D levels are associated with higher depressive symptom scores in early and late pregnancy. Future investigations should study whether vitamin D supplementation in early pregnancy may prevent perinatal depressive symptoms.Trial registrationhttps://clinicaltrials.gov/ Registration Number: NCT00711971

Highlights

Vitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults
As a secondary aim of this study, we evaluated whether vitamin D levels were associated with Mini International Neuropsychiatric Interview diagnoses of major depressive disorder (MDD), generalized anxiety disorder (GAD), or anxiety symptoms (MINI anxiety subtest, question 1a) [34]
Using analysis of covariance (ANCOVA), and adjusting for season, we found that vitamin D at 12–20 weeks was a significant predictor of the Beck Depression Inventory (BDI) score at 12–20 (P < 0.05) weeks and at 34–36 weeks gestation (P < 0.05)

Summary

Introduction

Vitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. A systematic review and meta-analysis of observational studies involving 31,424 non-pregnant adults found low vitamin D levels to be significantly associated with clinical diagnoses of depression [13]. One hypothesized physiologic mechanism through which Vitamin D may act to affect depressive symptoms has emerged with the understanding that vitamin D acts as a neuroactive hormone, in addition to its role as a fatsoluble vitamin [15]. Supporting this concept, Eyles et al demonstrated that vitamin D receptors are broadly distributed throughout the human brain [16] and animal studies have found that vitamin D deficiency or dietary manipulation/addition of vitamin D alters neurotransmitters that are known to be involved in depressive symptoms and depression [17,18,19,20]. Vitamin D may play a role in neuroimmunomodulation and neuroplasticity, a proposed mechanism for the observed effect on mood [21]

Objectives

Methods

Results

Discussion

Conclusion