Depression in pregnancy: omega-3 deficiency and inflammation among causes?
Depression in pregnancy, a disorder that affects about 16 percent of pregnant women, is associated with omega-3 deficiency in the blood and increased inflammation. At the second and third months of gestation, depressed women, compared with healthy women, show lower concentrations of EPA and DHA and higher amounts of TNF-α, a signal molecule of the inflammatory state. Omega-3 deficiency is also related to prolonged depressive episodes, which may last even after delivery.
This was reported in a recent study conducted by researchers at China Medical University in Taichung, Taiwan, and published in the scientific journal Progress in NeuroPsychopharmacology and Biological Psychiatry.
Prenatal depression: a common but often unrecognized disorder
Prenatal depression (PND), or depression in pregnancy, is a very common condition in women of childbearing age and is a major complication during pregnancy and the major risk factor for postpartum depression.
Prenatal depression is a psychiatric disorder that affects about 16% of women during the period of motherhood. The prevalence of depression in pregnancy is highest in the first trimester, while it decreases in the second and third trimesters. Only 49% of pregnant women affected by depression seek medical attention, and the symptoms are frequently underestimated by both patients and specialists, so much so that the disorder often goes unrecognized. Depression in pregnancy can have major consequences in the lives of the mother-to-be, the baby, and the rest of the family.
This type of disorder can affect women of any age, background, and social background, although the most common risk factors include both socioeconomic and health and physiological conditions of women, including:
- pregnancy at a very young age
- lack of family support
- conflictual relationship with the partner
- poor socio-economic conditions
- hormonal problems
- physical or psychological disorders
The consequences of depression in pregnancy can lead the mother-to-be to engage in dangerous behaviors such as poor self-care, lack of appetite and malnutrition, alcohol or tobacco abuse, and inability to recognize the prodromes of childbirth. In addition, as mentioned above, prenatal depression may predispose to postpartum depression, which is an important cause of psychosocial dysfunction, suicide, and adverse care of the newborn. Several studies over the years have shown the importance of a healthy diet and the right intake of vitamins and omega-3s for the health of mothers and babies, and have suggested the existence of a link between EPA and DHA deficiency and an increased risk of suffering from depression both before and after childbirth.
Depression in pregnancy is more frequent when there is omega-3 deficiency
The study by Taiwanese researchers measured in women with PND and those without depression, levels of omega-3 and inflammatory markers, such as tumor necrosis factor-alpha (TNF-α), during the second and third trimesters of pregnancy. Their results showed that mothers-to-be with depressive disorder had significantly lower levels of omega-3 and higher levels of TNF-α, compared with healthy women. These data are in agreement with those of other studies indicating that high levels of DHA and EPA in the blood act as protective factors against major depressive disorder. In addition, higher DHA concentration in breast milk and higher consumption of DHA-rich fish were associated with lower prevalence of postpartum depression. As well as, both DHA and EPA have been shown to be effective in the prevention and treatment of depressive disorders.
Omega-3s are essential fatty acids for fetal development, with an important role in cellular and physiological function in the perinatal period, that is, the period from pregnancy to 12 months after birth. In this period therefore, the increased requirement for EPA and DHA, could increase the risk of PND in pregnant women, especially because the physiological and psychological stress caused by pregnancy could trigger the release of inflammatory substances, such as pro-inflammatory cytokines and TNF- α, which may be a biological indicator or even precursor of depression in pregnancy.
Some details of the study
Thirty-three women were involved in the study; 16 healthy and 17 with PND. Blood samples were taken and analyzed from each of them. The cases of depression were diagnosed with a specific diagnostic and mental disorders manual. Once collected, the data were correlated with specific statistical analysis, showing that depressive syndrome was significantly associated with lower levels of DHA, EPA, total omega-3, and a high ratio of omega-6 to omega-3. The duration of PND was found to be associated with lower levels of DHA and EPA, the ratio of omega-6 to omega-3, and the concentration of TNF-α. Omega-3s are essential to combat neuroinflammation According to the researchers who conducted the study, it is possible to hypothesize that sufficient levels of omega-3s are needed to combat neuroinflammation and produce an antidepressant effect in pregnant women. As is well known, these fatty acids are constituents of the membranes of neurons and are involved in the proper functioning of the transmission of neurotransmitters involved in mood regulation. However, further future studies with larger sample sizes will be needed to replicate the results and to help clarify the role of the inflammatory mechanism in patients with depression in pregnancy.
Source: Jane Pei-ChenChang et al, "Polyunsaturated fatty acids and inflammatory markers in major depressive episodes during pregnancy." Progress in Neuro-Psychopharmacology and Biological Psychiatry.
