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Serum n-3 polyunsaturated fatty acids are inversely associated with longitudinal changes in depressive symptoms during pregnancy

Published online by Cambridge University Press:  30 March 2016

T. J. P. Pinto ,
A. A. F. Vilela ,
D. R. Farias ,
J. Lepsch ,
G. M. Cunha ,
J. S. Vaz ,
P. Factor-Litvak  and
G. Kac
T. J. P. Pinto
Affiliation:
National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480 – Manguinhos, Rio de Janeiro, RJ, Brazil Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367/CCS – Bloco J – 2° andar, sala 29. Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, Brazil
A. A. F. Vilela
Affiliation:
Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367/CCS – Bloco J – 2° andar, sala 29. Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, Brazil
D. R. Farias
Affiliation:
Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367/CCS – Bloco J – 2° andar, sala 29. Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, Brazil
J. Lepsch
Affiliation:
Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367/CCS – Bloco J – 2° andar, sala 29. Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, Brazil
G. M. Cunha
Affiliation:
National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480 – Manguinhos, Rio de Janeiro, RJ, Brazil
J. S. Vaz
Affiliation:
Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367/CCS – Bloco J – 2° andar, sala 29. Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, Brazil Faculty of Nutrition, Federal University of Pelotas, Rua Gomes Carneiro, 1 – Campus Porto, Pelotas, RS, Brazil
P. Factor-Litvak
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York NY10032, USA
G. Kac*
Affiliation:
Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367/CCS – Bloco J – 2° andar, sala 29. Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, Brazil
*
*Address for correspondence: G. Kac, Department of Social and Applied Nutrition, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 373, CCS – Bloco J2, Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ 21941-902, Brazil. (Email: [email protected])
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Abstract

Backgrounds.

N-3 polyunsaturated fatty acids (PUFAs) have been hypothesised to be protective for depression during pregnancy. However, there are few data and no consensus regarding this association. In this line, we aim to evaluate if the concentration of n-3 and n-6 PUFAs, and their ratio, are associated with depressive symptoms throughout pregnancy.

Method.

A prospective cohort of 172 Brazilian women was followed at 5–13th, 20–26th and 30–36th weeks of gestation. The presence of depressive symptoms was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) at each pregnancy trimester. Depression was defined as an EPDS score ≥11. The concentrations of n-3 [α-linolenic acid; eicosapentaenoic acid (EPA); docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)] and n-6 PUFAs [linoleic acid; γ linolenic acid; eicosadienoic acid; eicosatrienoic acid; arachidonic acid; docosatetraenoic acid and docosapentaenoic acid] were expressed as absolute (μg/ml) values. The total n-6/n-3 ratio was calculated. Statistical analyses were performed using univariate and adjusted random intercept logistic model for each fatty acid (FA) considering the longitudinal nature of data. Covariates were selected as potential confounders based on their biological plausibility of having an association with the concentration of FA and depressive symptoms during pregnancy.

Results.

The prevalence of depressive symptoms was high in all pregnancy trimesters (1st = 33.7%; 2nd = 18.9%; 3rd = 17.4%). We did not find differences in means FA concentrations by depressive symptom classification, for each follow-up visit. The women presented a 5% decrease in the odds of having depressive symptoms for each one-week increase in the gestational age. As individual women progressed through pregnancy, higher concentrations of EPA (odds ratio (OR) = 0.92; 95% CI: 0.86–0.99), DHA (OR = 0.96; 95% CI: 0.93–0.99), DPA (OR = 0.87; 95% CI: 0.77–0.99) and total n-3 (OR = 0.98; 95% CI: 0.96–0.99) were associated with a lower odds of depressive symptoms, while higher total n-6/n-3 ratio were associated with greater odds of depressive symptoms (OR = 1.40; 95% CI: 1.09–1.79). We detected a decrease in the probability of depressive symptoms as concentrations of total n-3 FA, α-linolenic acid, DPA, and DHA increased. We also observed a sharper decline for women with initial greater chance of depressive symptoms compared with those with lower chance of having these symptoms.

Conclusions.

We found a high prevalence of depressive symptoms in low-income Brazilian pregnant women and no significant associations between n-6 FA and depressive symptoms. Lower serum concentrations of DHA, EPA and DPA and a higher n-6/n-3 ratio at each pregnancy trimester were associated with higher odds of depressive symptoms throughout pregnancy.

Keywords

Depressionmental healthnutritionpregnancyprospective study
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 26 , Issue 2 , April 2017 , pp. 157 - 168
Copyright
Copyright © Cambridge University Press 2016 

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