Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort

B.M. Leung, B.J. Kaplan, C.J. Field, S. Tough, M. Eliasziw, M.F. Gomez, L.J. McCargar, L. Gagnon, the APrON Study Team, V.J.M. Pop

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Abstract

Background
Postpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study investigated the association between prenatal micronutrient supplementation and the risk for symptoms of postpartum depression in a longitudinal pregnancy cohort from the Alberta Pregnancy Outcomes and Nutrition (APrON) study.
Methods
Participants came from a cohort of the first 600 APrON women. Supplemental nutrient intake and symptoms of depression (measured with the Edinburgh Postnatal Depression Scale (EPDS)) were collected at each trimester and 12 weeks postpartum.
Results
Of the 475 participants who completed the EPDS at least twice in pregnancy and at 12 weeks postpartum, 416 (88%) scored <10 and 59 (12%) scored ≥10, where an EPDS ≥10 is considered to be “at least probable minor depression”. Mean nutrient intakes from supplements were higher in women with lower EPDS scores, particularly selenium (p = 0.0015) and omega-3s (p = 0.01). Bivariate analyses showed that several demographic and social/lifestyle variables were associated with EPDS ≥10: not having been born in Canada (p = 0.01), greater number of chronic conditions (p = 0.05), greater number of stressful life events during this pregnancy (p = 0.02), and lower prenatal and postnatal support (p = 0.0043 and p = 0.0001, respectively). Adjusting for covariates and nutrients known to be associated with postpartum depression, logistic regression showed that having a prenatal EPDS ≥ 10 increased the odds of postpartum depressive symptoms (second and third trimester OR = 3.29, 95% CI = 1.55 - 7.01, p = 0.004 and OR = 4.26, 95% CI = 2.05 - 8.85, p < 0.0001, respectively), while prenatal supplemental selenium (per 10 mcg, OR = 0.76, 95% CI = 0.74 - 0.78, p = 0.0019) and postnatal social support (OR = 0.87, 95% CI = 0.78 - 0.97, p = 0.0015) were protective.
Conclusions
Multiple factors, including supplementary selenium intake, are associated with the risk of postpartum depressive symptoms. Future research on dietary supplementation in pregnancy with special attention to selenium intake is warranted.
Keywords: Postpartum depression, Dietary supplements, Selenium, Omega-3
Original languageEnglish
Article number2
JournalBMC Pregnancy and Childbirth
Volume13
DOIs
Publication statusPublished - 2013

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Postpartum Depression
Depression
Prenatal Nutritional Physiological Phenomena
Alberta
Mental Health
Logistic Models

Cite this

Leung, B.M. ; Kaplan, B.J. ; Field, C.J. ; Tough, S. ; Eliasziw, M. ; Gomez, M.F. ; McCargar, L.J. ; Gagnon, L. ; APrON Study Team, the ; Pop, V.J.M. / Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort. In: BMC Pregnancy and Childbirth. 2013 ; Vol. 13.
@article{98bdafa6e1a54d27bed6798c72cda8fe,
title = "Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort",
abstract = "BackgroundPostpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study investigated the association between prenatal micronutrient supplementation and the risk for symptoms of postpartum depression in a longitudinal pregnancy cohort from the Alberta Pregnancy Outcomes and Nutrition (APrON) study.MethodsParticipants came from a cohort of the first 600 APrON women. Supplemental nutrient intake and symptoms of depression (measured with the Edinburgh Postnatal Depression Scale (EPDS)) were collected at each trimester and 12 weeks postpartum.ResultsOf the 475 participants who completed the EPDS at least twice in pregnancy and at 12 weeks postpartum, 416 (88{\%}) scored <10 and 59 (12{\%}) scored ≥10, where an EPDS ≥10 is considered to be “at least probable minor depression”. Mean nutrient intakes from supplements were higher in women with lower EPDS scores, particularly selenium (p = 0.0015) and omega-3s (p = 0.01). Bivariate analyses showed that several demographic and social/lifestyle variables were associated with EPDS ≥10: not having been born in Canada (p = 0.01), greater number of chronic conditions (p = 0.05), greater number of stressful life events during this pregnancy (p = 0.02), and lower prenatal and postnatal support (p = 0.0043 and p = 0.0001, respectively). Adjusting for covariates and nutrients known to be associated with postpartum depression, logistic regression showed that having a prenatal EPDS ≥ 10 increased the odds of postpartum depressive symptoms (second and third trimester OR = 3.29, 95{\%} CI = 1.55 - 7.01, p = 0.004 and OR = 4.26, 95{\%} CI = 2.05 - 8.85, p < 0.0001, respectively), while prenatal supplemental selenium (per 10 mcg, OR = 0.76, 95{\%} CI = 0.74 - 0.78, p = 0.0019) and postnatal social support (OR = 0.87, 95{\%} CI = 0.78 - 0.97, p = 0.0015) were protective.ConclusionsMultiple factors, including supplementary selenium intake, are associated with the risk of postpartum depressive symptoms. Future research on dietary supplementation in pregnancy with special attention to selenium intake is warranted.Keywords: Postpartum depression, Dietary supplements, Selenium, Omega-3",
author = "B.M. Leung and B.J. Kaplan and C.J. Field and S. Tough and M. Eliasziw and M.F. Gomez and L.J. McCargar and L. Gagnon and {APrON Study Team}, the and V.J.M. Pop",
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doi = "10.1186/1471-2393-13-2",
language = "English",
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journal = "BMC Pregnancy and Childbirth",
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Leung, BM, Kaplan, BJ, Field, CJ, Tough, S, Eliasziw, M, Gomez, MF, McCargar, LJ, Gagnon, L, APrON Study Team, T & Pop, VJM 2013, 'Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort', BMC Pregnancy and Childbirth, vol. 13, 2. https://doi.org/10.1186/1471-2393-13-2

Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort. / Leung, B.M.; Kaplan, B.J.; Field, C.J.; Tough, S.; Eliasziw, M.; Gomez, M.F.; McCargar, L.J.; Gagnon, L.; APrON Study Team, the; Pop, V.J.M.

In: BMC Pregnancy and Childbirth, Vol. 13, 2, 2013.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort

AU - Leung, B.M.

AU - Kaplan, B.J.

AU - Field, C.J.

AU - Tough, S.

AU - Eliasziw, M.

AU - Gomez, M.F.

AU - McCargar, L.J.

AU - Gagnon, L.

AU - APrON Study Team, the

AU - Pop, V.J.M.

N1 - >2000 woorden

PY - 2013

Y1 - 2013

N2 - BackgroundPostpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study investigated the association between prenatal micronutrient supplementation and the risk for symptoms of postpartum depression in a longitudinal pregnancy cohort from the Alberta Pregnancy Outcomes and Nutrition (APrON) study.MethodsParticipants came from a cohort of the first 600 APrON women. Supplemental nutrient intake and symptoms of depression (measured with the Edinburgh Postnatal Depression Scale (EPDS)) were collected at each trimester and 12 weeks postpartum.ResultsOf the 475 participants who completed the EPDS at least twice in pregnancy and at 12 weeks postpartum, 416 (88%) scored <10 and 59 (12%) scored ≥10, where an EPDS ≥10 is considered to be “at least probable minor depression”. Mean nutrient intakes from supplements were higher in women with lower EPDS scores, particularly selenium (p = 0.0015) and omega-3s (p = 0.01). Bivariate analyses showed that several demographic and social/lifestyle variables were associated with EPDS ≥10: not having been born in Canada (p = 0.01), greater number of chronic conditions (p = 0.05), greater number of stressful life events during this pregnancy (p = 0.02), and lower prenatal and postnatal support (p = 0.0043 and p = 0.0001, respectively). Adjusting for covariates and nutrients known to be associated with postpartum depression, logistic regression showed that having a prenatal EPDS ≥ 10 increased the odds of postpartum depressive symptoms (second and third trimester OR = 3.29, 95% CI = 1.55 - 7.01, p = 0.004 and OR = 4.26, 95% CI = 2.05 - 8.85, p < 0.0001, respectively), while prenatal supplemental selenium (per 10 mcg, OR = 0.76, 95% CI = 0.74 - 0.78, p = 0.0019) and postnatal social support (OR = 0.87, 95% CI = 0.78 - 0.97, p = 0.0015) were protective.ConclusionsMultiple factors, including supplementary selenium intake, are associated with the risk of postpartum depressive symptoms. Future research on dietary supplementation in pregnancy with special attention to selenium intake is warranted.Keywords: Postpartum depression, Dietary supplements, Selenium, Omega-3

AB - BackgroundPostpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study investigated the association between prenatal micronutrient supplementation and the risk for symptoms of postpartum depression in a longitudinal pregnancy cohort from the Alberta Pregnancy Outcomes and Nutrition (APrON) study.MethodsParticipants came from a cohort of the first 600 APrON women. Supplemental nutrient intake and symptoms of depression (measured with the Edinburgh Postnatal Depression Scale (EPDS)) were collected at each trimester and 12 weeks postpartum.ResultsOf the 475 participants who completed the EPDS at least twice in pregnancy and at 12 weeks postpartum, 416 (88%) scored <10 and 59 (12%) scored ≥10, where an EPDS ≥10 is considered to be “at least probable minor depression”. Mean nutrient intakes from supplements were higher in women with lower EPDS scores, particularly selenium (p = 0.0015) and omega-3s (p = 0.01). Bivariate analyses showed that several demographic and social/lifestyle variables were associated with EPDS ≥10: not having been born in Canada (p = 0.01), greater number of chronic conditions (p = 0.05), greater number of stressful life events during this pregnancy (p = 0.02), and lower prenatal and postnatal support (p = 0.0043 and p = 0.0001, respectively). Adjusting for covariates and nutrients known to be associated with postpartum depression, logistic regression showed that having a prenatal EPDS ≥ 10 increased the odds of postpartum depressive symptoms (second and third trimester OR = 3.29, 95% CI = 1.55 - 7.01, p = 0.004 and OR = 4.26, 95% CI = 2.05 - 8.85, p < 0.0001, respectively), while prenatal supplemental selenium (per 10 mcg, OR = 0.76, 95% CI = 0.74 - 0.78, p = 0.0019) and postnatal social support (OR = 0.87, 95% CI = 0.78 - 0.97, p = 0.0015) were protective.ConclusionsMultiple factors, including supplementary selenium intake, are associated with the risk of postpartum depressive symptoms. Future research on dietary supplementation in pregnancy with special attention to selenium intake is warranted.Keywords: Postpartum depression, Dietary supplements, Selenium, Omega-3

U2 - 10.1186/1471-2393-13-2

DO - 10.1186/1471-2393-13-2

M3 - Article

VL - 13

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

SN - 1471-2393

M1 - 2

ER -