Cross-sectional Association Between Vitamin B12 Status and Probable Postpartum Depression in Indian Women

Abstract

BackgroundVitamin B12 is an essential micronutrient for neurological function, as it leads to the regeneration of methionine from homocysteine, which is precursor of biologically active molecule SAM. Pregnancy is a state of increased demand and delayed postpartum repletion of nutrients may predispose women to depression. MethodsWomen attending postpartum clinic at 6 weeks post-delivery were screened for the presence of depressive symptoms using Edinburg postpartum depression scale (EPDS). Based on a cut-off of 10, two groups were taken- women with probable depression with EPDS score>10 (n=217) and women without probable depression with EPDS score<10(n=217). Plasma total vitamin B12, holotranscobalamin, homocysteine, MMA, 5-methyl THF, SAM and serotonin levels were estimated using commercially available ELISA kits. Combined B12(cB12) score was calculated and analysis of resulting data was done using SPSS ver20.0. ResultsTotal vitamin B12 was significantly lower (p=0.001) and MMA (p=0.002) and 5-methyl THF(p<0.001) levels were higher in women with probable depression than women without probable depression. Combined B12 index was also lower in women with probable PPD (p=0.001). Women in the lowest vitamin B12 quartile had 4.53 times higher likelihood of probable postpartum depression (p < 0.001). Decreasing vitamin B12 (OR = 0.394; 95% CI: 0.189-0.822) and cB12 (OR=0.293; 95% CI:0182-0.470) and increasing MMA (OR = 2.14; 95% CI: 1.63-2.83) and 5-methyl THF levels (OR = 3.29; 95% CI: 1.59-6.83) were significantly associated with the risk of PPD.ConclusionLow vitamin B12 may contribute to depressive symptoms in vulnerable postpartum period.