The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression

Abstract

Depressive symptoms are common during pregnancy and the post-partum period. Although essential n-3 PUFA may have beneficial effects on depression, it remains unclear whether they are also effective for perinatal depression. The purpose of the present study was to assess the efficacy of n-3 supplementation for perinatal depression, by performing a meta-analysis on currently available data. After a thorough literature search, we included seven randomised controlled trials in the meta-analysis, all with EPA and/or DHA supplementation. Most studies were judged to be of low-to-moderate quality, mainly due to small sample sizes and failure to adhere to Consolidated Standards of Reporting Trials guidelines. Some studies were not primarily designed to address perinatal depression. A total of 309 women on n-3 fatty acid supplementation were compared with 303 women on placebo treatment. n-3 Supplementation was not found to be significantly more effective than placebo at post-treatment with a pooled effect size (Hedges's g) of 20·03 (95 % CI 2 0·18, 0·13; P¼ 0·76) using a fixed-effects model. Heterogeneity was low-to-moderate (I 2 ¼ 30 %). In a subgroup analysis of three small studies of pregnant women with major depression, there was some indication of effectiveness (effect size 0·17; 95 % CI 2 0·21, 0·55). In conclusion, the question of whether EPA and DHA administration is effective in the prevention or treatment of perinatal depression cannot be answered yet. Future research should focus on women who are clinically depressed (or at risk). The quality of research in this area needs to improve.

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

“…61,121,123,129,[146][147][148][149][150] Yield of systematic reviews Twenty-three reviews were included (i.e. Austin et al, 230 Bennett et al, 231 Cuijpers et al, 68 Dale et al, 232 Dennis and Creedy, 233 Dennis, 234 Dennis, 118 Dennis, 235 Dennis and Kingston, 236 Dennis et al, 237 Dennis, 238 Dodd and Crowther, 239 Fontein-Kuipers et al, 240 Howard et al, 241 Jans et al, 242 Lawrie et al, 243 Leis et al, 244 Lumley et al, 245 Marc et al, 246 Miller et al, 247 Sado et al, 248 Shaw et al 249 and Sockol et al…”

Estado actual del conocimiento sobre el cuidado nutricional de la mujer embarazada

“…Asimismo, los metaanálisis apuntan a que no existen evidencias concluyentes que permitan hacer una recomendación en torno a la suplementación con omega-3 para tratar o prevenir la depresión prenatal o postparto, la preeclampsia y el parto prematuro [11][12][13][14][15] . Existe, por lo tanto, inconsistencia de datos, y son necesarios más estudios para poder establecer una recomendación al respecto.…”

“…Intermittent iron supplementation can also be an appropriated intervention. If the diet does not guarantee and adequate support, iodine, vitamin B 12 and vitamin D supplements should also be necessaries. The anthropometric assessment by the pattern of weight gain should be present at each prenatal care visit to prevent maternal and fetal complications.…”

Table of Contents

“…1 Although PBA is rarely life-threatening, it can have a significant impact on the patient's quality of life, thus meriting treatment. 2 PBA is reported to affect 10% of patients with MS, 11% of patients 1 year following a stroke, 11% of patients 1 year following traumatic brain injury, 18% of patients with Alzheimer's disease (AD), and 49% of patients with ALS. Despite its prevalence in these patient populations, PBA remains underrecognized and undertreated, write Pioro and colleagues.…”

“…3 Small placebo-controlled trials and case series have found tricyclic anti depressants and selective serotonin reuptake inhibitors (SSRIs) effective in treating PBA. 2 Other trials have investigated L-dopa in PBA, yielding mixed results. Much of the clinical trial data have been limited by small sample sizes, ambiguous definitions of PBA improvement, and a strong placebo effect, which make "uncontrolled findings all the more difficult to interpret.…”