Vitamin D Status during Pregnancy and the Risk of Subsequent Postpartum Depression: A Case-Control Study

Nielsen, Nina Odgaard; Strøm, Marin; Boyd, Heather A.; Andersen, Elisabeth Wreford; Wohlfahrt, Jan; Lundqvist, Marika; Cohen, Arieh; Hougaard, David M.; Melbye, Mads

doi:10.1371/journal.pone.0080686

Cited by 61 publications

(86 citation statements)

References 43 publications

(51 reference statements)

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“…Similarly, Robinson et al 27 reported that women in the lowest quartile for 25(OH)D status were more likely to have a higher level of PPD symptoms than were women who were in the highest quartile, even after accounting for a range of confounding variables. In contrast, a study by Nielsen et al 28 29 reported that symptoms of depression during or before pregnancy can predict higher PPD symptoms. Similarly, our findings also suggested that depression during or prior to pregnancy can be seen as a predictor of PPD.…”

Section: Resultsmentioning

confidence: 86%

Association between serum 25‐hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression

et al. 2014

BJOG

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Objective To assess the possible relationship between serum levels of 25[OH]D (25-hydroxyvitamin D) collected 24 hours after delivery and postpartum depression in a Chinese cohort sample.Design Cohort study.Setting One city hospital in Beijing, China.Population Women delivering a full-term, singleton, live-born infant at one city hospital in Beijing between August 2013 and November 2013.Methods Women were enrolled immediately postpartum. A blood sample was obtained 24-48 hours after childbirth to test serum levels of 25[OH]D. Participation consisted of a visit to an obstetric unit 3 months after delivery.Main outcome measure At 3 months' postpartum, women were screened for depression using the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measure was a prespecified EPDS score of ≥12.Results During the study period, 323 women were admitted. In all, 248 agreed to enrol and 213 completed 3 months' follow-up (21 were lost to follow-up and 14 withdrew). Of the 213 women who were included, 26 (12.2%) were considered to meet criteria for postpartum depression. Serum 25[OH]D levels in women with no postpartum depression were significantly higher than those in women with postpartum depression (P < 0.0001). Based on the receiver operating characteristic curve, the optimal cutoff value for serum 25[OH]D level as an indicator for screening for postpartum depression was estimated to be 10.2 ng/ml, with an area under the curve of 0.801 (95%CI 0.704-0.896). In multivariate analysis, there was an increased risk of postpartum depression associated with 25[OH]D levels ≤10.2 ng/ml (OR 7.17,; P < 0.0001) after adjusting for possible confounders.Conclusion Our study demonstrated that lower serum 25[OH]D levels were associated with postpartum depression. This association was independent of other possible variables.

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Section: Resultsmentioning

confidence: 86%

Association between serum 25‐hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression

et al. 2014

BJOG

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“…Bertone-Johnson 2009) and pregnant (Nielsen et al 2013) samples may be due to low levels of inflammatory markers. Our preliminary findings suggest that the effects of low 25(OH)D on PPD symptoms may be potentiated only in the presence of inflammation.…”

Section: Discussionmentioning

confidence: 99%

Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: Preliminary evidence for moderation by inflammatory cytokines

Accortt

Schetter

Peters

et al. 2015

Arch Womens Ment Health

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Purpose Vitamin D deficiency and elevated pro-inflammatory cytokines have been associated individually with postpartum depression (PPD). African American women are at increased risk for prenatal vitamin D deficiency, inflammation, and prenatal and postpartum depressive symptoms, but biological risk factors for PPD in this population have rarely been tested. This prospective study tested whether low prenatal vitamin D status (serum 25-hydroxyvitamin D, 25[OH]D) predicted PPD symptomatology in pregnant African American women, and whether high levels of prenatal inflammation interacted with low 25(OH)D in effects on PPD symptoms. Methods Vitamin D status was measured in the first trimester in a sample of 91 African American pregnant women who also had a second trimester blood sample assayed for inflammatory markers. Depressive symptoms were assessed at a postpartum visit. Results An inverse association between prenatal log 25(OH)D and PPD symptomatology approached significance (β = -0.209, p = 0.058), and interleukin-6 and IL-6/IL-10 ratio significantly moderated the effect. Among women with higher levels of inflammatory markers, lower prenatal log 25(OH)D was associated with significantly higher PPD symptoms (p <0.05). Conclusion These preliminary results are intriguing because if replicable, simple translational opportunities, such as increasing vitamin D status in pregnant women with elevated pro-inflammatory cytokines, may reduce PPD symptoms.

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“…Vitamin D has a high stability and limited deterioration over time [16]. Analyses have been described in detail elsewhere [20]. We defined the total maternal vitamin D status as the sum of the measured 25(OH)D 2 and 25(OH)D 3 concentrations.…”

Section: Methodsmentioning

confidence: 99%

Vitamin D Measured in Maternal Serum and Offspring Neurodevelopmental Outcomes: A Prospective Study with Long-Term Follow-Up

et al. 2014

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Background: Vitamin D is obtained from dietary sources and synthesized in the skin during exposure to ultraviolet B radiation in sunlight. During pregnancy, vitamin D is transported from mother to fetus through the placenta in the form of 25-hydroxyvitamin D [25(OH)D]. There is evidence that vitamin D influences neuronal differentiation, endocrine functions, and fetal brain growth. Animal studies indicate alterations in the offspring brain as a consequence of vitamin D deficiency during pregnancy. In humans, maternal vitamin D insufficiency has been linked to impaired child language development. Using data from a prebirth cohort with up to 22 years of follow-up, we examined the association of vitamin D status with proxies of offspring neurodevelopmental outcomes. During 1988-1989, pregnant women were recruited for the DaFO88 cohort (n = 965) in Aarhus, Denmark. Maternal concentrations of 25(OH)D were quantified in serum from week 30 of gestation via the LC-MS/MS method (n = 850). Offspring were followed up through national registries until the age of 22 years. We evaluated the association of the maternal concentration of 25(OH)D with offspring neurodevelopmental outcomes defined as first admission diagnosis or prescription of medication for (1) ADHD, (2) depression, and (3) scholastic achievement based on the mean grade on standardized written examinations in the 9th grade (final exams after 10 years of compulsory school in Denmark). Key Messages: Maternal concentrations of 25(OH)D were higher compared to current levels (median 76 nmol/l; 5th to 95th percentiles 23-152). There was a direct association between maternal vitamin D status and offspring depression (p_trend = 0.01); for ADHD there was no association. Scholastic achievement was slightly higher for offspring of mothers with a vitamin D status in the range of >50-125 nmol/l, but this nonlinear association was not statistically significant. Conclusions: Our analyses based on biomarker measurement of 25(OH)D from a cohort of 850 pregnant women combined with long-term follow-up showed no support for a beneficial fetal programming effect of vitamin D status with regard to behavioral and affective disorders and scholastic achievement.

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Vitamin D Status during Pregnancy and the Risk of Subsequent Postpartum Depression: A Case-Control Study

Cited by 61 publications

References 43 publications

Association between serum 25‐hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression

Association between serum 25‐hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression

Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: Preliminary evidence for moderation by inflammatory cytokines

Vitamin D Measured in Maternal Serum and Offspring Neurodevelopmental Outcomes: A Prospective Study with Long-Term Follow-Up

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