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Maternal n-3 PUFA Intake During Pregnancy and Perinatal Mental Health Problems: A Systematic Review of Recent Evidence

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Abstract

Purpose of Review

Pregnant women are vulnerable to mental health problems. Increasing evidence shows that omega-3 polyunsaturated fatty acid (n-3 PUFA) intake during pregnancy is beneficial to maternal perinatal mental health. A systematic review is needed to examine the associations reported in recent studies. The objective of this review was to provide an updated review on the association of antenatal n-3 PUFA intake via different sources (seafood, fish, overall diet, and supplementation) with perinatal mental health problems including depression, anxiety, and psychological distress.

Recent Findings

Searches were performed in Web of Science, Embase, PubMed, and APA PsycInfo databases on 21 June 2021. A total of 2133 records were screened. Data including the name of the first author, publication year, study design, sample characteristics, dietary assessment time and tools, mental health outcome measures, and other relevant information were extracted. In total, 13 articles were included in this review and assessed qualitatively. The results demonstrated that dietary intake of n-3 PUFA during pregnancy was associated with perinatal mental health, but the effect of n-3 PUFA supplementation was influenced by pre-existing medical conditions, socio-demographic characteristics, and dietary and lifestyle patterns during pregnancy.

Summary

Our review found that sources of n-3 PUFA may have differential effects on woman’s mental health during and after pregnancy. Further research using large-size cohort or well-controlled trial protocol is needed to determine the effect of n-3 PUFA supplementation during pregnancy on perinatal mental health.

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Availability of Data and Materials

The data that support the findings of this study are available on request from the corresponding author.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Sūdžiūtė K, Murauskienė G, Jarienė K, Jaras A, Minkauskienė M, Adomaitienė V, et al. Pre-existingmental health disorders affect pregnancy and neonatal outcomes: a retrospective cohort study. BMC Pregnancy Childbirth. 2020;20(1):1–7. This article adopts a retrospective cohort design to examine the link between maternal mental disorders and neonatal outcomes. Results indicate the importance of addressing maternal mental health problems during pregnancy for neonatal health.

    Article  Google Scholar 

  2. Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92.

    Article  CAS  PubMed  Google Scholar 

  3. Fairbrother N, Janssen P, Antony MM, Tucker E, Young AH. Perinatal anxiety disorder prevalence and incidence. J Affect Disord. 2016;200:148–55.

    Article  PubMed  Google Scholar 

  4. O’Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):3–12.

    Article  PubMed  Google Scholar 

  5. Paschetta E, Berrisford G, Coccia F, Whitmore J, Wood AG, Pretlove S, et al. Perinatal psychiatric disorders: an overview. Am J Obstet Gynecol. 2014;210(6):501–9 e6.

  6. Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012;25(2):141–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Stein AP, Pearson RMP, Goodman SHP, Rapa ED, Rahman AP, McCallum MMA, et al. Effects of perinatal mental disorders on the fetus and child. The Lancet (British edition). 2014;384(9956):1800–19.

    Google Scholar 

  8. Bremner JD, Moazzami K, Wittbrodt MT, Nye JA, Lima BB, Gillespie CF, et al. Diet, stress and mental health. Nutrients. 2020;12(8).

  9. Nathanson R, Hill B, Skouteris H, Bailey C. Antenatal diet and postpartum depressive symptoms: a prospective study. Midwifery. 2018;62:69–76.

    Article  PubMed  Google Scholar 

  10. Hamazaki K, Takamori A, Tsuchida A, Kigawa M, Tanaka T, Ito M, et al. Dietary intake of fish and n-3 polyunsaturated fatty acids and risks of perinatal depression: the Japan Environment and Children’s Study (JECS). J Psychiatr Res. 2018;98:9–16.

    Article  PubMed  Google Scholar 

  11. •• Hamazaki K, Matsumura K, Tsuchida A, Kasamatsu H, Tanaka T, Ito M, et al. Dietary intake of fish and n-3 polyunsaturated fatty acids and risk of postpartum depression: a nationwide longitudinal study–the Japan Environment and Children’s Study (JECS). Psychol Med. 2020;50(14):2416–24. This was a large-scale nationwide longitudinal study in Japan assessing the effect of fish and n-3 polyunsaturated fatty acid intake during pregnancy on the risk of postpartum depression. This article is an example of a study demonstrating the protective effect of fish intake against postpartum depression and other mental disorders in women.

    Article  PubMed  Google Scholar 

  12. McManus A, Newton W. Seafood, nutrition and human health: a synopsis of the nutritional benefits of consuming seafood. 2011.

  13. Kendall-Tackett K. Long-chain omega-3 fatty acids and women’s mental health in the perinatal period and beyond. J Midwifery Womens Health. 2010;55(6):561–7.

    Article  PubMed  Google Scholar 

  14. Covington M. Omega-3 fatty acids. Am Fam Physician. 2004;70(1):133–40.

    PubMed  Google Scholar 

  15. Parker G, Gibson NA, Brotchie H, Heruc G, Rees A-M, Hadzi-Pavlovic D. Omega-3 fatty acids and mood disorders. Am J Psychiatry. 2006;163(6):969–78.

    Article  PubMed  Google Scholar 

  16. Study BSC, Health NIo. Information about mental illness and the brain. NIH Curriculum Supplement Series [Internet]: National Institutes of Health (US); 2007.

  17. Lindsay KL, Buss C, Wadhwa PD, Entringer S. The interplay between maternal nutrition and stress during pregnancy: issues and considerations. Ann Nutr Metab. 2017;70(3):191–200.

    Article  CAS  PubMed  Google Scholar 

  18. Larrieu T, Laye S. Food for mood: relevance of nutritional omega-3 fatty acids for depression and anxiety. Front Physiol. 2018;9:1047.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Punia S, Sandhu KS, Siroha AK, Dhull SB. Omega 3-metabolism, absorption, bioavailability and health benefits–a review. PharmaNutrition. 2019;10.

  20. Judge MP. Omega-3 consumption during pregnancy to support optimal outcomes. J Obstet Gynecol Neonatal Nurs. 2018;47(3):429–37.

    Article  PubMed  Google Scholar 

  21. Wei-Hong L, Cheng-Gui Z, Peng-Fei G, Heng L, Jian-Fang Y. Omega-3 fatty acids as monotherapy in treating depression in pregnant women: a meta-analysis of randomized controlled trials. Iranian journal of pharmaceutical research: IJPR. 2017;16(4):1593.

    PubMed  PubMed Central  Google Scholar 

  22. Sparling TM, Henschke N, Nesbitt RC, Gabrysch S. The role of diet and nutritional supplementation in perinatal depression: a systematic review. Maternal & child nutrition. 2017;13(1).

  23. Khan R, Waqas A, Bilal A, Mustehsan ZH, Omar J, Rahman A. Association of maternal depression with diet: a systematic review. Asian J Psychiatr. 2020;52: 102098.

    Article  PubMed  Google Scholar 

  24. Altun A, Brown H, Szoeke C, Goodwill AM. The Mediterranean dietary pattern and depression risk: a systematic review. Neurol Psychiatry Brain Res. 2019;33:1–10.

    Article  Google Scholar 

  25. Mocking RJ, Steijn K, Roos C, Assies J, Bergink V, Ruhé HG, et al. Omega-3 fatty acid supplementation for perinatal depression: a meta-analysis. The Journal of clinical psychiatry. 2020;81(5):0-.

  26. Nguyen-Pollard M. The effect of maternal omega-3 polyunsaturated fatty acid supplementation on perinatal depression: a systematic review and meta-analysis 2018.

  27. Silva DFO, Cobucci RN, Gonçalves AK, Lima SCVC. Systematic review of the association between dietary patterns and perinatal anxiety and depression. BMC Pregnancy Childbirth. 2019;19(1):1–13.

    Article  CAS  Google Scholar 

  28. Suradom C, Suttajit S, Oon-Arom A, Maneeton B, Srisurapanont M. Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation for prevention and treatment of perinatal depression: a systematic review and meta-analysis of randomized-controlled trials. Nord J Psychiatry. 2021;75(4):239–46.

    Article  PubMed  Google Scholar 

  29. Zhang MM, Zou Y, Li SM, Wang L, Sun YH, Shi L, et al. The efficacy and safety of omega-3 fatty acids on depressive symptoms in perinatal women: a meta-analysis of randomized placebo-controlled trials. Transl Psychiatry. 2020;10(1):193.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Liu W-H, Zhang C-G, Gao P-F, Liu H, Yang J-F. Omega-3 fatty acids as monotherapy in treating depression in pregnant women: a meta-analysis of randomized controlled trials. Iranian journal of pharmaceutical research : IJPR. 2017;16(4):1593–9.

    CAS  Google Scholar 

  31. Nillni YI, Mehralizade A, Mayer L, Milanovic S. Treatment of depression, anxiety, and trauma-related disorders during the perinatal period: a systematic review. Clin Psychol Rev. 2018;66:136–48.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Baskin R, Hill B, Jacka FN, O’Neil A, Skouteris H. The association between diet quality and mental health during the perinatal period. A systematic review Appetite. 2015;91:41–7.

    PubMed  Google Scholar 

  33. Falah-Hassani K, Shiri R, Dennis CL. Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety. J Affect Disord. 2016;198:142–7.

    Article  PubMed  Google Scholar 

  34. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–41.

    Article  PubMed  Google Scholar 

  35. Joanna Briggs Institute. Critical appraisal tools: checklist for prevalence studies. [Available from: https://jbi.global/critical-appraisal-tools.

  36. Kobayashi M, Ogawa K, Morisaki N, Tani Y, Horikawa R, Fujiwara T. Dietary n-3 polyunsaturated fatty acids in late pregnancy and postpartum depressive symptom among Japanese women. FRONT PSYCHIATRY. 2017;8:241-.

  37. Cao L, Liu Y, Liang X, Zheng Y, Li W, Yan J, et al. Association between dietary patterns during the third trimester and the risk of postpartum depression in China. J Affect Disord. 2020;264:370–5.

    Article  PubMed  Google Scholar 

  38. Shi D, Wang G-H, Feng W. Nutritional assessments in pregnancy and the risk of postpartum depression in Chinese women: a case-control study. Medicine (Baltimore). 2020;99(33):e21647-e.

  39. Miyake Y, Tanaka K, Okubo H, Sasaki S, Furukawa S, Arakawa M. Dietary patterns and depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study. J Affect Disord. 2018;225:552–8.

    Article  PubMed  Google Scholar 

  40. Álvarez-Ramírez M, Lara MA, Cervantes-Alfaro JM, Robinson-Fuentes VA, Alveano-Hernández J. Correlation between intake of omega-3 fatty acids and depressive and anxiety symptoms during pregnancy. Salud Ment. 2018;41(1):31–8.

    Article  Google Scholar 

  41. Sousa TMd, Santos LCd. Dietary fatty acids, omega-6/omega-3 ratio and cholesterol intake associated with depressive symptoms in low-risk pregnancy. Nutr Neurosci. 2020:1–6.

  42. Nishi D, Su K-P, Usuda K, Chang JP-C, Chiang Y-JJ, Guu T-W, et al. Differences between Japan and Taiwan in the treatment of pregnant women with depressive symptoms by omega-3 fatty acids: An open-label pilot study. Nutr Neurosci. 2019;22(1):63–71.

  43. •• Nishi D, Su K-P, Usuda K, Chang JP-C, Hamazaki K, Ishima T, et al. Plasma estradiol levels and antidepressant effects of omega-3 fatty acids in pregnant women. Brain Behav Immun. 2020;85:29–34. This was a randomised controlled trial aiming to examine the effect of omega-3 fatty acids supplementation on depressive symptoms during pregnancy. This article is an example of a study demonstrating the protective effect of supplement use against postpartum depression in women.

  44. Vaz JdS, Farias DR, Adegboye ARA, Nardi AE, Kac G. Omega-3 supplementation from pregnancy to postpartum to prevent depressive symptoms: a randomized placebo-controlled trial. BMC Pregnancy and Childbirth. 2017;17(1):180-.

  45. Farshbaf-Khalili A, Mohammad-Alizadeh S, Farshbaf-Khalili A, Mohammadi F, Ostadrahimi A. Fish-oil supplementation and maternal mental health: a triple-blind, randomized controlled trial. Iran Red Crescent Medical Journal. 2017;19(1).

  46. U.S. Food and Drug Administration. Advice about eating fish. United States: U.S. Food and Drug Administration; 2021.

  47. Haggarty P. Effect of placental function on fatty acid requirements during pregnancy. Eur J Clin Nutr. 2004;58(12):1559–70.

    Article  CAS  PubMed  Google Scholar 

  48. Makrides M, Gibson RA. Long-chain polyunsaturated fatty acid requirements during pregnancy and lactation. Am J Clin Nutr. 2000;71(1):307S-S311.

    Article  CAS  PubMed  Google Scholar 

  49. Cooper RE, Tye C, Kuntsi J, Vassos E, Asherson P. The effect of omega-3 polyunsaturated fatty acid supplementation on emotional dysregulation, oppositional behaviour and conduct problems in ADHD: a systematic review and meta-analysis. J Affect Disord. 2016;190:474–82.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China

    Keith T. S. Tung, Rosa S. Wong & Ray T. W. Mak

  2. Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China

    Rosa S. Wong

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Correspondence to Rosa S. Wong.

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Tung, K.T.S., Wong, R.S. & Mak, R.T.W. Maternal n-3 PUFA Intake During Pregnancy and Perinatal Mental Health Problems: A Systematic Review of Recent Evidence. Curr Nutr Rep 12, 426–438 (2023). https://doi.org/10.1007/s13668-023-00484-x

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