The aim of the present study was to examine the association between depressive symptoms in pregnancy and the concentration of long-chain polyunsaturated fatty acids (LCPUFAs) in breast milk. Women (n = 287) enrolled in the Pregnancy, Infection, and Nutrition Study completed the Center for Epidemiologic Studies Depression Scale in pregnancy (< 20 and 24-29 weeks) and had LCPUFAs measured in breast milk (4 months postpartum). Multiple linear regression was used to examine associations between depressive symptoms and breast milk LCPUFAs. Increasing depressive symptoms at < 20 weeks were associated with lower docosahexaenoic acid concentrations (adjusted β = −1.15, 95% confidence interval = −2.12, −0.19). No similar associations were observed with other fatty acids nor between symptoms at 24-29 weeks and LCPUFAs. Depressive symptoms, even in the subclinical range, early in pregnancy are inversely associated with breast milk docosahexaenoic acid. This may have implications for the timing of screening and interventions for perinatal depression and the nutritional value of breast milk.
GaynesBGavinNMeltzer-BrodyS. Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. Rockville, MD: Agency for Healthcare Research and Quality; 2005. Evidence report/technology assessment 119. AHRQ publication 05-E006-2.
2.
LiperotiRLandiFFuscoOBernabeiROnderG. Omega-3 polyunsaturated fatty acids and depression: a review of the evidence. Curr Pharm Des. 2009;15:4165-4172.
3.
EdwardsRPeetMShayJHorrobinD. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord. 1998;48: 149-155.
4.
McNamaraRKHahnCGJandacekR. Selective deficits in the omega-3 fatty acid docosahexaenoic acid in the postmortem orbitofrontal cortex of patients with major depressive disorder. Biol Psychiatry. 2007;62:17-24.
5.
PeetMMurphyBShayJHorrobinD. Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients. Biol Psychiatry. 1998;43:315-319.
6.
InnisSM. Omega-3 fatty acids and neural development to 2 years of age: do we know enough for dietary recommendations?J Pediatr Gastroenterol Nutr. 2009;48(suppl 1):S16-S24.
7.
LauritzenLHansenHSJorgensenMHMichaelsenKF. The essentiality of long chain n-3 fatty acids in relation to development and function of the brain and retina. Prog Lipid Res. 2001;40:1-94.
8.
FreemanMPHibbelnJRWisnerKLWatchmanMGelenbergAJ. An open trial of Omega-3 fatty acids for depression in pregnancy. Acta Neuropsychiatr. 2006;18:21-24.
9.
FreemanMPHibbelnJRWisnerKLBrumbachBHWatchmanMGelenbergAJ. Randomized dose-ranging pilot trial of omega-3 fatty acids for postpartum depression. Acta Psychiatr Scand. 2006;113:31-35.
10.
FreemanMPDavisMSinhaPWisnerKLHibbelnJRGelenbergAJ. Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled study. J Affect Disord. 2008;110:142-148.
11.
LlorenteAMJensenCLVoigtRGFraleyJKBerrettaMCHeirdWC. Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing. Am J Obstet Gynecol. 2003;188:1348-1353.
12.
MarangellLBMartinezJMZboyanHAChongHPuryearLJ. Omega-3 fatty acids for the prevention of postpartum depression: negative data from a preliminary, open-label pilot study. Depress Anxiety. 2004;19:20-23.
13.
BrowneJCScottKMSilversKM. Fish consumption in pregnancy and omega-3 status after birth are not associated with postnatal depression. J Affect Disord. 2006;90:131-139.
14.
De VrieseSRChristopheABMaesM. Lowered serum n-3 polyunsaturated fatty acid (PUFA) levels predict the occurrence of postpartum depression: further evidence that lowered n-PUFAs are related to major depression. Life Sci. 2003;73:3181-3187.
15.
OttoSJde GrootRHHornstraG. Increased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the functional docosahexaenoic acid status. Prostaglandins Leukot Essent Fatty Acids. 2003;69: 237-243.
16.
ReesAMAustinMPOwenCParkerG. Omega-3 deficiency associated with perinatal depression: case control study. Psychiatry Res. 2009;166:254-259.
17.
BeckCT. A meta-analysis of predictors of postpartum depression. Nurs Res. 1996;45:297-303.
18.
InnisS. Human milk: maternal dietary lipids and infant development. Proc Nutr Soc. 2007;66:397-404.
19.
MakridesMNeumannMAGibsonRA. Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition. Eur J Clin Nutr. 1996;50:352-357.
20.
HacheyDLThomasMREmkenEA. Human lactation: maternal transfer of dietary triglycerides labeled with stable isotopes. J Lipid Res. 1987;28:1185-1192.
21.
van GoorSASmitENSchaafsmaADijck-BrouwerDAMuskietFA. Milk of women with lifetime consumption of the recommended daily intake of fish fatty acids should constitute the basis for the DHA contents of infant formula. J Perinat Med. 2008;36:548-549.
22.
JensenCLMaudeMAndersonREHeirdWC. Effect of docosahexaenoic acid supplementation of lactating women on the fatty acid composition of breast milk lipids and maternal and infant plasma phospholipids. Am J Clin Nutr. 2000;71(1)(suppl):292S-299S.
23.
Siega-RizAMHerringAHCarrierKEvensonKRDoleNDeierleinA. Sociodemographic, perinatal, behavioral, and psychosocial predictors of weight retention at 3 and 12 months postpartum. Obesity (Silver Spring). 2010;18:1996-2003.
24.
MumfordSLSiega-RizAMHerringAEvensonKR. Dietary restraint and gestational weight gain. J Am Diet Assoc. 2008;108: 1646-1653.
25.
RadloffLS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385-401.
26.
BlighEGDyerWJ. A rapid method of total lipid extraction and purification. Can J Biochem Physiol. 1959;37:911-917.
27.
Siega-RizAMBodnarLMSavitzDA. What are pregnant women eating? Nutrient and food group differences by race. Am J Obstet Gynecol. 2002;186:480-486.
28.
Food and Nutrition Board. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). A Report of the Panel on Macronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington, DC: Institute of Medicine; 2005.
HibbelnJR. Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis. J Affect Disord. 2002;69:15-29.
31.
EvansJHeronJFrancombHOkeSGoldingJ. Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001;323:257-260.
32.
MattheySBarnettBUngererJWatersB. Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord. 2000;60:75-85.
33.
BirchEEHoffmanDRUauyRBirchDGPrestidgeC. Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. Pediatr Res. 1998;44: 201-209.
