Wojcicki Janet M, Heyman Melvin B
Department of Pediatrics, University of California, San Francisco, CA, USA.
J Matern Fetal Neonatal Med. 2011 May;24(5):680-6. doi: 10.3109/14767058.2010.521873. Epub 2010 Oct 7.
A systematic review was conducted to assess the possible association between omega-3 polyunsaturated fatty acid (PUFA) supplementation and intake in the perinatal period and the risk of maternal perinatal depression.
Two PubMed searches and a BIOSIS Preview, a Web of Science and a PsychInfo search were conducted with the search terms 'DHA, pregnancy and depression' and 'omega-3 fatty acids, pregnancy and depression'.
Ten articles - three longitudinal cohort studies, five randomized controlled trials and two pilot trials- that met selection criteria were reviewed. Six found no association, two found mixed results, and two found a positive association between omega-3 PUFAs and reduced incidence of maternal perinatal depression. The heterogeneity of results can be explained by dissimilar study designs, including differences in study duration, time period of measurement and number of participants, and in varied dosages and types of supplemental PUFAs. Some of the larger studies and those that found a positive effect were more likely to be using higher doses, close to 2 g of docosahexaeonic acid (DHA) + eicosapentaenoic acid (EPA), and began the supplementation earlier in pregnancy.
Future RCTs to investigate the role of PUFA supplementation and risk for maternal perinatal depression should begin supplementation early in pregnancy and use a dosage closer to 2 g of DHA + EPA. Depression should also be measured using a diagnostic interview schedule in addition to a screener.
进行一项系统评价,以评估围产期补充和摄入ω-3多不饱和脂肪酸(PUFA)与孕产妇围产期抑郁症风险之间的可能关联。
使用检索词“DHA、妊娠与抑郁”和“ω-3脂肪酸、妊娠与抑郁”在PubMed进行了两次检索,并在BIOSIS Preview、Web of Science和PsychInfo中进行了检索。
对符合入选标准的10篇文章进行了综述,其中包括3项纵向队列研究、5项随机对照试验和2项试点试验。6项研究未发现关联,2项研究结果不一,2项研究发现ω-3多不饱和脂肪酸与孕产妇围产期抑郁症发病率降低之间存在正相关。结果的异质性可由不同的研究设计来解释,包括研究持续时间、测量时间段和参与者数量的差异,以及补充多不饱和脂肪酸的剂量和类型的不同。一些规模较大的研究以及那些发现有积极效果的研究更有可能使用较高剂量,接近2克二十二碳六烯酸(DHA)+二十碳五烯酸(EPA),并且在妊娠早期就开始补充。
未来调查补充PUFA的作用与孕产妇围产期抑郁症风险的随机对照试验应在妊娠早期开始补充,并使用接近2克DHA+EPA的剂量。除了筛查工具外,还应使用诊断访谈时间表来测量抑郁症。