Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA.
Am J Obstet Gynecol. 2013 Apr;208(4):313.e1-9. doi: 10.1016/j.ajog.2013.01.038.
Maternal deficiency of the omega-3 fatty acid, docosahexaenoic acid (DHA), has been associated with perinatal depression, but there is evidence that supplementation with eicosapentaenoic acid (EPA) may be more effective than DHA in treating depressive symptoms. This trial tested the relative effects of EPA- and DHA-rich fish oils on prevention of depressive symptoms among pregnant women at an increased risk of depression.
We enrolled 126 pregnant women at risk for depression (Edinburgh Postnatal Depression Scale score 9-19 or a history of depression) in early pregnancy and randomly assigned them to receive EPA-rich fish oil (1060 mg EPA plus 274 mg DHA), DHA-rich fish oil (900 mg DHA plus 180 mg EPA), or soy oil placebo. Subjects completed the Beck Depression Inventory (BDI) and Mini-International Neuropsychiatric Interview at enrollment, 26-28 weeks, 34-36 weeks, and at 6-8 weeks' postpartum. Serum fatty acids were analyzed at entry and at 34-36 weeks' gestation.
One hundred eighteen women completed the trial. There were no differences between groups in BDI scores or other depression endpoints at any of the 3 time points after supplementation. The EPA- and DHA-rich fish oil groups exhibited significantly increased postsupplementation concentrations of serum EPA and serum DHA respectively. Serum DHA- concentrations at 34-36 weeks were inversely related to BDI scores in late pregnancy.
EPA-rich fish oil and DHA-rich fish oil supplementation did not prevent depressive symptoms during pregnancy or postpartum.
母体 ω-3 脂肪酸二十二碳六烯酸(DHA)的缺乏与围产期抑郁症有关,但有证据表明,与 DHA 相比,补充二十碳五烯酸(EPA)在治疗抑郁症状方面可能更有效。本试验检测了富含 EPA 和 DHA 的鱼油对预防处于抑郁高风险的孕妇抑郁症状的相对作用。
我们在孕早期招募了 126 名有抑郁风险的孕妇(爱丁堡产后抑郁量表评分 9-19 或有抑郁病史),并将其随机分配接受富含 EPA 的鱼油(1060mg EPA 加 274mg DHA)、富含 DHA 的鱼油(900mg DHA 加 180mg EPA)或大豆油安慰剂。受试者在入组时、26-28 周、34-36 周和产后 6-8 周完成贝克抑郁量表(BDI)和迷你国际神经精神访谈。在入组时和 34-36 周妊娠时分析血清脂肪酸。
118 名妇女完成了试验。在补充后的 3 个时间点,各组的 BDI 评分或其他抑郁终点均无差异。富含 EPA 和 DHA 的鱼油组分别显著增加了血清 EPA 和 DHA 的浓度。34-36 周时的血清 DHA 浓度与妊娠晚期的 BDI 评分呈负相关。
富含 EPA 的鱼油和富含 DHA 的鱼油补充剂不能预防孕期和产后的抑郁症状。