Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Brazil.
Division of Women's Health, Women's Health Academic Centre, King's College London, Biomedical Research Centre, King's Health Partners, London, UK.
J Affect Disord. 2018 May;232:185-203. doi: 10.1016/j.jad.2018.02.004. Epub 2018 Feb 15.
Nutritional requirements need to be met in order to adapt to pre- and postnatal changes. Our aim was to systematically review the evidence of associations between nutritional biomarkers and psychological distress during pregnancy and in the first postnatal year.
MEDLINE, EMBASE, PsycINFO, Scielo, LILACS, clinicaltrials.gov, International Clinical Trials Registry, Cochrane Library, Scopus and Web of Science databases were searched for articles from inception to 4/15/2016. Studies of maternal nutritional biomarkers in blood (fatty acids/micronutrients/amino acids) and associations with psychological distress (depression/anxiety/stress) were included. Two independent reviewers extracted data based on study designs, participants, outcomes, exposures, and association measures.
Thirty-eight studies were included. A total of 13 studies showed divergent or no associations between serum/plasma/erythrocyte fatty acid concentrations and depression/anxiety during pregnancy and postpartum. Changes in serum cholesterol levels from pregnancy to postpartum showed a significant inverse correlation with depression in one out of three studies. Five out of seven studies found an inverse association between serum vitamin D levels and pre- and postnatal depression. Plasma tryptophan levels were inversely correlated with postnatal depression scores in three out of four studies. We identified that one out of two studies presented no significant association between vitamin B/folate/ferritin concentrations and depression in postpartum.
There was higher variability between association measures, time and scales of depression and anxiety assessments.
The majority of high-quality studies suggest that lower vitamin D levels may be associated with postpartum depression. However, further evidence is needed for guiding clinical practice on nutritional biomarkers.
为了适应产前和产后的变化，需要满足营养需求。我们的目的是系统地回顾营养生物标志物与妊娠和产后第一年心理困扰之间关联的证据。
从建库到 2016 年 4 月 15 日，我们检索了 MEDLINE、EMBASE、PsycINFO、Scielo、LILACS、clinicaltrials.gov、国际临床试验注册中心、Cochrane 图书馆、Scopus 和 Web of Science 数据库，以查找关于血液中（脂肪酸/微量营养素/氨基酸）母体营养生物标志物及其与心理困扰（抑郁/焦虑/压力）之间关联的文章。两位独立的综述作者根据研究设计、参与者、结局、暴露和关联测量标准提取数据。
共纳入 38 项研究。共有 13 项研究表明血清/血浆/红细胞脂肪酸浓度与妊娠和产后抑郁/焦虑之间没有关联或存在不一致的关联。三项研究中的一项研究表明，从妊娠到产后血清胆固醇水平的变化与抑郁呈显著负相关。七项研究中有五项发现血清维生素 D 水平与产前和产后抑郁呈负相关。四项研究中有三项发现血浆色氨酸水平与产后抑郁评分呈负相关。我们发现，两项研究中有一项表明维生素 B/叶酸/铁蛋白浓度与产后抑郁之间没有显著关联。
各研究之间关联测量、抑郁和焦虑评估的时间和量表存在较大差异。
大多数高质量研究表明，维生素 D 水平较低可能与产后抑郁有关。但是，需要进一步的证据来指导临床实践中营养生物标志物的应用。
