Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Am J Clin Nutr. 2023 Jun;117(6):1130-1142. doi: 10.1016/j.ajcnut.2023.03.025. Epub 2023 Apr 3.
Dietary interventions are a widely available mediation for depression and anxiety among pregnant and/or postpartum (i.e., perinatal) persons, but their effectiveness is not well known.
We performed a systematic review and meta-analysis to assess the effectiveness of dietary interventions for the treatment of perinatal depression and/or anxiety.
We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science from their inception to 2 November, 2022. Studies were included if they were available in English and examined the effectiveness of a dietary intervention for perinatal depression and/or anxiety in a randomized controlled trial.
Our search identified 4246 articles, of which 36 were included and 28 were eligible for meta-analysis. Random-effects meta-analyses were performed. Polyunsaturated fatty acids (PUFAs) were not found to improve symptoms of perinatal depression compared to control conditions [standardized mean differences (SMD): -0.11; 95% CI: -0.26 to 0.04]. These results neither changed when examined during pregnancy or the postpartum period separately nor varied according to the fatty acid (FA) ratio. Elemental metals (iron, zinc, and magnesium) were also not found to be superior to placebo (SMD: -0.42; 95% CI: -1.05 to 0.21), although vitamin D yielded a small to medium effect size improvement (SMD: -0.52; 95% CI: -0.84 to -0.20) in postpartum depression. Iron may help in those with confirmed iron deficiency. Narrative synthesis was performed for studies ineligible for meta-analyses.
Despite their widespread popularity, PUFAs and elemental metals do not appear to effectively reduce perinatal depression. Vitamin D taken in doses of 1800-3500 International Units per day may be, to some extent, promising. Additional high-quality, large-scale randomized controlled trials are needed to determine the true effectiveness of dietary interventions on perinatal depression and/or anxiety. This study was registered at PROSPERO (registration date: 5 July, 2020; CRD42020208830).
饮食干预是一种广泛应用于治疗孕妇和/或产后（即围产期）人群抑郁和/或焦虑的方法，但它们的疗效并不明确。
我们进行了一项系统评价和荟萃分析，以评估饮食干预治疗围产期抑郁和/或焦虑的效果。
我们从建库起至 2022 年 11 月 2 日检索了 MEDLINE、EMBASE、PsycINFO、CINAHL 和 Web of Science，纳入了在随机对照试验中检查饮食干预对围产期抑郁和/或焦虑疗效的英文研究。
我们的检索共识别出 4246 篇文章，其中 36 篇被纳入，28 篇符合荟萃分析的纳入标准。采用随机效应荟萃分析。与对照组相比，多不饱和脂肪酸（PUFAs）并未改善围产期抑郁症状[标准化均数差（SMD）：-0.11；95%置信区间（CI）：-0.26 至 0.04]。这些结果在分别检查妊娠期间和产后期间或根据脂肪酸（FA）比例时没有改变。元素金属（铁、锌和镁）也不比安慰剂优越（SMD：-0.42；95% CI：-1.05 至 0.21），尽管维生素 D 在产后抑郁中产生了较小到中等的效应量改善（SMD：-0.52；95% CI：-0.84 至 -0.20）。铁可能对已确诊缺铁的患者有帮助。对于不符合荟萃分析纳入标准的研究进行了叙述性综合分析。
尽管它们广泛流行，但 PUFAs 和元素金属似乎并不能有效减轻围产期抑郁。每天摄入 1800-3500 国际单位的维生素 D 在某种程度上可能是有希望的。需要更多高质量、大规模的随机对照试验来确定饮食干预对围产期抑郁和/或焦虑的真实疗效。本研究在 PROSPERO 注册（注册日期：2020 年 7 月 5 日；CRD42020208830）。
