From the Amsterdam UMC, location Vrije Universiteit Amsterdam, Midwifery Science (de Jonge, Henrichs); Midwifery Academy Amsterdam Groningen, InHolland (de Jonge, Henrichs); Amsterdam Public Health, Mental Health (de Jonge, Henrichs), Amsterdam; Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen (Domacassé, de Jonge, Henrichs), Groningen; Amsterdam UMC location University of Amsterdam, Epidemiology and Data Science (de Rooij); Amsterdam UMC location University of Amsterdam, Reproduction and Development Research Institute (de Rooij, Vrijkotte); Amsterdam UMC location University of Amsterdam, Amsterdam Public Health Research Institute, Aging and Later Life, Health Behaviors and Chronic Diseases (de Rooij, Vrijkotte); and Amsterdam UMC, Department of Public and Occupational Health, University of Amsterdam (Vrijkotte), Amsterdam, the Netherlands.
Psychosom Med. 2024 Sep 1;86(7):648-657. doi: 10.1097/PSY.0000000000001328. Epub 2024 Jul 3.
Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.
In 2483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks' gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30-49.9 nM), sufficient (50-79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum.
After adjustments for confounders, vitamin D deficiency was only associated with increased postpartum anxiety symptoms ( B = 0.17, 95% confidence interval [CI] = 0.03-0.30, p = .017) compared to normal vitamin D levels (≥80 nM). In women not taking vitamin D supplementation ( n = 2303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms ( B = 0.14, 95% CI = 0.03-0.28, p = .045; and B = 0.17, 95% CI = 0.03-0.32, p = .015). Antepartum CRP did not mediate these links.
We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.
产妇产后抑郁和焦虑症状是随后母婴心理健康问题的危险因素。关于产前维生素 D 和 C 反应蛋白（CRP）在产妇产后情感症状发病机制中的潜在作用知之甚少。我们研究了产前维生素 D 状况与产后抑郁和焦虑症状之间的关联，以及产前 CRP 是否介导这些关联。
在阿姆斯特丹出生的儿童及其发展前瞻性队列的 2483 名参与者中，在妊娠中位数 13 周时测量了母体血清维生素 D 和 CRP。维生素 D 状况定义为缺乏（≤29.9 nM）、不足（30-49.9 nM）、充足（50-79.9 nM）或正常（≥80 nM）。产后 3 个月评估产妇抑郁症状（流行病学研究中心抑郁量表）和焦虑症状（状态特质焦虑量表）。
在调整了混杂因素后，与正常维生素 D 水平（≥80 nM）相比，维生素 D 缺乏仅与产后焦虑症状增加相关（ B = 0.17，95%置信区间 [CI] = 0.03-0.30， p =.017）。在未服用维生素 D 补充剂的女性（ n = 2303）中，维生素 D 缺乏与产后抑郁和焦虑症状增加相关（ B = 0.14，95% CI = 0.03-0.28， p =.045；B = 0.17，95% CI = 0.03-0.32， p =.015）。产前 CRP 并未介导这些关联。
我们发现一些证据表明，产前维生素 D 缺乏与产后情感症状增加有关，尤其是在未服用维生素 D 补充剂的女性中。临床试验应确定维生素 D 补充是否可以降低产后情感障碍的风险。
