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Randomized Controlled Trial
. 2018 Feb;21(1):55-63.
doi: 10.1007/s00737-017-0752-7. Epub 2017 Jul 11.

Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial

Harriet Okronipa  1   2 , Seth Adu-Afarwuah  3 , Anna Lartey  3 , Per Ashorn  4 , Stephen A Vosti  5 , Rebecca R Young  6 , Kathryn G Dewey  6
Affiliations
Randomized Controlled Trial

Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial

Harriet Okronipa et al. Arch Womens Ment Health. 2018 Feb.

Abstract

We examined the impact on depression at 6 months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20 weeks gestation (n = 1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6 months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6 months postpartum. Maternal depressive symptoms were measured at 6 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS = 382, IFA = 387 and MMN = 382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n = 1151) and those who were not (n = 169). At 6 months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS = 13.1%, IFA = 11.2% and MMN = 14.7%. P = 0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed = 0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.

Trial registration: ClinicalTrials.gov NCT00970866.

Keywords: Ghana; Lipid-based nutrient supplements; Postpartum depression.

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Conflict of interest statement

Funding

This study is funded by a grant to the University of California, Davis, from the Bill & Melinda Gates Foundation. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the institutional review boards of the University of California, Davis; Ghana Health Service; and University of Ghana Noguchi Memorial Institute for Medical Research.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Study profile. The IFA group received 60 mg iron plus 400 mg folic acid. The MMN group received 1–2 Recommended Dietary Allowances of 18 vitamins and minerals (including 20 mg iron). The LNS group received SQ-LNS with the same micronutrients as the MMN group, plus another four minerals (Ca, P, K and Mg), as well as macronutrients. All three supplements were intended for daily consumption. IFA iron and folic acid, SQ-LNS small-quantity lipid-based nutrient supplement, MMN multiple micronutrients
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