Effects of Varied Omega-3 Fatty Acid Supplementation on Postpartum Mental Health and the Association between Prenatal Erythrocyte Omega-3 Fatty Acid Levels and Postpartum Mental Health

Abstract

We investigated the postpartum mental health of women who had consumed perilla oil or fish oil containing various omega-3 fatty acids for 12 weeks starting in mid-pregnancy. The association between fatty acids in maternal erythrocytes and mental health risk factors was also examined. Healthy Japanese primiparas in mid-pregnancy (gestational weeks 18-25) were randomly divided into two groups and consumed approximately 2.0 g/day of omega-3 fatty acids in either perilla oil (the ALA dose was 2.4 g/day) or fish oil (the EPA + DHA dose was 1.7 g/day) for 12 weeks. Maternal mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS) as the primary measure and the Mother-to-Infant Bonding Scale (MIBS) as the secondary measure. Data from an observational study were used as a historical control. Maternal blood, cord blood, and colostrum samples were collected for fatty acid composition analysis. In addition, completers of the observational studies were enrolled in a case-control study, wherein logistic regression analysis was performed to examine the association between maternal fatty acids and EPDS score. The proportion of participants with a high EPDS score (≥9) was significantly lower in the perilla oil group (12.0%, p = 0.044) but not in the fish oil group (22.3%, p = 0.882) compared with the historical control (21.6%), while the proportions between the former groups also tended to be lower (p = 0.059). No marked effect of omega-3 fatty acid intake was observed from the MIBS results. In the case-control study of the historical control, high levels of α-linolenic acid in maternal erythrocytes were associated with an EPDS score of <9 (odds ratio of 0.23, 95% confidence interval: 0.06, 0.84, p = 0.018 for trend). The results of this study suggest that consumption of α-linolenic acid during pregnancy may stabilize postpartum mental health.

Keywords: DHA; EPA; Edinburgh Postnatal Depression Scale; Mother-to-Infant Bonding Scale; fish oil; mental; omega-3 fatty acids; perilla oil; pregnant woman; α-linolenic acid.

Figure 1

Flowchart of participant screening and enrollment.

Figure 2

Changes in fatty acids in maternal erythrocytes (% of total fatty acids). Data are presented as means ± SEM. Open square, historical control; gray circle, perilla oil; closed circle, fish oil. (A) α-Linolenic acid (ALA); (B) eicosapentaenoic acid (EPA); (C) docosahexaenoic acid (DHA); (D) omega-6/omega-3 ratio. Statistical analysis using two-way analysis of variance yielded the following results: (A) Group effects: F (2, 1166) = 34.935, p < 0.01. Tukey’s test indicated the following significant differences between all groups: p < 0.01. Interaction effect: F (6, 1166) = 12.649, p < 0.001. (B) Group effects: F (2, 1166) = 244.447, p < 0.01. Tukey’s test indicated the following significant differences: historical control, p < 0.01; perilla, p < 0.01 compared with fish oil group. Interaction effect: F (6, 1166) = 47.553, p < 0.01. (C) Group effects: F (2, 1166) = 13.016, p < 0.01. Tukey’s test indicated the following significant differences: historical control, p < 0.01; perilla oil, p < 0.01 compared with the fish oil group. Interaction effect: F (6, 1166) = 4.486, p < 0.01. (D) Group effects: F (2, 1166) = 81.651, p < 0.01. Tukey’s test indicated the following significant differences: historical control, p < 0.01; perilla oil, p < 0.01 compared with fish oil group. Interaction effect: F (6, 1166) = 18.405, p < 0.01. Regarding the omega-3 oil intake status at blood collection in the Late, 32% of the participants in perilla oil group and 46% of the participants in fish oil group had completed supplementation.