Seafood consumption, the DHA content of mothers' milk and prevalence rates of postpartum depression: a cross-national, ecological analysis.
BACKGROUND
Mothers selectively transfer docosahexaenoic acid (DHA) to their fetuses to support optimal neurological development during pregnancy. Without sufficient dietary intake, mothers become depleted of DHA and may increase their risk of suffering major depressive symptoms in the postpartum period. We postulated that the DHA content of mothers' milk and seafood consumption would both predict prevalence rates of postpartum depression across countries.


METHODS
Published prevalence data for postpartum depression were included that used the Edinburgh Postpartum Depression Scale (n=14532 subjects in 41 studies). These data were compared to the DHA, eicosapentaenoic acid (EPA) and arachidonic acid (AA) content in mothers' milk and to seafood consumption rates in published reports from 23 countries.


RESULTS
Higher concentrations of DHA in mothers' milk (r=-0.84, p<0.0001, n=16 countries) and greater seafood consumption (r=-0.81, p<0.0001, n=22 countries) both predicted lower prevalence rates of postpartum depression in simple and logarithmic models, respectively. The AA and EPA content of mothers' milk were unrelated to postpartum depression prevalence.


CONCLUSIONS
These findings do not prove that higher omega-3 status cause lower prevalence rates of postpartum depression. Data on potentially confounding factors were not uniformly available for all countries.


CONCLUSIONS
Both lower DHA content in mothers' milk and lower seafood consumption were associated with higher rates of postpartum depression. These results do not appear to be an artifact of cross-national differences in well-established risk factors for postpartum depression. Interventional studies are needed to determine if omega-3 fatty acids can reduce major postpartum depressive symptoms.
Hibbeln
Joseph R
JR
Laboratory of Membrane Biophysics and Biochemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Park 5, Room 150, 12420 Parklawn Drive, Rockville, MD 20892, USA. jhibbeln@niaaa.nih.gov
D016718:Arachidonic Acid / Q000032:analysis; D001315:Australia / Q000453:epidemiology; D019052:Depression, Postpartum / Q000453:epidemiology*; D004281:Docosahexaenoic Acids / Q000032:analysis*; D015118:Eicosapentaenoic Acid; D005231:Fatty Acids, Unsaturated / Q000032:analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008895:Milk, Human / Q000737:chemistry*; D009426:Netherlands / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D017747:Seafood; D012846:Singapore / Q000453:epidemiology; D013019:South Africa / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D005231:Fatty Acids, Unsaturated; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid