Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study.
Studies in the general population have proposed links between nutrition and depression, but less is known about the perinatal period. Depletion of nutrient reserves throughout pregnancy and delayed postpartum repletion could increase the risk of perinatal depression. We examined the relationships of plasma folate and vitamin B12 concentrations during pregnancy with perinatal depression. At 26th-28th weeks of gestation, plasma folate and vitamin B12 were measured in women from the GUSTO mother-offspring cohort study in Singapore. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3-month postpartum. EPDS scores of ≥15 during pregnancy or ≥13 at postpartum were indicative of probable depression. Of 709 women, 7.2% (n = 51) were identified with probable antenatal depression and 10.4% (n = 74) with probable postnatal depression. Plasma folate concentrations were significantly lower in those with probable antenatal depression than those without (mean ± SD; 27.3 ± 13.8 vs 40.4 ± 36.5 nmol/L; p = 0.011). No difference in folate concentrations was observed in those with and without probable postnatal depression. In adjusted regression models, the likelihood of probable antenatal depression decreases by 0.69 for every unit variation (increase) in folate (OR = 0.69 per SD increase in folate; 95% CI: 0.52, 0.94). Plasma vitamin B12 concentrations were not associated with perinatal depression. Lower plasma folate status during pregnancy was associated with antenatal depression, but not with postnatal depression. Replication in other studies is needed to determine the direction of causality between low folate and antenatal depression.


BACKGROUND
NCT01174875.
Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. Electronic address: mary_chong@sics.a-star.edu.sg.
Mary F F
MF
Chong
Singapore Institute for Clinical Sciences, A*STAR, Singapore.
Jocelyn X Y
JX
Wong
Singapore Institute for Clinical Sciences, A*STAR, Singapore.
Marjorelee
M
Colega
Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Ling-Wei
LW
Chen
Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Rob M
RM
van Dam
Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Chuen Seng
CS
Tan
Singapore Institute for Clinical Sciences, A*STAR, Singapore.
Ai Lin
AL
Lim
Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Shirong
S
Cai
Singapore Institute for Clinical Sciences, A*STAR, Singapore; Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Birit F P
BF
Broekman
Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Yung Seng
YS
Lee
Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Seang Mei
SM
Saw
KK Women's and Children's Hospital, Singapore; McGill University, Montreal, Canada.
Kenneth
K
Kwek
MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton; University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Keith M
KM
Godfrey
Singapore Institute for Clinical Sciences, A*STAR, Singapore; Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Yap Seng
YS
Chong
Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Liggins Institute, Auckland, New Zealand.
Peter
P
Gluckman
Singapore Institute for Clinical Sciences, A*STAR, Singapore; McGill University, Montreal, Canada.
Michael J
MJ
Meaney
KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore.
Helen
H
Chen
D000328:Adult; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000097:blood / Q000453:epidemiology*; D003866:Depressive Disorder / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012846:Singapore / Q000453:epidemiology; D014805:Vitamin B 12 / Q000097:blood*
D005492:Folic Acid; D014805:Vitamin B 12
Antenatal depression; Edinburgh Postnatal Depression Scale; Folate; Postnatal depression; Pregnancy diet; Vitamin B12