title: Long-chain polyunsaturated fatty acid status during pregnancy and maternal mental health in pregnancy and the postpartum period: results from the GUSTO study.
abstract: OBJECTIVE
  Studies have demonstrated a relationship between lower omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) status and anxiety and depression. It is uncertain whether similar associations occur in pregnant women, when anxiety and depression could have long-term effects on the offspring. We examined the associations between plasma LC-PUFA status during pregnancy and perinatal mental health.
  
  
  METHODS
  At 26-28 weeks' gestation, plasma LC-PUFAs were measured in mothers of the Growing Up in Singapore Toward healthy Outcomes (GUSTO) mother-offspring cohort study, who were recruited between June 2009 and September 2010. Maternal symptoms of anxiety and depression were assessed with the State-Trait Anxiety Inventory (STAI) and Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3 months' postpartum. The STAI-state subscale was used as a continuous measure of current anxiety, while EPDS scores ≥ 15 during pregnancy or ≥ 13 postpartum were indicative of symptoms of probable depression.
  
  
  RESULTS
  In adjusted regression analyses (n = 698), lower plasma total omega-3 PUFA concentrations (β = -6.49 STAI-state subscale scores/unit increase of omega-3 fatty acid; 95% CI, -11.90 to -1.08) and higher plasma omega-6:omega-3 PUFA ratios (β = 6.58 scores/unit increase of fatty acid ratio; 95% CI, 1.19 to 12.66), specifically higher arachidonic acid (AA):docosahexaenoic acid, AA:eicosapentaenoic acid, and AA:docosapentaenoic acid ratios, were associated with increased antenatal anxiety (P < .05 for all), but not postpartum anxiety. There was no association between plasma PUFAs and perinatal probable depression.
  
  
  CONCLUSIONS
  No association was found with probable depression in pregnancy or postpartum. Lower plasma omega-3 fatty acids and higher omega-6:omega-3 fatty acid ratios were associated with higher antenatal anxiety, but not postpartum anxiety. Replication in other studies is needed to confirm the findings and determine the direction of causality.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01174875.
authors.affiliation: Singapore Institute for Clinical Sciences, Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609 mary_chong@sics.a-star.edu.sg.
authors.forename: Mary F F
authors.initials: MF
authors.lastname: Chong
authors.forename: Yi-Lin
authors.initials: YL
authors.lastname: Ong
authors.forename: Philip C
authors.initials: PC
authors.lastname: Calder
authors.forename: Marjorelee
authors.initials: M
authors.lastname: Colega
authors.forename: Jocelyn X Y
authors.initials: JX
authors.lastname: Wong
authors.forename: Chuen Seng
authors.initials: CS
authors.lastname: Tan
authors.forename: Ai Lin
authors.initials: AL
authors.lastname: Lim
authors.forename: Helena L
authors.initials: HL
authors.lastname: Fisk
authors.forename: Shirong
authors.initials: S
authors.lastname: Cai
authors.forename: Wei Wei
authors.initials: WW
authors.lastname: Pang
authors.forename: Birit F P
authors.initials: BF
authors.lastname: Broekman
authors.forename: Seang Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.forename: Peter
authors.initials: P
authors.lastname: Gluckman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Meaney
authors.forename: Helen
authors.initials: H
authors.lastname: Chen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood*; D003863:Depression / Q000097:blood*; D019052:Depression, Postpartum / Q000097:blood / Q000453:epidemiology; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D006801:Humans; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy / Q000097:blood*; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology; D012846:Singapore / Q000453:epidemiology
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6