22nd September 2020

2 min read

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Disclosure:
The authors of the study do not report any relevant financial information. Sarris and Freeman report several links to industry that are listed in the editorial.

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Omega-3 polyunsaturated fatty acids appeared to have a small but significant positive effect on perinatal depression, according to the results of a meta-analysis published in the Journal of Clinical Psychiatry.

“The lack of recommendations is problematic because of omega-3 PUFAs [polyunsaturated fatty acids] are currently widely used during pregnancy and after childbirth (both to prevent and treat symptoms of depression), and women seek advice from their health care professionals on safety and effectiveness. ” Roel JT Mocking, MD, PhD, of the Department of Psychiatry at the University of Amsterdam, and colleagues wrote. “To facilitate clinical decision-making, we wanted to continue the debate on the effectiveness of omega-3 PUFAs in treating perinatal depressive symptoms by conducting a meta-analysis of all available [randomized controlled trials] and perform a meta-regression. “

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In particular, the researchers compared published clinical results of the use of omega-3 PUFA in pregnant women with women after childbirth and for the prevention of treatment of perinatal depression. They searched four databases and combined terms on omega-3 PUFAs and perinatal depression, and included data from 18 randomized controlled trials with 4,052 participants published by February 18, 2019.

The results showed that omega-3 PUFAs had an overall small but significant positive effect on depressive symptoms compared to placebo. Mocking and colleagues reported considerable heterogeneity, with 55% of the variance between studies being explained by significant subgroup differences. Omega-3 PUFAs showed a moderate effect in women with depression and no effect in women without depression. Postpartum women had moderate to large effects versus negligible effects during pregnancy.

The researchers observed the greatest effect among the studies specifically looking at postpartum depression.

“We do not recommend prescribing omega-3 PUFAs for the treatment or prevention of depressive symptoms during pregnancy because a negligible effect with little heterogeneity is observed,” they write. “Alternatively, omega-3 PUFA supplementation appears to be a promising (additional) treatment option for major postpartum depression episodes.”

In a related editorial Jerome Sarris, PhD, MHSc, of the NICM Health Research Institute at Western Sydney University in Australia and Marlene P. Freeman, MD, of the Ammon Pinizzotto Center for Women’s Mental Health at Harvard Medical School provided clinical reflections on the use of omega-3 PUFA in this patient population.

“A balanced evidence-based approach would be to advise women in the perinatal period to eat appropriately [omega-3], while supplementation can occur if the deficiency is severe, ”they wrote. “An additional clinical consideration may also include the potential use of [omega-3] in comorbid obesity and inflammatory diseases, [whereas] For vegetarians, algae-based preparations can also be an option.

“After all, most studies have shown no significant nonselective benefit from [omega-3] for acute or preventive treatment of perinatal [major depressive disorder]We can also point out that other potential pregnancy benefits, such as increasing the gestation period, may affect the risk-benefit profile of [omega-3] still attractive in pregnancy, ”they added. “This application can be used more effectively as a potential complement to standard medication and psychotherapy.”

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