Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation for prevention and treatment of perinatal depression: a systematic review and meta-analysis of randomized-controlled trials

Abstract

Background

Available interventions for preventing and treating perinatal depression remain unsatisfactory.

Aims

We examined the prophylactic and therapeutic effects, as well as adverse effects, of n-3 PUFA supplementation in reducing depressive symptoms during perinatal periods.

Methods

We included randomized, placebo-controlled trials that reported the changes of depression severity after the perinatal participants received n-3 PUFA supplementation. After the comprehensive searches in October 2019, we selected the trials, extracted the data, and assessed the quality of included trials. We compared the standardized mean differences (SMD) of depression score changes between groups using a random-effect model.

Results

We included 11 trials in the meta-analysis and one more trial for qualitative analysis (N = 3,181). The pooled standardized mean of decreased depression scores revealed no statistically significant difference between the n-3 PUFA and the placebo groups (N = 920, SMDs = −0.05, 95% CI −0.20 to 0.10, I² = 21%). The pooled SMDs showed no statistically significant efficacy of n-3 PUFA supplementation for prevention (N = 779, SMDs = −0.03, 95% CI −0.20 to 0.13, I² = 24%) and treatment (N = 141, SMDs = −0.14, 95% CI −0.55 to 0.27, I² = 31%) of perinatal depression. The efficacy of n-3 PUFA supplementation was not associated with the daily doses of DHA, EPA, or DHA plus EPA. No trial reported any serious adverse effect of n-3 PUFA supplements.

Conclusions

Although n-3 PUFA supplementation may improve maternal and infant outcomes, our meta-analysis found insufficient evidence to determine its benefit for perinatal depression.

Keywords:

• Omega-3
• polyunsaturated fatty acids
• perinatal depression
• pregnancy
• postpartum

Disclosure statements

MS has received grants and/or speaker’s honoraria from Janssens (Thailand), Lundbeck, Sumitomo Dainippon Pharma. SS has received speaker’s honoraria from Mitsubishi Tanabe Pharma (Thailand) and Sumitomo Pharmaceuticals (Thailand). The remaining authors report no financial or other relationship relevant to the subject of this article.

Additional information

Funding

This work was supported by Chiang Mai University, Chiang Mai, Thailand. However, Chiang Mai University had no role for research conception, study design, data analysis, or study report.

Notes on contributors

Chawisa Suradom

Chawisa Suradom, MD, Lecturer: Areas of interest - Consultation-Liaison Psychiatry and General Psychiatry.

Sirijit Suttajit

Sirijit Suttajit, MD, Associate Professor: Areas of interest - Severe Mental Illnesses and General Psychiatry.

Awirut Oon-arom

Awirut Oon-arom, MD, Lecturer: Areas of interest - Substance Abuse, Gender and Psychiatry, and General Psychiatry.

Benchalak Maneeton

Benchalak Maneeton, MD, Professor: Areas of interest - Consultation-Liaison Psychiatry and General Psychiatry.

Manit Srisurapanont

Manit Srisurapanont, MD, Professor: Areas of interest - Severe Mental Illnesses and General Psychiatry.