Association between serum 25‐hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression

Abstract

Objective To assess the possible relationship between serum levels of 25[OH]D (25-hydroxyvitamin D) collected 24 hours after delivery and postpartum depression in a Chinese cohort sample.Design Cohort study.Setting One city hospital in Beijing, China.Population Women delivering a full-term, singleton, live-born infant at one city hospital in Beijing between August 2013 and November 2013.Methods Women were enrolled immediately postpartum. A blood sample was obtained 24-48 hours after childbirth to test serum levels of 25[OH]D. Participation consisted of a visit to an obstetric unit 3 months after delivery.Main outcome measure At 3 months' postpartum, women were screened for depression using the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measure was a prespecified EPDS score of ≥12.Results During the study period, 323 women were admitted. In all, 248 agreed to enrol and 213 completed 3 months' follow-up (21 were lost to follow-up and 14 withdrew). Of the 213 women who were included, 26 (12.2%) were considered to meet criteria for postpartum depression. Serum 25[OH]D levels in women with no postpartum depression were significantly higher than those in women with postpartum depression (P < 0.0001). Based on the receiver operating characteristic curve, the optimal cutoff value for serum 25[OH]D level as an indicator for screening for postpartum depression was estimated to be 10.2 ng/ml, with an area under the curve of 0.801 (95%CI 0.704-0.896). In multivariate analysis, there was an increased risk of postpartum depression associated with 25[OH]D levels ≤10.2 ng/ml (OR 7.17,; P < 0.0001) after adjusting for possible confounders.Conclusion Our study demonstrated that lower serum 25[OH]D levels were associated with postpartum depression. This association was independent of other possible variables.

Correlation between postpartum depression and omega-3, micronutrients

“…24 Maternal vitamin D deficiency is common during pregnancy and even with vitamin D supplements vitamin D is sufficient in only a small percentage of women and babies. 25 Low levels of vitamin D can be overlooked as a risk factor for PPD. High prevalence of maternal vitamin D deficiency (vitamin D levels of 25-50 nmol/L) during pregnancy and following giving birth were indicated in various populations at different latitudes as 5 to 20% in populations with fair skin and 30 to 70% in populations with dark skin or wearing hijab.…”

“…In fact, vitamin D deficiency is endemic in some populations. 25,26 Taking into account the high percentage of vitamin D deficiency seen in pregnant women along with prevalence of PPD lends itself to the notion that the link between vitamin D deficiency and PPD play an important role on public health. In a study done to shed a light on the effect of vitamin D deficiency on the occurrence of PPD, a significant correlation between low levels of 25-OH D3 over time, which is a sign of postpartum depression, and high EPDS scores was discovered.…”

“…27,28 In a study, Fu et al have found serum 25-OH D3 levels in women without PPD higher that in women suffering from postpartum depression. 25 A prospective study has discovered a negative correlation between prenatal vitamin D levels at week 18 of gestation and PPD symptoms. 29 …”

Serum leptin level measured 48 h after delivery is associated with development of postpartum depressive symptoms: a 3-month follow-up study

“…Postpartum depression (PPD) is considered as one of the most common psychiatric complications of childbirth and a major cause of maternal mortality worldwide (Fu et al 2015). It is well established that maternal prenatal and PPD is prevalent and has negative personal, family, and child developmental outcomes.…”

“…However, postpartum women represent a specific group, with both hormonal and psychosocial events that have no parallel in a woman's life time. In addition to sensitivity to estrogen and progesterone fluctuations (Albacar et al 2011), biologic theories have included fluctuations of other gonadal hormone and neuroactive steroid levels after delivery, altered cytokines and HPA axis hormones, and altered fatty acid, oxytocin, vitamin D, brain-derived neurotrophic factor, and arginine vasopressin levels (Zonana and Gorman 2005;Corwin and Pajer 2008;Albacar et al 2010;Gazal et al 2012;Fu et al 2015). Unfortunately, no clear biologic measure has been identified to be causative or predictive of postpartum blues (Pearlstein et al 2009).…”