Association Between Vitamin D Levels During Pregnancy and Postpartum Depression

Abstract

Article BackgroundSeveral studies have found that low levels of serum 25-hydroxyvitamin D (25(OH)D) are linked to many diseases and disorders such as premenstrual syndrome, nonspecific mood disorder, major depressive disorder, cancer, autoimmune disorders, bone diseases, cardiovascular diseases, preeclampsia, seasonal affective disorder, and post-partum depression (PPD). 1-4 It is suggested that vitamin D is a potential neurosteroid and that it is found in high concentrations in the amygdala, thalamus, hypothalamus, dorsal raphae nucleus, and in the motor neurons, which supports possible effects on the sensory pathway, as well as on endocrine, autonomic, and motor systems. Thus, deficiency in vitamin D could be related to many of the symptoms of depression such as fatigue, mood disturbance, and motor function. 5,6 Vitamin D is a cholesterol-derivative steroid hormone that can be synthesized in the human body after the cutaneous exposure to ultraviolet B radiation. It may also be obtained from dietary sources such as fish and egg yolk.Pregnant women often do not get sufficient vitamin D due to the liberal application of sunscreen, related to fear of skin cancer as well as decreased fish in the diet, due to fear of mercury content. 7,8 Vitamin D deficiency in the general population is more prevalent than many realize, especially during pregnancy. Studies have found that pregnant women are more likely to have low serum 25(OH)D than nonpregnant women and that the level of 25(OH)D seems to vary among trimesters with the first and third trimesters being lower than second trimester in 25(OH)D concentration. 9,10 Abstract Objective: To evaluate evidence regarding 25-hydroxyvitamin D (25(OD)D) levels during pregnancy and its association with postpartum depression (PPD). Data Sources: Primary literature was accessed through MEDLINE, Google Scholar, and International Pharmaceutical Abstracts searches through January 2015. Data from published trials were retrieved for analysis using the following search terms: vitamin D, 25-hydroxyvitamin D, 25(OH)D, postpartum, pregnancy, and depression. Data Extraction: Inclusion criteria were human subjects, English language, vitamin D as the sole micronutrient under study, and measurement of vitamin D level during pregnancy. Studies measuring vitamin D levels after delivery were excluded. Also any antenatal or prepartum depression was excluded. Data Synthesis: Although a variety factors may contribute to the likelihood and severity of PPD, there are 3 published prospective cohort studies specifically evaluating the relationship between vitamin D and PPD. The results are conflicting: 2 of these studies found a significant correlation between patients with low vitamin D level and PPD, but the third found that high vitamin D levels are associated with a greater incidence of PPD. Conclusion: Available evidence suggests a possible correlation between vitamin D levels at midpregnancy and PPD. Women with risk factors for PPD should be educated on this potential association and ways to maintain ...

Vitamin D Deficiency and Antenatal and Postpartum Depression: A Systematic Review

“…Ultimately, 21 eligible studies were assessed, and 14 of these were selected for full review, all of which were full-text publications [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Articles were excluded for the following reasons: a general review [ 36 ], study of other nutritional factors, e.g., milk and calcium [ 37 , 38 ], lack of comparison group [ 39 ], not measuring the outcome of interest/not population of interest [ 40 , 41 ], or published as an abstract [ 42 ] ( Figure 1 ).…”

A systematic review of the associations between maternal nutritional biomarkers and depression and/or anxiety during pregnancy and postpartum

“…However, not all of the studies reported data on these factors or the percentages of women with deficient or insufficient levels. A recent review investigated vitamin D levels measured during pregnancy and their association with postpartum depression, the results of which suggested a correlation (Mahmood et al, 2015). Three studies were included, one of which classified depression by antidepressant use (Nielsen et al, 2013).…”

Association between Vitamin D Levels During Pregnancy and Postpartum Depression: A Narrative Reviews

“…VD is a steroid hormone that is produced by our bodies after being exposed to ultraviolet B radiation through the skin,[ 26 ] it can also be acquired from food like fish, egg yolk, liver oil, beef liver, portabella mushrooms, fortified foods such as breakfast cereal and milk. [ 27 28 29 ] Ultraviolet light converts 7-dehydrocholesterol to pre- VD, which is convert to cholecalciferol (VD3),[ 24 ] that exhibits no biological activity within the body. Then it passes through two hydroxylation steps to be activated, the first one in the liver to produce 25hydroxy vitamin D (25(OH)D), which is the predominant vitamin form in our blood,[ 30 ] and the second hydroxylation occur mainly inside the kidney, brain, and immune system by 1alpha-hydroxylase using specialized cells to produce the functional form of VD, which is called calcitriol.…”

“…[ 3 42 ] Increased circulating 25(OH)D concentrations following 8-week VD supplementation (50,000 IU) resulted in a significant decrease in Beck Depression Inventory-II (BDI-II) scores in patients with mild-to-moderate depression. [ 42 ] The relationship between VD levels and PPD is controversial; few studies revealed the association between VD level and PPD,[ 7 13 29 43 ] while others showed no association. [ 7 ] This study aims to review the studies concerning the association between 25(OH)D levels during pregnancy and PPD development.…”