Effect of fish oil omega-3 fatty acids on reduction of depressive symptoms among HIV-seropositive pregnant women: a randomized, double-blind controlled trial

Abstract

BackgroundGlobally, it is known that HIV-infected pregnant women are prone to depressive symptoms. Research evidences also suggest that nutrient deficiencies may enhance the depressive illness, and that fish oil omega-3 fatty acids may alleviate the depressive symptoms. The aim of this study was to assess the effect of fish oil omega-3 eicosapentaenoic acid-rich supplements on depressive symptoms among HIV-seropositive pregnant women.Trial designA randomized double-blinded controlled trial with two parallel groups was conducted. The intervention group received fish oil omega-3 of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) per day for 8 weeks, while the control group received soybean oil for a similar period.MethodParticipants were HIV-seropositive pregnant women who were enrolled in prevention of mother-to-child transmission programs and attending antenatal clinics at selected Nairobi city county’s health facilities. Recruitment was done from health records of HIV-infected pregnant women. Data analysis followed per-protocol analysis. Participants who completed the 8-week trial were included in the analysis of covariance statistical model with omega-3 as main effect. The covariates in the change in BDI-II depressive symptom score outcome were baseline characteristics and nutrient adequacy.Results282 participants were recruited 109 randomized to fish oil, and 107 to soybean oil. Completion rate was 86/109 (78.9%) and 96/107 (89.7%) respectively. At the end of week-8 of follow up most participants in both arms had mild depressive symptoms 82/86 (95.3%) in the Fish oil group and 94/96 (97.9%) in the Soybean oil group. The difference in effect between the intervention and control group was not statistically significant (1.01 (95% CI − 0.58 to 2.60), p = 0.21).ConclusionFish oil omega-3 with a daily dosage of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) appears to provide no added benefit in reduction of the symptoms of depression in HIV-infected pregnant women.Trial Registration Clinical Trial Registry: NCT01614249. Registered on June 5, 2012. https://clinicaltrials.gov/ct2/show/NCT01614249

Mental health interventions for persons living with HIV in low‐ and middle‐income countries: a systematic review

“…The study’s total sample size ranged from 32 to 1140, intervention sample sizes ranged from 19 to 578 and control group sample sizes ranged from 13 to 562. The majority of studies (n = 22, 73.33 %) reported on interventions for depression [33‐55]. Major depressive disorder was confirmed using diagnostic interviews such as SCID or MINI in three studies [34‐36].…”

“…This review revealed six studies which evaluated complementary and alternative interventions for depression. The interventions evaluated included omega‐3 fatty acids [49,52], physical exercise [33] an herbal supplement [38] and yoga [37]. The study evaluating physical exercise and one study evaluating omega‐3 fatty acids did not register any advantage over placebo.…”

Association between maternal depression during pregnancy and newborn DNA methylation

“…The BDI-II scale has 21 questions, scores ranging from 0 to 63, and is used to screen for depression [19]. The BDI-II scale has been validated for prenatal depression [20] and used for prenatal depression in countries such as Ethiopia and Kenya [21,22]. For EPDS, thresholds of 10 and 13 are commonly used to screen for depression with 10 having a higher sensitivity and 13 having a higher specificity [23].…”

Targeting divergent pathways in the nutritional management of depression

“…Effect of fish oil omega-3 fatty acids on reduction of depressive symptoms among HIVseropositive pregnant women: a randomized, double-blind controlled trial [42].…”