Effects of fish-oil and folate supplementation of pregnant women on maternal and fetal plasma concentrations of docosahexaenoic acid and eicosapentaenoic acid: a European randomized multicenter trial

Krauss‐Etschmann, Susanne; Shadid, Rania; Campoy, Cristina; Hoster, Eva; Demmelmair, Hans; Jiménez, M. Consuelo; Gil, Ángel; Rivero, Montserrat; B, Veszprémi; Décsi, Támas; Koletzko, Berthold

doi:10.1093/ajcn/85.5.1392

Cited by 180 publications

(102 citation statements)

References 41 publications

(41 reference statements)

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“…When only the EPDS was used as the outcome measure, the pooled mean effect size was 0·02 (n 450; 95 % CI 2 0·17, 0·21; P¼0·83 using a fixed-effects model). Repeating the analyses while excluding the trial by Krauss-Etschmann et al (36) resulted in a similar pre-to post-treatment effect size (Hedges's d ¼ 20·05; n 342; 95 % CI 2 0·26, 0·17; P¼0·68; Table 3). Therefore, the pooled mean effect size was non-significant and indicated no or a small pre-to post-treatment decrease in the perinatal depression.…”

Section: Meta-analysismentioning

confidence: 82%

“…Of these eleven intervention papers, four were additionally excluded due to our inclusion and exclusion criteria (37 -40) , and seven randomised, placebocontrolled, double-blind trials were included in the metaanalysis (35,36,41 -45) . For three studies, depression was not the primary outcome measure (35,36,41) . All included studies used marine-derived n-3 PUFA interventions; some used fish oil (35,36,44) , some DHA (41,43) , and some a combination of DHA and EPA (42,45) .…”

Section: Resultsmentioning

confidence: 99%

“…When means or mean differences and standard deviations were not reported, we used other statistics (i.e. P value) to compute the effect sizes, which applied to one study (36) . To calculate the pooled mean effect sizes, we used the computer program Comprehensive Meta-analysis (version 2.2.021; Biostat, Englewood, NJ, USA).…”

Section: Meta-analysismentioning

confidence: 99%

“…In a four-arm study by Krauss-Etschmann et al (36) , apparently healthy pregnant women received fish oil (500 mg DHA and 150 mg EPA); 400 mg methyltetrahydrofolic acid; both or placebo from week 22 of gestation until delivery. Plasma fatty acid analyses were performed at baseline (gestation week 20), gestation week 30 and at delivery.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…The number of participants was low in most studies. In one study, which was the largest study, depression was presumably measured on only one occasion (36) . In contrast with Consolidated Standards of Reporting Trials guidelines, ITT analyses were presented in only one of the seven studies (44) .…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression

2010

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Depressive symptoms are common during pregnancy and the post-partum period. Although essential n-3 PUFA may have beneficial effects on depression, it remains unclear whether they are also effective for perinatal depression. The purpose of the present study was to assess the efficacy of n-3 supplementation for perinatal depression, by performing a meta-analysis on currently available data. After a thorough literature search, we included seven randomised controlled trials in the meta-analysis, all with EPA and/or DHA supplementation. Most studies were judged to be of low-to-moderate quality, mainly due to small sample sizes and failure to adhere to Consolidated Standards of Reporting Trials guidelines. Some studies were not primarily designed to address perinatal depression. A total of 309 women on n-3 fatty acid supplementation were compared with 303 women on placebo treatment. n-3 Supplementation was not found to be significantly more effective than placebo at post-treatment with a pooled effect size (Hedges's g) of 20·03 (95 % CI 2 0·18, 0·13; P¼ 0·76) using a fixed-effects model. Heterogeneity was low-to-moderate (I 2 ¼ 30 %). In a subgroup analysis of three small studies of pregnant women with major depression, there was some indication of effectiveness (effect size 0·17; 95 % CI 2 0·21, 0·55). In conclusion, the question of whether EPA and DHA administration is effective in the prevention or treatment of perinatal depression cannot be answered yet. Future research should focus on women who are clinically depressed (or at risk). The quality of research in this area needs to improve.

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Section: Meta-analysismentioning

confidence: 82%