Maternal omega-3 fatty acid supplementation and risk for perinatal maternal depression

Objective. A systematic review was conducted to assess the possible association between omega-3 polyunsaturated fatty acid (PUFA) supplementation and intake in the perinatal period and the risk of maternal perinatal depression. Methods. Two PubMed searches and a BIOSIS Preview, a Web of Science and a PsychInfo search were conducted with the search terms 'DHA, pregnancy and depression' and 'omega-3 fatty acids, pregnancy and depression'. Results. Ten articles - three longitudinal cohort studies, five randomized controlled trials and two pilot trials-that met selection criteria were reviewed. Six found no association, two found mixed results, and two found a positive association between omega-3 PUFAs and reduced incidence of maternal perinatal depression. The heterogeneity of results can be explained by dissimilar study designs, including differences in study duration, time period of measurement and number of participants, and in varied dosages and types of supplemental PUFAs. Some of the larger studies and those that found a positive effect were more likely to be using higher doses, close to 2 g of docosahexaeonic acid (DHA) + eicosapentaenoic acid (EPA), and began the supplementation earlier in pregnancy. Conclusions. Future RCTs to investigate the role of PUFA supplementation and risk for maternal perinatal depression should begin supplementation early in pregnancy and use a dosage closer to 2 g of DHA+EPA. Depression should also be measured using a diagnostic interview schedule in addition to a screener.