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Fish and long-chain n–3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort^1,2,3

¹ From the Maternal Nutrition Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MS, TIH, and SFO); the Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark (ELM); and the Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali University Hospital, Reykjavik, Iceland (IT and TIH).

² Supported by the Faroese Research Council, the Fisheries Research Fund of the Faroe Islands, the European Union 6th framework programme Integrated Research Project SEAFOODplus (FOOD-CT-2004-506359), and the European Union 6th framework programme EARNEST (FOOD-CT-2005-007036). Funding for the Danish National Birth Cohort was provided by the March of Dimes Birth Defects Foundation, the Danish Heart Association, the Danish Medical Research Council, Sygekassernes Helsefond, the Danish National Research Foundation, the Danish Pharmaceutical Association, the Ministry of Health, the National Board of Health, and Statens Serum Institut.

³ Address correspondence to M Strøm, Maternal Nutrition Group, Department of Epidemiology Research, Statens Serum Institut Artillerivej 5, 2300 Copenhagen, Denmark. E-mail: mrm{at}ssi.dk.

ABSTRACT

Background: Mothers may be reluctant to receive medical treatment of postpartum depression (PPD), despite the detrimental consequences the disorder can impose on mother and child. Research on alternative methods of prevention and treatment of PPD is warranted. Previous studies have suggested that long-chain n–3 polyunsaturated fatty acids (PUFAs) might have a beneficial effect on depression.

Objective: The objective was to explore the association between intake of fish and n–3 PUFAs during pregnancy and PPD in the Danish National Birth Cohort (DNBC).

Design: Exposure information from the DNBC was linked to the Danish patient and prescription registries for data on clinically identified cases of depression up to 1 y postpartum. Intake of fish and n–3 PUFAs was assessed in midpregnancy with a food-frequency questionnaire. Admission to the hospital for PPD (PPD-admission) and prescription of antidepressants (PPD-prescription) were treated as separate outcomes. A total of 54,202 women were included in the present study sample.

Results: Rates of depression were 0.3% (PPD-admission) and 1.6% (PPD-prescription). No association was observed between fish intake and risk of PPD-admission [crude odds ratio of 1.01 (95% CI: 0.52, 1.97) and adjusted odds ratio of 0.82 (95% CI: 0.42, 1.64)], whereas a higher risk of PPD-prescription was found for the lowest compared with the highest fish intake group [crude odds ratio of 1.61 (95% CI: 1.26, 2.06) and adjusted odds ratio of 1.46 (95% CI: 1.12, 1.90)]. No association was observed with respect to n–3 PUFA intake.

Conclusion: Overall, our data from a large prospective cohort linked with high-quality registers showed little evidence to support an association between intake of fish or n–3 PUFAs and PPD.

Received for publication January 28, 2009. Accepted for publication April 25, 2009.