Perinatal depression: prevalence, risks, and the nutrition link

The following blog post is excerpts from a Journal of the Academy of Nutrition and Dietetics article published by researchers Brenda Leung and Bonnie Kaplan.

“By the year 2020, WHO predicts that depression will be the second largest contributor to the global disability adjusted lives per years for all ages and both sexes. Today, depression is already the second largest cause of disability adjusted lives per years for those of reproductive age (15 to 44 years of age). Women are two to three times more likely to experience depression than men. The consequences of depression in women impart greater importance during or after pregnancy.”

What is perinatal depression?

“Perinatal depression refers to major and minor episodes during pregnancy (termed antenatal) or within the first 12 months after delivery (termed postpartum or postnatal). The term maternal depression has also been used interchangeably with perinatal depression.

“Signs and symptoms for perinatal depression are the same as those for depression in the general population: depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.”

Nutrition and maternal mood

“Pregnant women are especially susceptible to the effects of low nutrient intakes. During pregnancy and lactation, nutritional requirements are increased so that fetal and infant growth are adequately supported, as well as maternal metabolic needs specific to reproduction. In other words, the fetus is preprogrammed with specific energy and nutrient needs in order to grow and develop at set times during gestation, and these needs must be met by the mother.

“Nutrient demands from the fetus change over time and during different developmental stages. Thus, it is important that pregnant women select foods with enhanced nutrient density in order to avoid risking nutritional inadequacy, which may have long-lasting effects on both the women and their children.”

Dietary inadequacy in pregnant women

“The link between nutrient deficiency and maternal depression in developed countries might not seem obvious. However, nutrient deficiencies among those who consume a typical western diet might be more common than people realize.

“A study of pregnant adolescents and adults living in the United States found mean intake for energy, iron, zinc, calcium, magnesium, folate, and vitamins D and E to be below recommended standards in both groups.

“Another study also found pregnant women did not consume adequate amounts to meet the nutrient requirements for calcium, iron, folate, n-3 essential fatty acids, and vitamin D. Even middle- to upper-income pregnant women did not consume adequate amounts of iron and possibly magnesium from foods.

“A British study found a high percentage of pregnant women did not meet the estimated average requirement (a nutrient intake value that is estimated to meet the requirement of half of the healthy individuals in a particular life-stage and sex group) for calcium (40%), iron (67%), and folate (69%).

“Marchioni and colleagues found inadequate iodine intake in pregnant women, even though they lived in a region of Italy reported to have sufficient iodine levels available in their diets. A study of obese pregnant women found low status for a number of minerals in both the mother and their fetuses.

“Other studies have also found that pregnant women did not meet daily recommended intakes of nutrients through dietary means.

“Given the evidence of dietary inadequacy in pregnant women and the link between nutrient deficiency and depression, it is reasonable to theorize about the potential influence of nutrient deficiency on the incidence of maternal depression. Proper nutrition during pregnancy is vital to the health of a woman and her fetus, as pregnancy presents unique stresses that challenge overall physical and psychological adaptation in women.

“Women are particularly vulnerable to the adverse effects of poor nutrition on mood because pregnancy and lactation increase nutrient requirements. It has been proposed by others that depletion of nutrient reserves throughout pregnancy and a lack of recovery postpartum may increase a woman’s risk for maternal depression.”

To find out more, read the entire article in the Journal of the Academy of Nutrition and Dietetics.