A systematic review of the associations between maternal nutritional biomarkers and depression and/or anxiety during pregnancy and postpartum.
A systematic review of the associations between maternal nutritional biomarkers and depression and/or anxiety during pregnancy and postpartum.
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DOI：
10.1016/j.jad.2018.02.004
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发表时间：
2018-02
影响因子：
6.6
通讯作者：
J. Trujillo;M. Vieira;J. Lepsch;F. Rebelo;L. Poston;D. Pasupathy;G. Kac
中科院分区：
文献类型：
--
作者：
J. Trujillo;M. Vieira;J. Lepsch;F. Rebelo;L. Poston;D. Pasupathy;G. Kac
为了适应产前和产后的变化，需要满足营养需求。我们的目的是系统地回顾怀孕期间和产后第一年营养生物标志物与心理困扰之间关联的证据。方法检索medline、EMBASE、PsycINFO、Scielo、LILACS、clinicaltrials.gov、International Clinical Trials Registry、Cochrane Library、Scopus和Web of Science等数据库自建站至2016年4月15日的文章。包括血液中母体营养生物标志物（脂肪酸/微量营养素/氨基酸）和与心理困扰（抑郁/焦虑/压力）的关联的研究。两名独立审稿人根据研究设计、参与者、结果、暴露和关联测量提取数据。结果共纳入38项研究。共有13项研究显示，血清/血浆/红细胞脂肪酸浓度与妊娠和产后抑郁/焦虑之间存在差异或无关联。三分之一的研究显示，从怀孕到产后血清胆固醇水平的变化与抑郁症呈显著的负相关。七项研究中有五项发现血清维生素D水平与产前和产后抑郁症呈负相关。在四分之三的研究中，血浆色氨酸水平与产后抑郁评分呈负相关。我们发现，两项研究中有一项表明维生素B12/叶酸/铁蛋白浓度与产后抑郁症之间没有显著关联。局限性：抑郁和焦虑评估的关联测量、时间和量表之间存在较大的可变性。结论：大多数高质量的研究表明，维生素D水平较低可能与产后抑郁症有关。然而，需要进一步的证据来指导营养生物标志物的临床实践。
BackgroundNutritional requirements need to be met in order to adapt to pre- and postnatal changes. Our aim was to systematically review the evidence of associations between nutritional biomarkers and psychological distress during pregnancy and in the first postnatal year.MethodsMEDLINE, EMBASE, PsycINFO, Scielo, LILACS, clinicaltrials.gov, International Clinical Trials Registry, Cochrane Library, Scopus and Web of Science databases were searched for articles from inception to 4/15/2016. Studies of maternal nutritional biomarkers in blood (fatty acids/micronutrients/amino acids) and associations with psychological distress (depression/anxiety/stress) were included. Two independent reviewers extracted data based on study designs, participants, outcomes, exposures, and association measures.ResultsThirty-eight studies were included. A total of 13 studies showed divergent or no associations between serum/plasma/erythrocyte fatty acid concentrations and depression/anxiety during pregnancy and postpartum. Changes in serum cholesterol levels from pregnancy to postpartum showed a significant inverse correlation with depression in one out of three studies. Five out of seven studies found an inverse association between serum vitamin D levels and pre- and postnatal depression. Plasma tryptophan levels were inversely correlated with postnatal depression scores in three out of four studies. We identified that one out of two studies presented no significant association between vitamin B12/folate/ferritin concentrations and depression in postpartum.LimitationsThere was higher variability between association measures, time and scales of depression and anxiety assessments.ConclusionsThe majority of high-quality studies suggest that lower vitamin D levels may be associated with postpartum depression. However, further evidence is needed for guiding clinical practice on nutritional biomarkers.