Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort

Longitudinal prospective cohort (APrON) in Alberta, Canada; 600 pregnant women enrolled; inclusion: age ≥16 years, gestational age ≤27 weeks at enrollment; exclusions: non-English speakers, known drug/alcohol abusers, planning to move within 6 months; data collected via questionnaires/interviews at each trimester and 12 weeks postpartum; postpartum depression assessed with Edinburgh Postnatal Depression Scale (EPDS); 475 participants completed EPDS data across pregnancy and postpartum.

Prenatal micronutrient supplementation during pregnancy (vitamins/minerals and omega-3 fatty acids); intake quantified via the Supplement Intake Questionnaire across 2–3 prenatal visits; no standardized dosage regimen; average nutrient intake calculated per nutrient across visits; frequency reported as daily or several times per week.

Of 475 participants with postpartum EPDS data, 416 (88%) scored <10 and 59 (12%) scored ≥10. Higher mean supplement intakes were associated with lower EPDS scores, especially selenium (p=0.0015) and omega-3s (p=0.01). In multivariate logistic regression adjusting for covariates and nutrients, prenatal EPDS ≥10 increased the odds of postpartum depressive symptoms (second trimester OR 3.29, 95% CI 1.55–7.01, p=0.004; third trimester OR 4.26, 95% CI 2.05–8.85, p<0.0001). Prenatal selenium intake (per 10 mcg) reduced odds (OR 0.76, 95% CI 0.74–0.78, p=0.0019) and postnatal social support reduced odds (OR 0.87, 95% CI 0.78–0.97, p=0.0015). Conclusions: Selenium supplementation and postnatal social support are associated with lower risk of postpartum depressive symptoms; evidence supports focusing on selenium intake in pregnancy; further research is needed to confirm causality and explore interactions among nutrients.

Self-reported supplement intake; lack of serum nutrient measurements; dietary intake not accounted for; observational design cannot establish causality; 125 participants lacked postpartum EPDS data; potential recall/reporting bias; potential multicollinearity among nutrients; no assessment of interactions among nutrients; limited generalizability to other populations.