The Role of Omega-3 Unsaturated Fatty Acids in Postpartum Depression: A Systematic Review and Narrative Synthesis

Abstract

Background: Postpartum depression (PPD) is a complex mental health disorder that affects women during their childbearing years. It is a serious medical condition that occurs in approximately 13–20% of women after birth and has an adverse effect on both the mother and the infant. Certain dietary deficiencies in a pregnant or postnatal woman’s diet may cause postnatal depression. It is unclear whether Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are effective for treating or preventing PPD. Objectives: To assess the best available evidence to date regarding the effect of n-3 PUFAs on the etiology, prevention and treatment of postnatal depression. Methods: A systematic review and narrative synthesis was conducted in order to address the gaps in knowledge. For the systematic review, a broad search of electronic databases of published quantitative literature was conducted. Quality appraisal was performed using the tools produced by the effective public health practice project (EPHPP). The narrative synthesis consists of four elements: 1) developing a theory; 2) developing a preliminary synthesis; 3) exploring relationships in the data; 4) assessing the robustness of the synthesis. Results: Out of 181 potential articles, a total of 17 studies met the inclusion criteria. The overwhelming majority of the studies found that n-3 PUFAs had no association with PPD evaluations versus only few ones observed a beneficial effect of n-3 PUFAs supplementation on depressive symptoms. Significant heterogeneity was observed among included studies which can be explained by dissimilar study designs, differences in study duration, time period of measurement and number of participants, and in varied dosages and types of supplemental n-3 PUFAs. Conclusions: Overall, This systematic review and narrative synthesis failed to find a significant positive association between n-3 PUFAs intake and PPD. However further investigation of the specific molecular mechanisms underlying the function of n-3 PUFAs in the brain and the factors related to the pathophysiological nature of depression is warranted.