Protecting Mothers: How Micronutrients Can Prevent Postnatal Depression for Mothers who are Depressed During Their Pregnancy

Depression during pregnancy, also known as ‘antenatal depression’, is a debilitating condition for soon-to-be mothers and a risk factor for postnatal depression (1 -2) and poor birth outcomes (3).

In New Zealand, 12% of women experience antenatal depression (4) and up to 14% of mothers experience postnatal depression (5). There is strong predictability that mothers who are depressed during their pregnancy will go on to develop postnatal depression (estimates range from 39-92% of mothers) (6). Currently women suffering from antenatal depression are recommended psychological treatments (7); however, many women struggle to attend appointments due to time constraints, lack of appointments available, high costs, stigma, and childcare issues (8).

Women experiencing severe antenatal depression are often prescribed antidepressants. Pregnant women are often reluctant to use psychiatric medications, despite assurances of the absence of serious adverse effects. This reluctance persists despite the risks of stopping medication and untreated maternal psychiatric illness being deemed higher risk for the infant than the continuation of medications (9), with dispensing rates dropping during the pregnancy period (10).

Study overview:

This study is a secondary analysis of six-month data from the NUTRItional Intervention for Maternal difficUlities in Mental health (NUTRIMUM) study (11). This study investigated whether broad spectrum micronutrients (vitamins and minerals) administered during pregnancy to women with clinical depression, mitigated the increased risk of developing postnatal depression at six months post-birth.

Sixty-one mothers from the NUTRIMUM study who took micronutrients antenatally were monitored for symptoms of depression during pregnancy and at six months post birth.

The micronutrient supplement used in the NUTRIMUM study was Daily Essential Nutrients (DEN) a commercially available formula that has been well-researched to treat psychiatric conditions (12). On average, mothers in this study took micronutrients for 98 days during their pregnancy.

Key findings:

The results showed that mothers who took micronutrients during their pregnancy were less depressed at six months after the birth of their child:

• Clinician-rated depression measures showed that 92% of mothers were no longer depressed at six months (scores fell in the normal nonclinical range).
• Self-reported depression measures showed that 86% of mothers were no longer depressed at six months.
• Greater length of exposure to micronutrients during pregnancy was associated with greater improvement in depression scores at birth.
• Mothers who added or switched to antidepressants at six months after birth, had higher depression scores than mothers who continued micronutrient supplementation or were not taking any treatment. On average they were taking the supplements for less time during pregnancy (mean days on DEN 39.8 days).
• Continued supplementation of micronutrients after birth was not necessary to reduce postnatal depression, taking micronutrients during pregnancy had the greatest effect.

This study’s analysis on six-month postnatal data highlights the protective and symptom reduction potential of micronutrient supplementation during pregnancy to prevent postnatal depression in mothers at higher risk. Replication with a more controlled design postnatally is now required to confirm these preliminary findings.

What Does This  Mean for You?

There is growing interest in nutritional approaches to alleviating depression, the NUTRIMUM study(11) and this study provides further evidence to support the safety and efficacy of using micronutrients to improve birth outcomes and treat depression. Micronutrient supplementation can offer an alternative to antidepressant medications during pregnancy for mothers who are struggling and seeking other treatment options.

Taking micronutrients should not be a replacement for eating nutritious food but taken alongside to better support the nutritional environment for the growing foetus and the mother’s mental health during pregnancy and after birth.