Impact of preconceptional micronutrient supplementation on maternal mental health during pregnancy and postpartum: results from a randomized controlled trial in Vietnam

BMC Women's Health

Research Article

Reynaldo Martorell¹  Usha Ramakrishnan¹  Ines Gonzalez-Casanova¹  Wei Hao¹  Ann M. DiGirolamo²  Phuong H. Nguyen³  Kimberly B. Harding⁴  Hoa Pham⁵  Son Nguyen⁵  Hieu Nguyen⁵  Truong V. Truong⁵  Gregory A. Reinhart⁶ 

[1] Emory University, Atlanta, GA, USA;Georgia State University, Atlanta, GA, USA;International Food Policy Research Institute, Washington, DC, USA;Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam;Micronutrient Initiative, Ottawa, ON, Canada;Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam;The Mathile Institute for the Advancement of Human Nutrition, Dayton, OH, USA;

关键词: Preconception;    Multiple micronutrient;    Supplement;    Women of reproductive age;    Mental health;    Randomized controlled trial;    Vietnam;   

DOI  :  10.1186/s12905-017-0401-3

 received in 2016-11-29, accepted in 2017-06-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMicronutrient malnutrition has been associated with maternal depressive symptoms (MDS), but little is known about the effects of preconceptional micronutrient supplementation. This paper examined the effects of preconceptional micronutrient supplementation on MDS during pregnancy and postpartum.MethodsWe used data from a double-blind controlled trial (PRECONCEPT) in which 5011 Vietnamese women were randomized to receive weekly supplements containing either a) multiple micronutrients (MM) b) iron and folic acid (IFA) or c) folic acid (FA) until conception (n = 1813). Maternal mental health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline (preconception), and the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and 3 months postpartum. Elevated MDS was defined as EPDS score ≥ 4. All group comparisons were done using ANOVA or chi-square tests of proportions intention to treat and per protocol analyses (women consumed supplements ≥26 weeks before conception). We also conducted stratified analyses by preconception CES-D scores, underweight, or anemia status using generalized linear models.ResultsBaseline CES-D scores were similar across treatment groups. The proportion of women experiencing elevated MDS was 11.3, 8.1 and 4.9% at first, second and third trimesters of pregnancy, respectively, and 3.6% at 3 mo postpartum. Mean EPDS scores at first (1.5 ± 2.7), second (1.1 ± 2.4), and third trimester of pregnancy (0.7 ± 2.0) and early postpartum (0.6 ± 1.8) were low and did not differ by treatment group. However, among women in the highest tertile of CES-D scores at preconception, mean EPDS scores in the first and second trimesters of pregnancy were lower in the MM and IFA groups compared to FA only (P < 0.05).ConclusionsWeekly preconceptional micronutrient supplements containing iron did not improve depression measures relative to folic acid alone among all women, but may have benefitted women who were at risk for depression.Trial registrationThe trial was registered retrospectively at ClinicalTrials.Gov as NCT01665378 on August 13, 2012.

【 授权许可】

CC BY   
© The Author(s). 2017