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Published in: Archives of Gynecology and Obstetrics 6/2018

01-12-2018 | Review

Association between vitamin D deficiency and antepartum and postpartum depression: a systematic review and meta-analysis of longitudinal studies

Authors: Jie Wang, Na Liu, Weijia Sun, Dandan Chen, Jingxia Zhao, Wei Zhang

Published in: Archives of Gynecology and Obstetrics | Issue 6/2018

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Abstract

Purpose

The two previous reviews performed on the association of vitamin D deficiency in pregnancy with antepartum and postpartum depression were limited in reporting forms as they were both systematic reviews and the conclusions were also deemed to be inconclusive. Considering the high prevalence of vitamin D deficiency and depression during and after pregnancy as well as their numerous hazards to pregnancy outcomes, it is of great need to synthesize existing evidence in a more accurate statistical method, so that reliable guidance related to vitamin D supplementation during pregnancy could be provided for clinical decision making.

Methods

We performed a systematic review and meta-analysis to investigate the association of vitamin D deficiency with antepartum and postpartum depression.

Results

Nine longitudinal studies with 8470 participants were included in the meta-analysis. We found serum 25(OH)D levels < 50 nmol/l was associated with 2.67 times (OR 3.67; 95% CI 1.72–7.85) increased risk of postpartum depression than those 25(OH)D levels ≥ 50 nmol/l, but we did not find a significant association between low vitamin D levels and depressive symptoms during pregnancy with a serum 25(OH)D cut-off level of 30 nmol/l (OR 1.47; 95% CI 0.92–2.36).

Conclusions

The low status of maternal vitamin D could be an adverse factor for postpartum depression, but the available evidence suggested no association between vitamin D deficiency and depressive symptoms during pregnancy. However, this result should be interpreted with caution owning to the small number of studies. Well-designed intervention studies are also needed to further evaluate the benefits of vitamin D supplementation during pregnancy.
Literature
1.
go back to reference Wewerinke A, Honig A, Heres MH, Wennink JM (2006) Psychiatric disorders in pregnant and puerperal women. Ned Tijdschr Geneeskd 150(6):294–298PubMed Wewerinke A, Honig A, Heres MH, Wennink JM (2006) Psychiatric disorders in pregnant and puerperal women. Ned Tijdschr Geneeskd 150(6):294–298PubMed
2.
go back to reference Krauss P, Marcos G, Abelha L et al (2011) Depression during pregnancy: review of epidemiological and clinical aspects in developed and developing countries. In: Psychiatric disorders - trends and developments. InTech Krauss P, Marcos G, Abelha L et al (2011) Depression during pregnancy: review of epidemiological and clinical aspects in developed and developing countries. In: Psychiatric disorders - trends and developments. InTech
3.
go back to reference Nielsen NO, Strom M, Boyd HA et al (2013) Vitamin D status during pregnancy and the risk of subsequent postpartum depression: a case-control study. PLoS ONE 8(11):e80686CrossRef Nielsen NO, Strom M, Boyd HA et al (2013) Vitamin D status during pregnancy and the risk of subsequent postpartum depression: a case-control study. PLoS ONE 8(11):e80686CrossRef
4.
go back to reference Grote NK, Bridge JA, Gavin AR et al (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024CrossRef Grote NK, Bridge JA, Gavin AR et al (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024CrossRef
5.
go back to reference Beck CT (1995) The effects of postpartum depression on maternal-infant interaction: a meta-analysis. Nurs Res 44(5):298–304CrossRef Beck CT (1995) The effects of postpartum depression on maternal-infant interaction: a meta-analysis. Nurs Res 44(5):298–304CrossRef
6.
go back to reference Beck CT (1998) The effects of postpartum depression on child development: a meta-analysis. Arch Psychiatr Nurs 12(1):12–20CrossRef Beck CT (1998) The effects of postpartum depression on child development: a meta-analysis. Arch Psychiatr Nurs 12(1):12–20CrossRef
7.
go back to reference Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ (2005) Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat 29(1):21–30CrossRef Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ (2005) Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat 29(1):21–30CrossRef
8.
go back to reference Accortt EE, Schetter CD, Peters RM, Cassidy-Bushrow AE (2016) Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: preliminary evidence for moderation by inflammatory cytokines. Arch Womens Ment Health 19(2):373–383CrossRef Accortt EE, Schetter CD, Peters RM, Cassidy-Bushrow AE (2016) Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: preliminary evidence for moderation by inflammatory cytokines. Arch Womens Ment Health 19(2):373–383CrossRef
9.
go back to reference Anglin RE, Samaan Z, Walter SD, McDonald SD (2013) Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry 202:100–107CrossRef Anglin RE, Samaan Z, Walter SD, McDonald SD (2013) Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry 202:100–107CrossRef
10.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930CrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930CrossRef
11.
go back to reference Amegah AK, Klevor MK, Wagner CL (2017) Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: a systematic review and meta-analysis of longitudinal studies. PLoS ONE 12(3):e0173605CrossRef Amegah AK, Klevor MK, Wagner CL (2017) Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: a systematic review and meta-analysis of longitudinal studies. PLoS ONE 12(3):e0173605CrossRef
12.
go back to reference Aghajafari F, Nagulesapillai T, Ronksley PE et al (2013) Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 346:f1169CrossRef Aghajafari F, Nagulesapillai T, Ronksley PE et al (2013) Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 346:f1169CrossRef
13.
go back to reference Wei SQ, Qi HP, Luo ZC, Fraser WD (2013) Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 26(9):889–899CrossRef Wei SQ, Qi HP, Luo ZC, Fraser WD (2013) Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 26(9):889–899CrossRef
14.
go back to reference Brandenbarg J, Vrijkotte TG, Goedhart G, van Eijsden M (2012) Maternal early-pregnancy vitamin D status is associated with maternal depressive symptoms in the Amsterdam born children and their development cohort. Psychosom Med 74(7):751–757CrossRef Brandenbarg J, Vrijkotte TG, Goedhart G, van Eijsden M (2012) Maternal early-pregnancy vitamin D status is associated with maternal depressive symptoms in the Amsterdam born children and their development cohort. Psychosom Med 74(7):751–757CrossRef
15.
go back to reference Cassidy-Bushrow AE, Peters RM, Johnson DA, Li J, Rao DS (2012) Vitamin D nutritional status and antenatal depressive symptoms in African American women. J Womens Health (Larchmt) 21(11):1189–1195CrossRef Cassidy-Bushrow AE, Peters RM, Johnson DA, Li J, Rao DS (2012) Vitamin D nutritional status and antenatal depressive symptoms in African American women. J Womens Health (Larchmt) 21(11):1189–1195CrossRef
16.
go back to reference Robinson M, Whitehouse AJ, Newnham JP et al (2014) Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Arch Womens Ment Health 17(3):213–219CrossRef Robinson M, Whitehouse AJ, Newnham JP et al (2014) Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Arch Womens Ment Health 17(3):213–219CrossRef
17.
go back to reference Gould JF, Anderson AJ, Yelland LN et al (2015) Association of cord blood vitamin D at delivery with postpartum depression in Australian women. Aust N Z J Obstet Gynaecol 55(5):446–452CrossRef Gould JF, Anderson AJ, Yelland LN et al (2015) Association of cord blood vitamin D at delivery with postpartum depression in Australian women. Aust N Z J Obstet Gynaecol 55(5):446–452CrossRef
18.
go back to reference Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012CrossRef Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012CrossRef
19.
go back to reference Wells GA, Shea BJ, O’Connell D et al (2014) The Newcastle–Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appled Eng Agric 18(6):727–734 Wells GA, Shea BJ, O’Connell D et al (2014) The Newcastle–Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appled Eng Agric 18(6):727–734
20.
go back to reference Cochran WG (1954) The combination of estimates from different experiments. Biometrics 10(1):101–129CrossRef Cochran WG (1954) The combination of estimates from different experiments. Biometrics 10(1):101–129CrossRef
21.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef
22.
go back to reference Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101CrossRef Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101CrossRef
23.
go back to reference Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634CrossRef Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634CrossRef
24.
go back to reference Cunha Figueiredo AC, Trujillo J, Freitas-Vilela AA et al (2017) Association between plasma concentrations of vitamin D metabolites and depressive symptoms throughout pregnancy in a prospective cohort of Brazilian women. J Psychiatr Res 95:1–8CrossRef Cunha Figueiredo AC, Trujillo J, Freitas-Vilela AA et al (2017) Association between plasma concentrations of vitamin D metabolites and depressive symptoms throughout pregnancy in a prospective cohort of Brazilian women. J Psychiatr Res 95:1–8CrossRef
25.
go back to reference Fu CW, Liu JT, Tu WJ, Yang JQ, Cao Y (2015) Association between serum 25-hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression. BJOG 122(12):1688–1694CrossRef Fu CW, Liu JT, Tu WJ, Yang JQ, Cao Y (2015) Association between serum 25-hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression. BJOG 122(12):1688–1694CrossRef
26.
go back to reference Gur EB, Gokduman A, Turan GA et al (2014) Mid-pregnancy vitamin D levels and postpartum depression. Eur J Obstet Gynecol Reprod Biol 179:110–116CrossRef Gur EB, Gokduman A, Turan GA et al (2014) Mid-pregnancy vitamin D levels and postpartum depression. Eur J Obstet Gynecol Reprod Biol 179:110–116CrossRef
27.
go back to reference Vaziri F, Nasiri S, Tavana Z et al (2016) A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC Pregnancy Childbirth 16:239CrossRef Vaziri F, Nasiri S, Tavana Z et al (2016) A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC Pregnancy Childbirth 16:239CrossRef
28.
go back to reference Maunsell Z, Wright DJ, Rainbow SJ (2005) Routine isotope-dilution liquid chromatography-tandem mass spectrometry assay for simultaneous measurement of the 25-hydroxy metabolites of vitamins D2 and D3. Clin Chem 51(9):1683–1690CrossRef Maunsell Z, Wright DJ, Rainbow SJ (2005) Routine isotope-dilution liquid chromatography-tandem mass spectrometry assay for simultaneous measurement of the 25-hydroxy metabolites of vitamins D2 and D3. Clin Chem 51(9):1683–1690CrossRef
29.
go back to reference Higgins J, Green SR (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [Internet]. Naunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie 5(2):S38 Higgins J, Green SR (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [Internet]. Naunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie 5(2):S38
31.
go back to reference Garland CF, Garland FC, Gorham ED et al (2006) The role of vitamin D in cancer prevention. Am J Public Health 96(2):252CrossRef Garland CF, Garland FC, Gorham ED et al (2006) The role of vitamin D in cancer prevention. Am J Public Health 96(2):252CrossRef
32.
go back to reference Marian J, Conn PM (1979) Gonadotropin releasing hormone stimulation of cultured pituitary cells requires calcium. Mol Pharmacol 16(1):196–201PubMed Marian J, Conn PM (1979) Gonadotropin releasing hormone stimulation of cultured pituitary cells requires calcium. Mol Pharmacol 16(1):196–201PubMed
33.
go back to reference Tandon OP, Chintala R (2001) Hypothalamo-pituitary-gonadal axis in control of female reproductive cycle. Indian J Physiol Pharmacol 45(4):395–407PubMed Tandon OP, Chintala R (2001) Hypothalamo-pituitary-gonadal axis in control of female reproductive cycle. Indian J Physiol Pharmacol 45(4):395–407PubMed
34.
go back to reference Catterall WA (1995) Structure and function of voltage-gated ion channels. Annu Rev Biochem 64:493–531CrossRef Catterall WA (1995) Structure and function of voltage-gated ion channels. Annu Rev Biochem 64:493–531CrossRef
35.
go back to reference Ellsworth-Bowers ER, Corwin EJ (2012) Nutrition and the psychoneuroimmunology of postpartum depression. Nutr Res Rev 25(1):180–192CrossRef Ellsworth-Bowers ER, Corwin EJ (2012) Nutrition and the psychoneuroimmunology of postpartum depression. Nutr Res Rev 25(1):180–192CrossRef
36.
go back to reference Corwin EJ, Pajer K (2008) The psychoneuroimmunology of postpartum depression. J Womens Health (Larchmt) 17(9):1529–1534CrossRef Corwin EJ, Pajer K (2008) The psychoneuroimmunology of postpartum depression. J Womens Health (Larchmt) 17(9):1529–1534CrossRef
37.
go back to reference Newmark HL, Newmark J (2007) Vitamin D and Parkinson’s disease: a hypothesis. Mov Disord 22(4):461–468CrossRef Newmark HL, Newmark J (2007) Vitamin D and Parkinson’s disease: a hypothesis. Mov Disord 22(4):461–468CrossRef
38.
go back to reference Aghajafari F, Letourneau N, Mahinpey N, Cosic N, Giesbrecht G (2018) Vitamin D deficiency and antenatal and postpartum depression: a systematic review. Nutrients 10(4):478CrossRef Aghajafari F, Letourneau N, Mahinpey N, Cosic N, Giesbrecht G (2018) Vitamin D deficiency and antenatal and postpartum depression: a systematic review. Nutrients 10(4):478CrossRef
39.
go back to reference Brannon PM, Picciano MF (2011) Vitamin D in pregnancy and lactation in humans. Annu Rev Nutr 31:89–115CrossRef Brannon PM, Picciano MF (2011) Vitamin D in pregnancy and lactation in humans. Annu Rev Nutr 31:89–115CrossRef
40.
go back to reference Figueiredo ACC, Cocate PG, Adegboye ARA et al (2018) Changes in plasma concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort. Eur J Nutr 57(3):1059–1072CrossRef Figueiredo ACC, Cocate PG, Adegboye ARA et al (2018) Changes in plasma concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort. Eur J Nutr 57(3):1059–1072CrossRef
41.
go back to reference Greenland S, Rothman K (2008) modern epidemiology 3 ed. Lippincott Williams & Wilkins, Philadelphia Greenland S, Rothman K (2008) modern epidemiology 3 ed. Lippincott Williams & Wilkins, Philadelphia
42.
go back to reference Rodriguez A, Santa Marina L, Jimenez AM et al (2016) Vitamin D Status in pregnancy and determinants in a Southern European cohort study. Paediatr Perinat Epidemiol 30(3):217–228CrossRef Rodriguez A, Santa Marina L, Jimenez AM et al (2016) Vitamin D Status in pregnancy and determinants in a Southern European cohort study. Paediatr Perinat Epidemiol 30(3):217–228CrossRef
43.
go back to reference Henshaw C, Foreman D, Cox J (2009) Postnatal blues: a risk factor for postnatal depression. Journal of Psychosomatic Obstetrics & Gynecology 25(3–4):267–272 Henshaw C, Foreman D, Cox J (2009) Postnatal blues: a risk factor for postnatal depression. Journal of Psychosomatic Obstetrics & Gynecology 25(3–4):267–272
44.
go back to reference Robinson M, Oddy WH, Li J et al (2008) Pre- and postnatal influences on preschool mental health: a large-scale cohort study. J Child Psychol Psychiatry 49(10):1118–1128CrossRef Robinson M, Oddy WH, Li J et al (2008) Pre- and postnatal influences on preschool mental health: a large-scale cohort study. J Child Psychol Psychiatry 49(10):1118–1128CrossRef
45.
go back to reference Norman AW (1998) Sunlight, season, skin pigmentation, vitamin D, and 25-hydroxyvitamin D: integral components of the vitamin D endocrine system. Am J Clin Nutr 67(6):1108–1110CrossRef Norman AW (1998) Sunlight, season, skin pigmentation, vitamin D, and 25-hydroxyvitamin D: integral components of the vitamin D endocrine system. Am J Clin Nutr 67(6):1108–1110CrossRef
Metadata
Title
Association between vitamin D deficiency and antepartum and postpartum depression: a systematic review and meta-analysis of longitudinal studies
Authors
Jie Wang
Na Liu
Weijia Sun
Dandan Chen
Jingxia Zhao
Wei Zhang
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 6/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-018-4902-6

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