Background: Vitamin D has been linked with poor mood and depression, as well as cognitive delay. During pregnancy, with the demands placed on the body by the fetus, there is increased risk for vitamin D deficiency. Postpartum depression is a common disorder that has been shown to have significant effects on both mother and child. Postpartum depression has also been implicated in lower cognition and mood disorders in children of mothers that suffered from postpartum depression. The aim of this systematic review is to determine if low levels of vitamin D during pregnancy contribute to postpartum depression.
Methods: An exhaustive search of available medical literature was conducted using Medline-OVID, CINAHL and Web of Science using the keywords: postpartum depression and vitamin D levels. The search was then narrowed to include only English language articles. The bibliographies of the articles were further searched for relevant sources. Articles with primary data evaluating vitamin D levels during pregnancy with subsequent diagnosis of postpartum depression were included. Relevant articles were assessed for quality using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).20 A search on the National Institute of Health (NIH) clinical trials site revealed no currently registered trials, at any phase, relating to vitamin D levels during pregnancy and postpartum depression.
Results: A total of three articles met inclusion criteria and were included in this systematic review. A prospective cohort study conducted in Turkey with 689 participants demonstrated a significant relationship between low 25(OH)D3 levels in mid-pregnancy and postpartum depression by using the Edinburgh Postpartum Depression Scale (EDPS). A case-control study that included 1480 Danish women concluded that low 25(OH)D3 levels measured during pregnancy were not related to postpartum depression. A second case-control study that included 706 Australian women concluded that low 25(OH)D3 is a risk factor for postpartum depression.
Conclusion: There is confounding evidence to support the hypothesis that low serum vitamin D levels measured during pregnancy are indicative of risk of postpartum depression. Nonetheless, some studies do demonstrate a relationship. As such, low vitamin D levels during pregnancy should be addressed if not for risk of postpartum depression then for the evidence suggesting that vitamin D has other deleterious effects including negative cognitive effects in children as well as associations with poor mood. More research is needed to solidify a relationship between low serum vitamin D during pregnancy and postpartum depression.
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