When it comes to preventing and treating perinatal depression, a new and more effective approach may be nutritional intervention rather than psychotropic drugs.
A study published in the June issue of the Yale Journal of Biology and Medicine suggests that through the use of supplements either in conjunction with, or completely independent from, anti-depressants and other medications, the risks and severity of depression during pregnancy can be greatly reduced. Kaitlyn Rechenberg MPH ’15 NUR ’15, the author of the study, reviewed over 75 journal articles to complete her research.
“The topic in general doesn’t get a lot of attention, especially in locations where access to psychotropic medications are limited,” Rechenberg said. “Having additional nutritional intervention would improve the effectiveness of SSRIs and antidepressants.”
While certain drugs can be effective in treating perinatal depression, the risks often outweigh the benefits. Malformation of the fetus and pulmonary hypertension can result from medication use during pregnancy, making nutritional intervention a much safer alternative, according to the study.
Though one means of ingesting vital nutrients is through food, Rechenberg proposes using supplements as a way to ensure optimal benefits. The study primarily dealt with two categories of supplements: omega three fatty acids and B vitamins such as folate, B12 and B6. Prophylactic nutritional intervention, which entails taking these supplements before the onset of symptoms, may also be effective, Rechenberg said.
Psychotropics, or substances affecting brain functions such as perception and cognition, can significantly increase the chances of poor birth outcomes, Rechenberg added. Though some medications can be safely administered during pregnancy to either treat or prevent depression, nutritional intervention is not only many times safer, but also much more cost-effective.
“The interventions that get marketed most are the ones that make somebody a profit,” said Yale School of Public Health epidemiology clinical instructor Debbie Humphries, Rechenberg’s project adviser. “Nutritional intervention might actually be affordable in a wide range of settings.”
Rechenberg noted that most women will be deficient in certain nutrients by the end of their pregnancies, further supporting the notion that supplements can not only replenish the body but also work to prevent and mitigate moderate depression.
According to the World Health Organization, depression is the leading cause of mental disability worldwide. Risks associated with perinatal depression include difficult birth for mother and child and postpartum depression. Infants born to severely depressed mothers are at risk for below-average physical growth, malnutrition and chronic illness, the study found. Mothers with a personal or family history of depression are at a higher risk of becoming depressed during pregnancy, and risk factors can even be cyclical and affect the baby later in life.
In May 2010, Rechenberg was pursuing a masters in ethics with a focus in bioethics at Yale when she asked Humphries if she would be willing to advise her on a new project concerning nutritional intervention and perinatal depression — by the middle of July that summer, Humphries said the bulk of the article was complete.
“To have something that Kaitlyn did purely out of her own intellectual curiosity reach a publishable state is just phenomenal,” Humphries said. “If you had unlimited resources maybe you could get better outcomes with pharmaceuticals, but if you don’t have unlimited resources, can you make people a little better off?”
Approximately 13 percent of pregnant women and new mothers suffer from depression, according to the United States Department of Heatlh and Human Services’ Office of Women’s Health.