Fatty acid status and maternal mental health

Maternal mental health (MMH) problems are a major public health concern with adverse consequences for women, their offspring and families. Intake of long-chain polyunsaturated fatty acids, especially the n-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid, which are found predominantly in cold water fish, has been associated with a range of mental health outcomes and may improve MMH. The demands for these fatty acids are increased during pregnancy and lactation, and may influence MMH as they are integral parts of cell membranes especially in the brain and play a role in physiological processes such as membrane fluidity and neurotransmitter function. Observational studies and intervention trials that have examined the role of fatty acids and MMH disorders especially post-partum depression (PPD) were identified using Pubmed and have been reviewed. Only three well-designed large prospective studies were identified; these studies examined the relationship between dietary intakes of n-3 fatty acids and fish during pregnancy, and found limited evidence of an association with PPD. Several intervention trials (n = 8) have been done but generally suffer from small sample size and vary in terms of the study subject characteristics and timing, duration and dosage of the intervention. The results are mixed, but one recently completed large trial found no evidence of benefit among women who received DHA during pregnancy. Few studies have been conducted in developing countries, and gaps remain on the influence of other nutrient deficiencies, genetic polymorphisms that influence n-3 fatty acid synthesis and total fatty acid intake.