Depressed black pregnant women should take vitamin D

Created April 2018

Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes.

J Behav Med. 2018 Apr 18. doi: 10.1007/s10865-018-9924-9. [Epub ahead of print]

* Dark skin pregnancies and Vitamin D - many studies * Depression in pregnant blacks strongly associated to vitamin D levels – Nov 2012 * Pregnant blacks 50 pcnt more likely to be depressed if 3 ng less vitamin D – July 2012 The articles in Pregnancy AND Depression are here: {category} * New York Times on Postpartum depression June 2014, No mention of Vitamin D * Antenatal depression: Everything you need to know about depression during pregnancy July 2015, Vitamin D "is a proven mood booster"

Accortt EE1, Lamb A2, Mirocha J3, Hobel CJ4.

  • 1 Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Eynav.accortt@cshs.org.

  • 2 Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

  • 3 Cedars-Sinai Biostatistics Core, Research Institute, Clinical and Translational Science Institute (CTSI), Clinical and Translational Research Center (CTRC), Los Angeles, CA, USA.

  • 4 Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Calvin.Hobel@cshs.org.

Prenatal vitamin D deficiency and prenatal depression are both separately associated with adverse perinatal outcomes; however, to our knowledge no studies have investigated the effects of having both risk factors. Our objective was to determine to what extent vitamin D deficiency predicts adverse perinatal outcomes and whether elevated depressive symptoms in pregnancy places women at additional increased risk. This study was a secondary data analysis of prospective data collected from a cohort of pregnant women (N = 101) in an obstetric clinic of a large medical center. Maternal vitamin D deficiency (serum 25(OH)D ≤ 20 ng/ml) and depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS) were assessed in early pregnancy. A composite of four adverse perinatal outcomes (low birth weight, preterm birth, small-for-gestational age, and preeclampsia) were abstracted from medical charts.

Nineteen of the 101 women had one or more adverse perinatal outcome and 84% with an adverse outcome (16/19) were not White . Both prenatal and time of delivery vitamin D deficiency were associated with developing an

  • adverse outcome compared to those vitamin D sufficient ( prenatal relative risk 3.43 ; 95% CI 1.60-7.34, p = 0.004;

  • delivery time relative risk 5.14, 95% CI 2.68-9.86, p = 0.004).

These both remained significant after adjusting for BMI. A higher rate of adverse outcome was found when women had both prenatal vitamin D deficiency and elevated depressive symptoms (EPDS ≥ 10). Sixty percent with both risk factors had an adverse perinatal outcome versus 17% with only one or neither risk factor (relative risk 3.60; 95% CI 1.55-8.38, p = 0.045), worthy of investigation with larger samples.

Together, prenatal vitamin D deficiency and elevated depressive symptoms in pregnancy may increase risk for adverse perinatal outcomes, especially in racial minorities. Obstetric providers should consider routine prenatal depression screening. The impact of vitamin D supplementation to reduce risk for adverse perinatal outcomes should be studied in prospective trials. Our results suggest that supplementation early in pregnancy might be especially beneficial for depressed women.

Tags: Darker Skin Depression Pregnancy