Antenatal depression affects some 32 to 45 million women globally; it increases the pregnancy risks and complications in birth and newborns and has been linked with emotional, behavioural, and developmental problems in children.
Ground-breaking research conducted at Te Whare Wānanga o Waitaha | University of Canterbury (UC) by two recent PhD graduates, Dr Hayley Bradley and Dr Siobhan Campbell, along with from the Faculty of Science, looked to use a safe and accessible alternative to psychological therapy and antidepressants, which often have significant barriers such as cost, access and side-effects.
Professor Rucklidge said overall the research, using micronutrients (high doses of vitamins and minerals), produced positive and promising outcomes.
“Overall 75 percent of the participants were in remission in their symptoms of depression both in the micronutrient group and placebo group; however, 69 percent of those in the micronutrient group identified themselves as much to very much improved, compared with only 39 percent taking the placebo.
“The clinicians rated the participants on micronutrients as having greater change in their global functioning (how well someone is coping with day-to-day life) compared with those on placebo. Sleep also improved more on micronutrients.”
Blood tests during the pregnancy suggested that increased micronutrient intake resulted in meaningful increases in vitamins B12 and D, and there were fewer women developing vitamin C deficiency for those in the micronutrient group compared with placebo.
Both groups showing mood improvements is a positive outcome outside of looking at medication to treat depression. “This is great as it points out that just the act of being more attentive and receiving more care during your pregnancy can improve your mood,” Professor Rucklidge says.
Those who receive treatment for depression as well as take medication can struggle with side effects. An exciting finding of the research was the low rate of side effects from the micronutrients.
“Both groups reported similar side effects, showing the micronutrients themselves have little to no side effects, whereas anti-depressant side effects can include nausea, insomnia, and loss of appetite among other symptoms – which can be another barrier to taking medication,” says Professor Rucklidge.
Micronutrients were particularly helpful over placebo for participants who have taken psychiatric medication in the past and/or who were more susceptible to mental health struggles due to their patterns of thinking, behaviour, emotions and relating to others.
Observational follow up of the infants born to these mothers who took micronutrients antenatally showed positive effects on infant regulation, on par with or better than typical pregnancies and superior to antidepressants. The babies were observed for one year and showed no negative effects on temperament.
The NUTRIMUM trial recruited 88 women in their second trimester of pregnancy who reported depressive symptoms. They were randomly allocated to receive capsules for a 12-week period of either broad-spectrum micronutrients or an active placebo containing iodine and riboflavin. A reference group of mothers not taking the high dose micronutrients or taking antidepressants were also followed.
“Until now, there have been no published randomised controlled trials on micronutrients for antenatal depression. This type of trial is considered the gold standard method of assessing whether a treatment works, specifically designed to assess the efficacy and safety of broad-spectrum micronutrients on symptoms of antenatal depression and overall functioning,” Professor Rucklidge says.
The next step is to encourage independent replication to confirm the findings and get one step closer to accessible alternative treatment for antenatal depression.
