Correlation between antidepressant effects and plasma estriadol levels in pregnant women
Omega-3 polyunsaturated fatty acids reduce the symptoms of depression due to their anti-inflammatory effect and injecting a combination of omega-3 and estriadol (E2) induces similar effects to antidepressants in rats as it regulates inflammatory cytokine expression. This study examined the association of increased E2 with depressive symptoms and with inflammatory cytokines in two groups of women during pregnancy, one group receiving omega-3 supplement and one not.
To establish this correlation, the study recruited pregnant women at 12-24 weeks of gestation with Edinburgh Postnatal Depression Scale scores of ≥9. Participants were randomly assigned to receive 1800 mg of omega-3 fatty acids (containing 1206 mg of eicosapentaenoic acid (EPA)) or placebo for 12 weeks. E2, omega-3, high-sensitivity C-reactive protein, interleukin-6 and adiponectin were measured at the start of the study and after 12 weeks of treatment. Multivariable regression analyses were conducted to examine the association of changes of E2 and omega-3 with the changes in depressive symptoms and with the variability of inflammatory cytokines at follow-up by intervention group.
Of the 108 pregnant women in the trial, 100 (92.6%) completed the follow-up assessment, including blood sampling. The multivariable regression analysis revealed that the increase in EPA and E2 were significantly associated with a decrease in depressive symptoms among the pregnant women assigned to the omega-3 treatment group but not among those in the placebo group. Neither E2 nor omega-3 levels were associated with a change in inflammatory cytokines.
Supplementation with omega-3 and increased levels of E2 during pregnancy could be relevant to alleviating prenatal depression through a mechanism other than anti-inflammation.