Associations between Early-pregnancy Vitamin D Status and Postpartum Depressive and Anxiety Symptoms.

OBJECTIVE: Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.

METHODS: In 2,483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks' gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30-49.9 nM), sufficient (50-79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum.

RESULTS: After adjustments for confounders vitamin D deficiency was only associated with increased postpartum anxiety symptoms (B = 0.17, 95% CI [0.03, 0.30], p = .017) compared to normal vitamin D levels (>80 nM). In women not taking vitamin D supplementation (n = 2,303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms (B = 0.14, 95% CI 0.03, 0.28, p = .045; and B = 0.17, 95% CI 0.03, 0.32, p = .015). Antepartum CRP did not mediate these links.

CONCLUSIONS: We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.