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Biol Psychiatry. 2017 Oct 15;82(8):560-569. doi: 10.1016/j.biopsych.2017.02.1182. Epub 2017 Mar 9.

Polyunsaturated Fatty Acids in Perinatal Depression: A Systematic Review and Meta-analysis.

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Department of Psychiatry and Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore.
Department of Psychiatry, Brain Disease Research Center, and Mind-Body Interface Laboratory , China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Neural and Cognitive Sciences, China Medical University, Taichung, Taiwan. Electronic address:



Omega-3 (or n-3) polyunsaturated fatty acids (PUFAs) are promising antidepressant treatments for perinatal depression (PND) because of supporting evidence from clinical trials, the advantage in safety, and their anti-inflammatory and neuroplastic effects. Although several observational studies have shown n-3 PUFA deficits in women with PND, the results of individual PUFAs from different studies were inconsistent.


This systematic review and meta-analysis aims to compare the levels of PUFA indices, including eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, total n-3, total n-6, and the n-6/n-3 ratio between women with PND and healthy control subjects. The meta-analysis included 12 eligible studies available as of December 2016. The effect sizes were synthesized by using a random effects model. In addition, we performed subgroup analysis for the PUFA levels in patients with prenatal and postnatal depression, both of which were compared with healthy control subjects.


There were significantly lower levels of total n-3 PUFAs and docosahexaenoic acid and significantly increased n-6/n-3 ratios in PND patients. In the subgroup analyses, there were significantly lower levels of n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid in women with prenatal depression. The n-6/n-3 ratio was significantly increased in both prenatal and postnatal depression subgroups.


Our meta-analysis consolidates the important role of n-3 PUFAs in PND. Nutritional medicine is an important strategy to improve the effectiveness of treatment for depression, and our findings provide the strong rationale to conduct clinical trials to test the therapeutic and prophylactic effects of n-3 PUFAs in PND.


Arachidonic acid; Docosahexaenoic acid; Eicosapentaenoic acid; Omega-3; Perinatal depression; Polyunsaturated fatty acids

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