Continuous supplementation of folic acid in pregnancy and the risk of perinatal depression-A meta-analysis

Background: The blood folic acid(1)(FA) level of depressed patients seems to be lower than that of normal, and pregnant women are at greater risk of FA deficiency. The relationship between FA and perinatal depression has not been well described. Methods: We conducted a meta-analysis of the evidence for the association between the two, using current FA supplementation behavior during pregnancy and blood FA levels as exposures, and the incidence of perinatal depressive symptoms and mean Edinburgh Postnatal Depression Scale(2) (EPDS) scores as outcomes. The present study was recorded in PROSPERO (2019 CRD: 42,020,211,509). Results: Fifteen studies were identified, covering a total of 26,275 women from eleven observational studies and four randomized controlled trials. For the primary outcome of folic acid supplementation behavior and risk of perinatal depression, the overall odds ratio was 0.742 (95% CI: (0.647-0.852)), with a combined effect value of 0.84 (95% CI: (0.76, 0.93)) for studies in which an OR could be extracted. A negative association was observed between blood folate levels and depressive symptoms (Standardized mean difference (SMD) = -0.127, 95% CI: (-0.183,-0.071)). No association was observed between folic acid intervention and EPDS score. Continuous supplementation of folic acid during pregnancy may reduce the incidence of perinatal depressive symptoms (R = 0.017, (95 CI%:(0.014, 0.021)). Limitations: Lack of rigorous randomized controlled trials due to ethical issues, and the research is heterogeneous and does not consider the influence of genetic factors. Conclusions: Continuous use of FA during pregnancy may reduce the incidence of perinatal depressive symptoms.

Automated summary

Continuous use of folic acid during pregnancy may reduce the incidence of perinatal depressive symptoms, and there is a negative association between blood folate levels and depressive symptoms.