Relationship between Sera Vitamin D, Calcium, and Magnesium Levels in Pregnant Women with and without Postpartum Depression
Postpartum depression (PPD) is a significant mental health case after childbirth, distinguished by behavioral changes and emotional disturbance. PPD is a significant public issue estimated to affect 10–15% of women worldwide. The study's objective was to investigate whether low sera concentrations of vitamin D, calcium, and magnesium during the third trimester of pregnancy are associated with PPD. The study population included eighty pregnant women between the ages of 25 to 35 years. They were divided into two groups (control and depressed group). Simple samples technique collecting was used for serum collecting from the two groups. When the blood samples were taken, vitamin D level was determined using an ELISA device. Calcium and magnesium were measured by using the spectrophotometric method. A health questionnaire structure was used for screening depression after birth. After measuring pregnancy serum concentrations of vitamin D of (40) pregnant control and (40) pregnant with PPD, we found that there was no significant relationship between vitamin D concentrations and risk of PPD (p= 0.6497). Statistical analysis indicated the significant differences (p= 0.0003) between sera calcium levels of the control group as compared with the depressed group. Significant differences (p= 0.0005) in magnesium levels between the two groups were observed. Our study detected that vitamin D concentrations in the serum of women during their last trimester of pregnancy had no statistical link with their risk of PPD. Whereas direct associated with calcium and magnesium deficiency in the third trimester of pregnancy and the incidence of PPD were reported.
N. O. Nielsen, M. Strøm, H. A. Boyd, E. W. Andersen, J. Wohlfarht, M. Lundqvist, A. Cohen, D. M. Hougaard, and
M. Melbye. Vitamin D status during pregnancy and the risk of subsequent postpartum depression: A case-control study. PLoS One, vol. 8, no. 11, p. e80686, 2013.
G. R. Benute, R. M. Nomura, J. S. Reis, R. Fraguas Junior, M. C. Lucia, and M. Zugaib. Depression during pregnancy in women with a medical disorder: Risk factors and perinatal outcomes. Clinics (Sao Paulo), vol. 65, no. 11, pp. 1127-1131, 2010.
E. O. Adeyemo, E. O. Oluwole, O. J. Kanma-Okafor, O. M. Izuka, and K. A. Odeyemi. Prevalence and predictors of postpartum depression among postnatal women in Lagos, Nigeria. African Health Sciences, vol. 20, no. 4, pp. 1943-1954, 2020.
R. Anokye, E. Acheampong, A. Budu-Ainooson, E. I. Obeng, and A. G. Akwasi. Prevalence of postpartum depression and interventions utilized for its management. Annals of General Psychiatry, vol. 17, p. 18, 2018.
P. Abedi, M. Bovayri, A. Fakhri, and S. Jahanfar. The relationship between Vitamin D and postpartum depression in reproductiveaged Iranian women. Journal of Medicine and Life, vol. 11, no. 4, pp. 286-292, 2018.
V. Sharma and P. Sharma. Postpartum depression: Diagnostic and treatment issues. Journal of Obstetrics and Gynaecology Canada, vol. 34, no. 5, pp. 436-442, 2012.
B. Levant. N-3 (omega-3) Fatty acids in postpartum depression: İmplications for prevention and treatment. Depression Research and Treatment, vol. 2011, p. 467349, 2011.
M. Ghaedrahmati, A. Kazemi, G. Kheirabadi, A. Ebrahimi, and M. Bahrami. Postpartum depression risk factors: A narrative review. Journal of Education and Health Promotion, vol. 6, p. 60, 2017.
Y. J. Bae and S. K. Kim. Low dietary calcium is associated with self-rated depression in middle-aged Korean women. Nutrition Research and Practice, vol. 6, no. 6, pp. 527-533, 2012.
Y. Milaneschi, W. Hoogendijk, P. T. Lips, A. C. Heijboer, R. Schoevers, A. M. van Hemert, A. T. Beekman, J. H. Smit, and B. W. Penninx. The association between low Vitamin D and depressive disorders. Molecular Psychiatry, vol. 19, no. 4, pp. 444-451, 2014.
V. Menon, S. K. Kar, N. Suthar, and N. Nebhinani. Vitamin D and depression: A critical appraisal of the evidence and future directions. Indian Journal of Psychological Medicine, vol. 42, no. 1, pp. 11-21, 2020.
F. Aghajafari, N. Letourneau, N. Mahinpey, N. Cosic, and G. Giesbrecht. Vitamin D deficiency and antenatal and postpartum depression: A systematic review. Nutrients, vol. 10, no. 4, p. 478, 2018.
G. Sağlam, G. Pektaş, S. Karakullukçu, A. Pektaş, and D. S. Aykut. Vitamin D deficiency is associated with depression, anxiety and sleep disturbance in pregnant women. Journal of Academic Research in Medicine, vol. 11, no. 1, pp. 51-55, 2021.
M. Fallah, G. Askari, and Z. Asemi. Is Vitamin D status associated with depression, anxiety and sleep quality in pregnancy: A systematic review. Advanced Biomedical Research, vol. 9, p. 32, 2020.
A. S. Ram, R. R. Abhijit, and B. S. Sangeeta. Serum calcium and magnesium levels do not correlate with severity of major depressive disorder. Indian Journal of Neurosciences, vol. 2, no. 1, pp. 6-10, 2016.
G. Cormick and J. M. Belizan. Calcium ıntake and health. Nutrients, vol. 11, no. 7, p. 1606, 2019.
B. Hanna. The role of calcium correction during normal pregnancy at third trimester in Mosul. Oman Medical Journal, vol. 24, no. 3, pp. 188-194, 2009.
A. Serefko, A. Szopa, P. Wlaź, G. Nowak, M. Radziwoń-Zaleska, M. Skalski, and E. Poleszak. Magnesium in
depression. Pharmacological Reports, vol. 65, no. 3, pp. 547-554, 2013.
S. Etebary, S. Nikseresht, H. R. Sadeghipour, and M. R. Zarrindast. Postpartum depression and role of serum trace elements. Iranian Journal of Psychiatry, vol. 5, no. 2, pp. 40-46, 2010.
A. Andretta, E. D. Batista, M. E. Schieferdecker, R. R. Petterle, C. L. Boguszewski, and E. Dos Santos Paiva.
Relation between magnesium and calcium and parameters of pain, quality of life and depression in women with fibromyalgia. Advances in Rheumatology, vol. 59, no. 1, p.55, 2019.
S. K. Sawhney and R. Singh. Introductory Practical Biochemistry. 2nd ed. Narosa Publishing House, New Delhi. p. 361, 2009.
W. L. Clark, E. S. Baginski, S. S. Marie, and B. Zak. Spectrophotometric study of a direct determination of serum calcium. Microchemical Journal, vol. 20, no. 1, pp. 22-32, 1975.
E. M. Gindler and D. A. Heth. Colorimetric determination with bound calmagite of magnesium in human blood serum. Clinical Chemistry, vol. 17, no. 7, p. 662, 1971.
C. Guille, R. Newman, L. D. Fryml, C. K. Lifton, and C. N. Epperson. Management of postpartum depression. Journal of Midwifery and Women’s Health, vol. 58, no. 6, pp. 643-653, 2013.
M. Righetti-Veltema, E. Conne-Perreard, A. Bousquet, and J. Manzano. Risk factors and predictive signs of postpartum depression. Journal of Affective Disorders, vol. 49, no. 3, pp. 167-180, 1998.
C. T. Beck and R. K. Gable. Comparative analysis of the performance of the Postpartum Depression Screening Scale with two other depression instruments. Nursing Research, vol. 50, no. 4, pp. 242-250, 2001.
Centers for Disease Control and Prevention. Pregnancy Risk Assessment Monitoring System (PRAMS): PRAMS and Postpartum Depression. Centers for Disease Control and Prevention, United States. 2004.
C. L. Dennis and E. Hodnett. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database of Systematic Reviews, vol. 4, p.CD006116, 2007.
C. T. Beck. State of the science on postpartum depression: What nurse researchers have contributed-part 1. MCN: The American Journal of Maternal/Child Nursing, vol. 33, no.2, pp. 121-126, 2008.
F. Cyprian, E. Lefkou, K. Varoudi, and G. Girardi. Immunomodulatory effects of Vitamin D in pregnancy and
beyond. Frontiers in Immunology, vol. 10, no. 10, p. 2739, 2019.
P. K. Murphy, M. Mueller, T. C. Hulsey, M. D. Ebeling, and C. L. Wagner. An exploratory study of postpartum depression and vitamin D. Journal of the American Psychiatric Nurses Association, vol. 16, no. 3, pp. 170-177, 2010.
E. E. Accortt, C. D. Schetter, R. M. Peters, and A. E. Cassidy-Bushrow. Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: Preliminary evidence for moderation by inflammatory cytokines. Archives of Women’s Mental Health, vol. 19, no. 2, pp. 373-383, 2016.
A. Ribamar, B. Almeida, A. Soares, B. Peniche, P. C. Jesus, S. Cruz, and A. Ramalho. Relationship between Vitamin D deficiency and both gestational and postpartum depression. Nutrición Hospitalaria, vol. 37, no. 6, pp. 1238-1245, 2020.
D. Lin, J. Zhang, Y. Bian, M. Pan, and X. Liu. Association between circulating concentrations of Vitamin D and risk of antenatal, postnatal depression: A meta-analysis. Archives of Clinical Psychiatry, vol. 48, no. 4, pp. 186-190, 2021.
J. Wang, N. Liu, W. Sun, D. Chen, J. Zhao, and W. Zhang. Association between Vitamin D deficiency and antepartum and postpartum depression: A systematic review and meta-analysis of longitudinal studies. Archives of Gynecology and Obstetrics, vol. 298, no. 6, pp. 1045-1059, 2018.
M. Robinson, A. J. Whitehouse, J. P. Newnham, S. Gorman, P. Jacoby, B. J. Holt, M. Serralha, J. E. Tearne, P. G. Holt, P. H. Hart, and M. M. Kusel. Low maternal serum Vitamin D during pregnancy and the risk for postpartum depression symptoms. Archives of Women’s Mental Health, vol. 17, no. 3, pp. 213-219, 2014.
C. W. Fu, J. T. Liu, W. J. Tu, J. Q. Yang, and Y. Cao. Association between serum 25-hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression. An International Journal of Obstetrics and Gynaecology, vol. 122, no. 12, pp. 1688-1694, 2015.
Q. Tan, S. Liu, and D. Chen. Poor Vitamin D status and the risk of maternal depression: A dose-response meta-analysis of observational studies. Public Health Nutrition, vol. 24, no. 8,pp. 2161-2170, 2021.
J. F. Gould, A. J. Anderson, L. N. Yelland, L. G. Smithers, C. M. Skeaff, R. A. Gibson, and M. Makrides. Association of cord blood Vitamin D at delivery with postpartum depression in Australian women. Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 55, no. 5, pp. 446-452, 2015.
J. A. Williams, V. C. Romero, C. M. Clinton, D. M. Vazquez, S. M. Marcus, J. L. Chilimigras, S. E. Hamilton, L. J. Allbaugh, A. M. Vahratian, R. M. Schrader, and E. L. Mozurkewich. Vitamin D levels and perinatal depressive symptoms in women at risk: A secondary analysis of the mothers, omega-3, and mental health study. BMC Pregnancy and Childbirth, vol. 16, no. 1, p. 203, 2016.
B. Li, J. Lv, W. Wang, and D. Zhang. Dietary magnesium and calcium intake and risk of depression in the general population: A meta-analysis. Australian and New Zealand Journal of Psychiatry, vol. 51, no. 3, pp. 219-229, 2017.
A. M. Paoletti, M. M. Orru, M. F. Marotto, M. Pilloni, P. Zedda, M. F. Fais, B. Piras, C. Piano, S. Pala, S. Lello, F. Coghe, R. Sorge, and G. B. Melis. Observational study on the efficacy of the supplementation with a preparation with several minerals and vitamins in improving mood and behaviour of healthy puerperal women. Gynecological Endocrinology, vol. 29, no. 8, pp. 779-783, 2013.
M. Nechifor. Interactions between magnesium and psychotropic drugs. Magnesium Research, vol. 21, no. 2, pp. 97-100, 2008.
M. Nechifor. Magnesium in major depression. Magnesium Research, vol. 22, no. 3, pp. 163-166, 2009.
F. N. Jacka, S. Overland, R. Stewart, G. S. Tell, I. Bjelland, and A. Mykletun. Association between magnesium intake and depression and anxiety in community-dwelling adults: The Hordaland Health Study. Australian and New Zealand Journal of Psychiatry, vol. 43, no. 1, pp. 45-52, 2009.
J. Wojcik, D. Dudek, M. Schlegel-Zawadzka, M. Grabowska, A. Marcinek, E. Florek, W. Piekoszewski, R. J. Nowak, W. Opoka, and G. Nowak. Antepartum/postpartum depressive symptoms and serum zinc and magnesium levels. Pharmacological Reports, vol. 58, no. 4, pp. 571-576, 2006.
F. E. Fard, M. Mirghafourvand, S. Mohammad-Alizadeh Charandabi, A. Farshbaf-Khalili, Y. Javadzadeh, and H. Asgharian. Effects of zinc and magnesium supplements on postpartum depression and anxiety: A randomized controlled clinical trial, Women and Health, vol. 57, no. 9, pp. 1115-1128, 2017.
J. Widmer, J. G. Henrotte, Y. Raffin, P. Bovier, H. Hilleret, and J. M. Gaillard. Relationship between erythrocyte magnesium, plasma electrolytes and cortisol, and intensity of symptoms in major depressed patients. Journal of Affective Disorders, vol. 34, no. 3, pp. 201-209, 1995.
Copyright (c) 2022 Hataw A. Mohammed, Hero H. Muhammed Saed, Bushra M. Jarallah
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License [CC BY-NC-ND 4.0] that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).