Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation for prevention and treatment of perinatal depression: a systematic review and meta-analysis of randomized-controlled trials.

Background: Available interventions for preventing and treating perinatal depression remain unsatisfactory.
Aims: We examined the prophylactic and therapeutic effects, as well as adverse effects, of n-3 PUFA supplementation in reducing depressive symptoms during perinatal periods.
Methods: We included randomized, placebo-controlled trials that reported the changes of depression severity after the perinatal participants received n-3 PUFA supplementation. After the comprehensive searches in October 2019, we selected the trials, extracted the data, and assessed the quality of included trials. We compared the standardized mean differences (SMD) of depression score changes between groups using a random-effect model.
Results: We included 11 trials in the meta-analysis and one more trial for qualitative analysis ( N  = 3,181). The pooled standardized mean of decreased depression scores revealed no statistically significant difference between the n-3 PUFA and the placebo groups ( N  = 920, SMDs = -0.05, 95% CI -0.20 to 0.10, I ² = 21%). The pooled SMDs showed no statistically significant efficacy of n-3 PUFA supplementation for prevention ( N  = 779, SMDs = -0.03, 95% CI -0.20 to 0.13, I ² = 24%) and treatment ( N  = 141, SMDs = -0.14, 95% CI -0.55 to 0.27, I ² = 31%) of perinatal depression. The efficacy of n-3 PUFA supplementation was not associated with the daily doses of DHA, EPA, or DHA plus EPA. No trial reported any serious adverse effect of n-3 PUFA supplements.
Conclusions: Although n-3 PUFA supplementation may improve maternal and infant outcomes, our meta-analysis found insufficient evidence to determine its benefit for perinatal depression.