Association between serum 25‐hydroxyvitamin D levels measured 24 hours after delivery and postpartum depression

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 122; no. 12; pp. 1688 - 1694
• Main Authors: Fu, C‐W, Liu, J‐T, Tu, W‐J, Yang, J‐Q, Cao, Y
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2015
• Subjects: 25‐Hydroxyvitamin D; Adult; Beijing - epidemiology; Childbirth & labor; China - epidemiology; Cohort Studies; Delivery, Obstetric; depression; Depression, Postpartum - blood; Depression, Postpartum - etiology; Female; Follow-Up Studies; Humans; Infant, Newborn; postpartum; Postpartum depression; Pregnancy; Risk Assessment; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D - therapeutic use; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; postpartum; depression; vitamin D; 25-Hydroxyvitamin D
• ISSN: 1470-0328; 1471-0528; 1471-0528
• DOI: 10.1111/1471-0528.13111

Objective To assess the possible relationship between serum levels of 25[OH]D (25‐hydroxyvitamin D) collected 24 hours after delivery and postpartum depression in a Chinese cohort sample. Design Cohort study. Setting One city hospital in Beijing, China. Population Women delivering a full‐term, singleton, live‐born infant at one city hospital in Beijing between August 2013 and November 2013. Methods Women were enrolled immediately postpartum. A blood sample was obtained 24–48 hours after childbirth to test serum levels of 25[OH]D. Participation consisted of a visit to an obstetric unit 3 months after delivery. Main outcome measure At 3 months' postpartum, women were screened for depression using the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome measure was a prespecified EPDS score of ≥12. Results During the study period, 323 women were admitted. In all, 248 agreed to enrol and 213 completed 3 months' follow‐up (21 were lost to follow‐up and 14 withdrew). Of the 213 women who were included, 26 (12.2%) were considered to meet criteria for postpartum depression. Serum 25[OH]D levels in women with no postpartum depression were significantly higher than those in women with postpartum depression (P < 0.0001). Based on the receiver operating characteristic curve, the optimal cutoff value for serum 25[OH]D level as an indicator for screening for postpartum depression was estimated to be 10.2 ng/ml, with an area under the curve of 0.801 (95%CI 0.704–0.896). In multivariate analysis, there was an increased risk of postpartum depression associated with 25[OH]D levels ≤10.2 ng/ml (OR 7.17, 95%CI 3.81–12.94; P < 0.0001) after adjusting for possible confounders. Conclusion Our study demonstrated that lower serum 25[OH]D levels were associated with postpartum depression. This association was independent of other possible variables.