Harauma, Yoshihara, Hoshi, Hamazaki, Moriguchi, 2023

A total of 321 participants were recruited for the observational study between November 2015 and June 2017 and 250 for the interventional study between July 2017 and April 2019. These were 2 different sets of participants, and none of those in the RCT were included in the observational study (Figure 1). This was a double-blind, parallel-group comparison study wherein participants were randomly assigned to two groups receiving omega-3 fatty acids in either perilla oil or fish oil (the recruited period was 21 months for July 2017 to April 2019), and the two abovementioned groups plus a group of participants in the observational study (historical control; the recruited period was 19 months for November 2015 and June 2017) were compared (Figure 1). 

An observational study was conducted between November 2015 and June 2017, and an interventional study was done between July 2017 and April 2019; in total, 321 participants completed these two studies. Each group was randomly assigned to receive either omega-3 fatty acids in perilla oil or fish oil. The study was double-blind, meaning the researchers did not know who was assigned to each treatment. These two groups were compared to a separate group of participants from a previous observational study completed from November 2015 to June 2017. 

The present study examined the effects of omega-3 fatty acids on perinatal mental health by examining the degree of psychological distress 1 month after giving birth using the Edinburgh Postnatal Depression Scale (EPDS) as well as the degree of attachment with their children using the Mother-to-Infant Bonding Scale (MIBS) in mothers who consumed omega-3 fatty acids in either perilla oil or fish oil. In addition, a case–control study was conducted to evaluate the association between prenatal erythrocyte fatty acid levels and postpartum mental health. 

This study was done to determine if the mental health of mothers around the time of giving birth who had been given an omega-3 fatty acid in perilla oil or fish oil was affected. To determine the effect, the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-to-Infant Bonding Scale (MIBS) were administered. To set a baseline, a separate control study was done to determine whether there is a relationship between prenatal erythrocyte fatty acid level and postpartum mental health. 

The proportions of participants with a high EPDS score (≥9) 1 month after giving birth were 21.6% in the historical control group, 12.0% in the perilla oil group, and 22.3% in the fish oil group; the proportion was significantly lower in the perilla oil group compared with the historical control group (p = 0.044), and the proportion with a high EPDS score was nearly significantly lower in the perilla vs. the fish oil group (p = 0.059; Table 4). The proportions of participants with an MIBS score ≥ 3 or ≥5 were 24–30% and 10–14%, respectively and did not differ markedly among the three groups (Table 4).  

One month after giving birth, 21.6% of participants in the historical control group had a high EPDS score (≥9). In the perilla oil group, 12.0% and 22.3% in the fish oil group had a high EPDS score. Compared to the historical group, the perilla oil group was significantly lower.  In terms of the MIBS score, a score of  ≥ 3 or ≥5  was present in 24-30% and 10-14% and was not much different in each of the three groups.

 Considering that it takes a long time to restore DHA in the body [34], we believe that it is necessary to sound the alarm, even in areas where seafood consumption was previously commonplace. No effect on maternal mental health was found in the fish oil group. However, given the changes observed in fatty acid compositions in maternal blood and cord blood, fish oil is expected to have beneficial effects on newborn babies [35]. Adequate supplementation of EPA and DHA in early pregnancy reduces the risk of preterm birth, and the resulting continuation of pregnancy leads to the prevention of premature births [36] 

The authors of this article want to raise awareness that consuming EPA and DHA in early pregnancy can lower the incidence of preterm birth. Maternal mental health was not affected in the fish oil group; however, it did affect the babies the mothers were carrying. 

In the future, the effect of pregnant women taking omega-3 fatty acids and the health and development of their newborns should be studied.

I found it hard to understand what the results of the EPDS and MIBS scores showed. I am a little familiar with the EPDS test, but not the MIBS. I didn’t understand how high or low a score needed to be to show poor or adequate mental health. I would find it helpful to gain more understanding of how these tests are administered and what the scores mean in terms of maternal mental health.