Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial

We examined the impact on depression at 6months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20weeks gestation (n=1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6months postpartum. Maternal depressive symptoms were measured at 6months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS=382, IFA=387 and MMN=382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n=1151) and those who were not (n=169). At 6months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS=13.1%, IFA=11.2% and MMN=14.7%. P=0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed=0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.