Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study Mary F.F. Chong a, b, e, * , Jocelyn X.Y. Wong b , Marjorelee Colega b , Ling-Wei Chen c , Rob M. van Dam c , Chuen Seng Tan c , Ai Lin Lim b , Shirong Cai f , Birit F.P. Broekman b, d , Yung Seng Lee a, b, e , Seang Mei Saw c , Kenneth Kwek g, k , Keith M. Godfrey h, i , Yap Seng Chong b, f , Peter Gluckman a, b, j , Michael J. Meaney b, k , Helen Chen g, l , on behalf of GUSTO study group a Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore b Singapore Institute for Clinical Sciences, A*STAR, Singapore c Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore d Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore e Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore f Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore g KK Women’s and Children’s Hospital, Singapore h MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton i University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom j Liggins Institute, Auckland, New Zealand k McGill University, Montreal, Canada l Duke-National University of Singapore, Singapore article info Article history: Received 6 February 2014 Received in revised form 2 April 2014 Accepted 4 April 2014 Keywords: Folate Vitamin B12 Pregnancy diet Antenatal depression Postnatal depression Edinburgh Postnatal Depression Scale abstract Studies in the general population have proposed links between nutrition and depression, but less is known about the perinatal period. Depletion of nutrient reserves throughout pregnancy and delayed postpartum repletion could increase the risk of perinatal depression. We examined the relationships of plasma folate and vitamin B12 concentrations during pregnancy with perinatal depression. At 26the28th weeks of gestation, plasma folate and vitamin B12 were measured in women from the GUSTO mother- offspring cohort study in Singapore. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3-month postpartum. EPDS scores of 15 during pregnancy or 13 at postpartum were indicative of probable depression. Of 709 women, 7.2% (n ¼ 51) were identified with probable antenatal depression and 10.4% (n ¼ 74) with probable postnatal depression. Plasma folate concentrations were significantly lower in those with probable antenatal depression than those without (mean  SD; 27.3  13.8 vs 40.4  36.5 nmol/L; p ¼ 0.011). No difference in folate concentrations was observed in those with and without probable postnatal depression. In adjusted regression models, the likelihood of probable antenatal depression decreases by 0.69 for every unit variation (increase) in folate (OR ¼ 0.69 per SD increase in folate; 95% CI: 0.52, 0.94). Plasma vitamin B12 concentrations were not associated with perinatal depression. Lower plasma folate status during pregnancy was associated with antenatal depression, but not with postnatal depression. Replication in other studies is needed to determine the direction of causality between low folate and antenatal depression. Clinical trial registry: NCT01174875. Ó 2014 Elsevier Ltd. All rights reserved. 1. Introduction The link between nutrition and mood is well-documented and a number of nutrients have been linked with depression in the * Corresponding author. Clinical Nutrition Research Centre, 14 Medical Drive, #07-02, MD6 Building, Singapore 117599, Singapore. Tel.: þ65 6407 4364; fax: þ65 6774 7134. E-mail address: mary_chong@sics.a-star.edu.sg (M.F.F. Chong). Contents lists available at ScienceDirect Journal of Psychiatric Research journal homepage: www.elsevier.com/locate/psychires http://dx.doi.org/10.1016/j.jpsychires.2014.04.006 0022-3956/Ó 2014 Elsevier Ltd. All rights reserved. Journal of Psychiatric Research xxx (2014) 1e7 Please cite this article in press as: Chong MFF, et al., Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study, Journal of Psychiatric Research (2014), http://dx.doi.org/10.1016/j.jpsychires.2014.04.006