Maternal Iron and Vitamin D Status during the Second Trimester Is Associated with Third Trimester Depression Symptoms among Pregnant Participants in the APrON Cohort
Anita L. Kozyrskyj, Elnaz Vaghef‐Mehrabany, Fariba Aghajafari, Rhonda C Bell, Deborah Dewey, Jenna L Evanchuk, Catherine J Field, Gerald F Giesbrecht, Yvonne Lamers, Nicole Letourneau, Brenda Leung, Elnaz Vaghef-Mehrabani
The maternal status of multiple micronutrients during pregnancy and postpartum and their potential associations with maternal health outcomes are largely undescribed.
Objectives
This study aimed to examine associations between maternal iron and vitamin D status, individually and in combination, on depression symptoms in pregnant individuals.
Methods
The Alberta Pregnancy Outcomes and Nutrition cohort study included pregnant participants and their children from Calgary and Edmonton, Canada. Iron biomarkers (serum ferritin [SF], soluble transferrin receptor, and hepcidin) were measured via immunoassays and vitamin D [25-hydroxyvitamin D3 (25(OH)D3) and 3-epi-25-hydoxyvitamin D3 (3-epi-25(OH)D3)] metabolites were quantifed using liquid chromatography with tandem mass spectroscopy. Four categories of maternal iron and vitamin D status during the second trimester were conceptualized using concentrations of SF and total 25-hydoxyvitamin D [25(OH)D], respectively. Maternal Edinburgh Postnatal Depression Scale (EPDS) scores during the third trimester (n = 1920) and 3 mo postpartum (n = 1822) were obtained.
Results
Concentrations of maternal 25(OH)D3, 3-epi-25(OH)D3, and the ratio of both metabolites were significantly higher during the second trimester compared with their status at 3 mo postpartum. Higher second trimester maternal concentrations of SF (β: -0.8; 95% confidence interval [CI]: -1.5, -0.01), hepcidin (β: -0.5; 95% CI: -0.9, -0.2), and 25(OH)D3 (β: -0.01; 95% CI: -0.02, -0.004) predicted lower maternal EPDS scores during the third trimester. Pregnant individuals with a low iron (SF <15 μg/L) and replete vitamin D (25(OH)D ≥75 nmol/L) (β: 1.1; 95% CI: 0.03, 2.1) or low iron (SF <15 μg/L) and vitamin D (25(OH)D <75 nmol/L) (β: 2.2; 95% CI: 0.3, 4.2) status during midpregnancy had higher third trimester EPDS scores compared with those that were replete in both micronutrients.
Conclusions
A higher midpregnancy maternal iron and vitamin D status, independently or in combination, predicted fewer maternal depression symptoms in the third trimester. Concentrations of maternal 25(OH)D3 and 3-epi-25(OH)D3 may be lower in the postpartum period compared with midpregnancy.
iron deficiency vitamin D pregnancy depression symptoms, maternal micronutrient status second trimester depression, serum ferritin vitamin D prenatal depression EPDS, iron and vitamin D combined status third trimester mood, APrON cohort maternal nutrition pregnancy outcomes, low ferritin low vitamin D Edinburgh Postnatal Depression Scale, hepcidin transferrin receptor pregnancy depression biomarkers, 25-hydroxyvitamin D3 postpartum versus pregnancy levels, micronutrient deficiency antenatal depression prospective cohort, maternal iron stores midpregnancy mental health outcomes, 3-epi-25-hydroxyvitamin D3 pregnancy postpartum changes
PMID 37984742 37984742 DOI 10.1016/j.tjnut.2023.10.029 10.1016/j.tjnut.2023.10.029
Cite this article
Evanchuk, J., Kozyrskyj, A., Vaghef Mehrabani, E., Lamers, Y., Giesbrecht, G., Letourneau, N., Aghajafari, F., Dewey, D., Leung, B., Bell, R. C., & Field, C. (2024). Maternal Iron and Vitamin D Status during the Second Trimester Is Associated with Third Trimester Depression Symptoms among Pregnant Participants in the APrON Cohort. *The Journal of nutrition*, *154*(1), 174-184. https://doi.org/10.1016/j.tjnut.2023.10.029
Evanchuk J, Kozyrskyj A, Vaghef Mehrabani E, Lamers Y, Giesbrecht G, Letourneau N, et al. Maternal Iron and Vitamin D Status during the Second Trimester Is Associated with Third Trimester Depression Symptoms among Pregnant Participants in the APrON Cohort. J Nutr. 2024;154(1):174-184. doi:10.1016/j.tjnut.2023.10.029
Evanchuk, Jenna, et al. "Maternal Iron and Vitamin D Status during the Second Trimester Is Associated with Third Trimester Depression Symptoms among Pregnant Participants in the APrON Cohort." *The Journal of nutrition*, vol. 154, no. 1, 2024, pp. 174-184.
Bragg MG et al., 2025
Open Access
The Journal of Nutrition
Background: Previous research on the role of maternal diet in relation to autism has focused on examining individual nutrient associations. Few studies have examined associations with multiple nutrien...
Background: Evidence is growing that the equilibrium between reactive oxygen species and antioxidants plays a vital role in women's reproductive health.
Objective: The objective of this study was to ...