Nutritional Deficiencies and Maternal Depression: Associations and Interventions in Lower and Middle-Income Countries: a Systematic Review of Literature

Nutrition deficiencies are common among pregnant and lactating women in middle- and low-income countries. At the same time, maternal mental disorders, mainly depression is highly prevalent during this period suggesting some connection between the two. The objective of this review is to determine the associations between nutritional deficiencies and maternal depression and identify the role of diet in depression to facilitate further research. A literature search included PubMed databases and Google Scholar search engine published from June 2008 to June 2019 and published in English. Medical subject heading terms was used to identify all relevant studies. All titles and abstracts identified by the search were screened then reviewed the full-text articles which were potentially eligible for inclusion. The original search identified 1250 articles but with cascaded elimination, based on quality. Twenty five met the inclusion criteria, of which 13 were cross-sectional, eight were prospective cohort study, and four were intervention studies. Most (95%) of these studies reported positive associations between nutrition deficiencies, poor diet, and maternal depression; thus, only 5% did not show associations between nutrition and depression. Our review findings suggest that nutritional interventions are some of the most promising intercessions for mental health illnesses. Not all studies consistently associate poor diet quality with poor maternal and offspring mental health outcomes, and the majority of those that show are cross-sectional. Considering that most of these associations are cross-sectional, studies devoid of exposing causal relationship; thus, longitudinal studies are needed to confirm the associations towards sufficing as a window of opportunity for reducing the risk of mental disorders in mothers and offspring alike.