Multinutrients for pregnancy & depression. 1st ever RCT NUTRIMUM trial. Benefits for mum & babies.
3 University of Canterbury (New Zealand) studies demonstrate that multinutrient treatment in pregnancy is great for health: Supports mums during pregnancy while improving birth & infant outcomes.
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Facts about depression & pregnancy (referenced in papers below):
Antenatal depression affects 15-21% of women world-wide, and increases risk of pre-term, birth and neonatal complications.
There appears to be no controlled trials to test the safety of antidepressant drugs in pregnancy.
Pregnant women are excluded from clinical antidepressant trials.
80% of women on antidepressants will choose to stop taking antidepressants in pregnancy.
Published evidence that antidepressants are associated with detrimental/negative impacts on birth outcomes (i.e. the Canterbury NZ studies are consistent with preexisting literature).
3% of pregnant women will take antidepressant psychiatric medications during pregnancy but there may be little data to support that prescribing rate.
Informed consent: patients should understand that there have never been controlled trials for antidepressant medication during pregnancy.
University of Canterbury trials were not financially supported by the micronutrient manufacturer, Hardy Nutritionals.
Results presented at the American Academy of Child and Adolescent Psychiatry conference.
Academics experienced a higher rejection rate for papers than expected.
FINDINGS FROM UNIVERSITY OF CANTERBURY NEW ZEALAND NUTRIMUM TRIALS:
[1] Hayley Bradley et al (2024). NUTRIMUM RCT, 2nd term of pregnancy for mothers with depression. Pregnant women diagnosed with depression, randomised to micronutrients or an active placebo between 12-24 weeks gestation. At end of 24 weeks women could elect to continue with micronutrients (open label).
Findings:
Safe way to help women to reduce symptoms of depression.
Global assessment of functioning and sleep: More responders in the micronutrient group (69%) compared to the placebo group (38%). Very much improved.
Much more likely to respond to micronutrients than placebo – ‘substantial and dramatic’:
Mothers with a history of taking psychiatric medication.
Mothers identified as having personality difficulties (emotionally dysregulated, getting along with other people, being very anxious).
Current recommended daily intake for nutrients for women in pregnancy may be insufficient: Placebo group on recommended daily intake nutrients had depleted nutrient levels. Micronutrient group nutrient levels remained stable: ‘we’re enabling that mum to function by giving those nutrients and preventing deficiency when those nutritional needs are much higher’. (Carr et al 2023).
[2] Siobhan Campbell et al (2024). Infant behavioural assessment within one month of birth. Mums with depression on at least 2 months micronutrients from second trimester onwards; the reference group (no depression); and a ‘standard care’ group prescribed antidepressants during pregnancy. Mums monitored throughout their pregnancy and infants monitored.
Findings ‘stunning results’:
Micronutrient exposed infants did really well on those early indicators of regulation: orientation, habituation to sounds or noises, motor control, affect regulation.
Not only as good as reference group, in some cases outcomes were superior.
Infant regulation outcomes for mothers on antidepressants during pregnancy much poorer.
[3] Jessica Heaton et al (2024). Effect on maternal and birth outcomes. Three groups: NUTRIMUM exposed mother/infant pairs (mothers with depression); reference group of mother/infant pairs not exposed to either micronutrients or antidepressants; and mother/infant pairs who were exposed to antidepressants during pregnancy. Assess potential harms to mothers from high dose micronutrients.
Findings:
Micronutrient exposed mothers on par with the reference group.
Preterm birth: Antidepressant prescribed mothers had higher rates than micronutrient mothers.
Low birth weight: More likely for antidepressant prescribed mothers than micronutrient mothers.
Infant resuscitation: Least in micronutrient group, more in reference group, most in antidepressant prescribed mothers’ group.
Post partum haemorrhage: Much less in micronutrient group, higher in reference group, highest in antidepressant prescribed mothers.
Neonatal intensive care unit admittance: most common in antidepressant prescribed mothers.
Estimated costs savings using US data (medical care, delivery costs, early intervention, lost labour market productivity) estimated at USD$3333 per mother.
UNIVERSITY OF CANTEBURY ARTICLES:
Micronutrients used to treat antenatal depression in world first study. 04 June 2024
From womb to world: The role of micronutrients in shaping infant development. 12 June 2024.
REFERENCES:
Bradley HA, Campbell SA, Mulder RT, et al.(2020) Can broad-spectrum multinutrients treat symptoms of antenatal depression and anxiety and improve infant development? Study protocol of a double blind, randomized, controlled trial (the ‘NUTRIMUM’ trial). BMC Pregnancy Childbirth. 2020;20:488. doi: 10.1186/s12884-020-03143-z
Rucklidge JJ, Bradley HA, Campbell SA, Heaton JL, Mulder RT, Henderson J, et al. (2022) Vitamins and minerals treat antenatal depression and improve birth and infant development: results of the double-blind NutriMum RCT. AACAP/CACAP 2022 annual meeting. 2022;61:S283. doi: 10.1016/j.jaac.2022.07.579
Bradley HA, Moltchanova E, Mulder RT, Dixon L, Henderson J, Rucklidge JJ. Efficacy and safety of a mineral and vitamin treatment on symptoms of antenatal depression: 12-week fully blinded randomised placebo-controlled trial (NUTRIMUM). BJPsych Open. 2024 Jun 3;10(4):e119. doi: 10.1192/bjo.2024.706. PMID: 38828982; PMCID: PMC11363078.
Campbell SA, Bradley HA, Mulder RT, Henderson JMT, Dixon L, Haslett LC, Rucklidge JJ. (2024) Effect of antenatal micronutrient or antidepressant exposure on Brazelton neonatal behavioral assessment scale (NBAS) performance within one-month of birth. Early Hum Dev. 2024;190:105948. doi: 10.1016/j.earlhumdev.2024.105948
Campbell SA, Dys SP, Henderson JMT, Bradley HA and Rucklidge JJ (2024) Exploring the impact of antenatal micronutrients used as a treatment for maternal depression on infant temperament in the first year of life. Front. Nutr. 2024;11:1307701. doi: 10.3389/fnut.2024.1307701
Heaton, JL; Campbell, SA; Bradley, HA; Mulder, RT; Dixon, L; Henderson, J; Rucklidge, JJ. Broad-Spectrum Micronutrients or Antidepressants for Antenatal Depression: Effect on Maternal and Infant Birth Outcomes in an Observational Secondary Analysis of NUTRIMUM. Journal of Clinical Psychopharmacology ():10.1097/JCP.0000000000001934, December 2, 2024. | doi: 10.1097/JCP.0000000000001934
Carr, A.C.; Bradley, H.A.; Vlasiuk, E.; Pierard, H.; Beddow, J.; Rucklidge, J.J. Inflammation and Vitamin C in Women with Prenatal Depression and Anxiety: Effect of Multinutrient Supplementation. Antioxidants 2023, 12, 941. https://doi.org/10.3390/antiox12040941
Most mammals eat their placenta after giving birth. It isn't for a tree, it isn't magical, it's a source of nutrients for the mother, and in the animal kingdom, ingestion of the placenta hides evidence of childbirth (from predators). Medicalisation of childbirth means the mother doesn't eat the placenta, or get the nutrients in it. Raw is best. Prove me wrong.