Operative delivery and postnatal depression: a cohort study

Postnatal depression and depression in pregnancy are theoretically preventable with high quality preconception care. The commonest nutritional deficiencies in women before conception are of zinc and magnesium and these cause unexplained infertility and recurrent miscarriages.1 Zinc deficiency causes depression and other mental illnesses, but this important fact is usually ignored by psychiatrists.2-5

During pregnancy maternal zinc levels fall as copper levels rise, provided copper stores are adequate.6 Years of hormonal contraceptive use before pregnancies increase mineral deficiencies and must therefore be contributing to this extremely high incidence, of 8-15% of women suffering from postnatal depression with increased risk of long term adverse effects on child development.7,8 Deficiencies of trace elements like zinc, copper and magnesium have been implicated in various reproductive events like infertility, pregnancy wastage, congenital anomalies, pregnancy induced hypertension, placental abruption, premature rupture of membranes, still births and low birth weight.9,10

There are no reports of postnatal depression among women who had poor obstetric histories followed by successful pregnancies while eating high protein, low-allergy diets, and taking appropriate nutritional supplements, based on nutritional analyses before and during pregnancy in Foresight surveys.1 Also, none of my patients have reported postnatal depression when taking multiple tailored supplements over the last 25 years. However, zinc supplements taken alone can lower copper stores and result in reduced superoxide dismutase activities. This can cause severe depression which responds dramatically to alternating copper and zinc supplements.

Animals eat their placentas, women do not, whether or not they have vaginal deliveries or caesarean sections. Therefore this excellent source of zinc, copper, iron and essential fatty acids is not utilized for lactation when the need for a high zinc intake and good serum zinc levels is greatest.8 However, toxic metals accumulate in placentas when zinc is deficient and high levels of cadmium, mercury, nickel, lead, aluminium relate to poor pregnancy outcomes.11

1 Grant ECG. Nutritional supplements to prevent pregnancy complications. http://bmj.com/cgi/eletters/329/7458/152#67502, 16 Jul 2004

2 Maes M, D'Haese PC, Scharpe S, D'Hondt P, Cosyns P, De Broe ME. Hypozincemia in depression. J Affect Disord. 1994 Jun;31(2):135-40.

3 Grant ECG. Re: Depression, Antidepressants, and Breast Cancer: Considering Only the "Facts" that Fit? http://bmj.com/cgi/eletters/329/7465/529#76040, 28 Sep 2004

4 Grant ECG. Schizophrenics need zinc and not DHEA or testosterone supplements. http://bmj.com/cgi/eletters/330/7484/158#95066, 1 Feb 2005

5 Grant ECG. Psychiatrists ignore science http://bmj.com/cgi/eletters/330/7485/260#94858, 30 Jan 2005

6 Jezerniczky J, Nagy Z, Dvoracsek E, Nagy B, Ilyes I, Csorba S. Trace elements in the serum of mothers and their children. Acta Paediatr Acad Sci Hung. 1976;17(3):193-7.

7 Roshni R Patel, Deirdre J Murphy, Tim J Peters, and for ALSPAC Operative delivery and postnatal depression: a cohort study.BMJ 2005; 0: bmj.38376.603426.D3v1

8 Kirksey A, Ernst JA, Roepke JL, Tsai TL. Influence of mineral intake and use of oral contraceptives before pregnancy on the mineral content of human colostrum and of more mature milk. Am J Clin Nutr. 1979 Jan;32(1):30-9.

9 Pathak P, Kapil U. Role of trace elements zinc, copper and magnesium during pregnancy and its outcome. Indian J Pediatr. 2004 Nov;71(11):1003-5.

10 Cengiz B, Soylemez F, Ozturk E, Cavdar AO. Serum zinc, selenium, copper, and lead levels in women with second-trimester induced abortion resulting from neural tube defects: a preliminary study. Biol Trace Elem Res. 2004 Mar;97(3):225-35.

11 Ward NI, Watson R, Bryce-Smith D, et al. Placental element levels in relation to fetal development for obstetrically "normal" births: a study of 37 elements. Evidence for effects of cadmium, lead, and zinc on fetal growth, and smoking as a source of cadmium. Int J Biosocial Res 1987; 9: 63-81.

Competing interests: None declared