Is there evidence for foetal origins of depression? Psych Med: Jan 13

14.01.13

Low birth weight is linked to  a variety of adult health outcomes (cardiovascular disease, Hypertension,Diabetes etc). Exposure to poor nutrition in early life can lead to physiological adaptations which on later life can lead to increased susceptibility to diseases (Barker hypothesis). Population based studies on low birth weight and depression has provided mixed results.The Ducth famine study (Brown et al. 2000) ) found supportive evidence for this ie those exposed to famine during 2nd or 3rd trimesters were at increased risk of mood disorders.

W. Wojcik, W. Lee. Colman, R. Hardy and M. Hotopf reports the results of a systematic review on this question.All primary research  (cohort and case control studies in general population samples) where association between low birth weight ( less than 2.5 kg)  and depression ( measured by rating scales/interview) were studied were included.

Results: From the initial 1739 studies 26  studies met inclusion criteria. 11 supported and 15 found no significant association between low birth weight and depression. Of this 15 negative studies, 13 reported positive findings for subgroups or other measures.  Meta analysis of 18 studies that provided appropriate binary measures (ie of  birth weight and depression) showed an Odds Ratio 1.15 (95% CI 1.00–1.32) ie a weak association. This weak association became non significant when publication bias was taken in to account ( by using trim and fill technique). Though there is no clear support for an association between low birth weight and depression adult life, heterogeneity of results suggest that there may be subgroups where association might be stronger.

Health register studies were excluded from the analysis as this review used only studies from general population samples. One important health register study is Abel et al 2010:  A sample of 1.49 million people were followed to their late 20s and a modest association ( Odds Ratio  1.37) was found for mood disorders. ie  Birth weight has a modest effect when the outcome is defined as severe affective disorders leading to contact with secondary care services.

From the meta analysis, there is currently inconclusive evidence for association between low birth weight  and adult depression.

Summary of the article:

Foetal origins of depression? A systematic review and meta-analysis of low birth weight and laterdepression Wojcik W, Lee W, Colman I, Hardy R, Hotopf M.Psychol Med. 2013 Jan;43(1):1-12

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