What is it about?

Many women experience postpartum psychiatric problems. But, we don’t fully understand what causes these problems, or why some new mothers have them while others don’t. Environmental factors (e.g. stress) affect our postpartum mental health. Research suggests that our genes and nutrient levels may also play a role. One gene - called MTHFR – helps our bodies regulate levels of folate. Some people have a change to this gene which we call the MTHFR C677T variant. Studies have shown that this change may be linked to lower levels of folate. Folate is a vitamin we get from food and supplements (like multivitamins or prenatal vitamins, in the form of folic acid). Low folate may increase a person's risk for mental health disorders like depression and psychosis. Folate is important in our bodies at all times, but we need more during pregnancy. So, we studied whether women with the MTHFR C677T variant had higher risk for postpartum psychiatric symptoms due to differences in folate levels. We looked to see if pregnant/postpartum women had 0, 1 or 2 copies of the MTHFR C677T variant. (0 copies is the “typical” MTHFR gene. We each have 2 copies of every gene). We used surveys and interviews to measure symptoms of depression, psychosis, and mania. We also measured folate levels in the blood during pregnancy and up to 3 times postpartum. We found that for women with 0 or 1 copy of the MTHFR C667T variant, those with higher folate had slightly less symptoms of mania. For women with 2 copies, folate levels (being higher or lower) did not influence their symptoms of mania. We also looked at symptoms of depression and psychosis. Folate levels did not influence these symptoms for any of the women (regardless of MTHFR) in the study.

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Why is it important?

What does this mean for me? To be honest, not much! Taking a folic acid supplement is already recommended during pre-conception and pregnancy. This is important for all women - no matter how many copies of the MTHFR C677T variant you have. It is also possible for any woman to develop postpartum mania (or depression or psychosis). For example, if you have higher levels of folate it does not mean you won’t experience postpartum mania. This is true even if you have 0 or 1 copy of the variant. This information will help scientists better understand what causes postpartum psychiatric problems. One day, this will show us how we can best protect postpartum mental health. But right now, knowing if you have 0, 1 or 2 copies of the MTHFR C677T variant doesn’t change anything. Recommendations for your diet and mental health care remain the same. So, continue to follow the standard guidelines for pregnancy care. Please talk to you doctor if you have any questions about your current mental health care.

Read the Original

This page is a summary of: A prospective study to explore the relationship between MTHFR C677T genotype, physiological folate levels, and postpartum psychopathology in at-risk women, PLoS ONE, December 2020, PLOS, DOI: 10.1371/journal.pone.0243936.
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