Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial
- 2017-10
- EBioMedicine 24
- R. Slykerman
- Fiona Hood
- K. Wickens
- John F. Thompson
- C. Barthow
- R. Murphy
- Janice Kang
- Judy Rowden
- P. Stone
- Julian Crane
- T. Stanley
- P. Abels
- G. Purdie
- Robyn M. Maude
- E. Mitchell
- PubMed: 28943228
- DOI: 10.1016/j.ebiom.2017.09.013
Abstract
Background: Probiotics may help to prevent symptoms of anxiety and depression through several putative mechanisms.
Objective: The aim of this study was to evaluate the effect of Lactobacillus rhamnosus HN001 (HN001) given in pregnancy and postpartum on symptoms of maternal depression and anxiety in the postpartum period. This was a secondary outcome, the primary outcome being eczema in the offspring at 12months of age.
Design, setting, participants: A randomised, double-blind, placebo-controlled trial of the effect of HN001 on postnatal mood was conducted in 423 women in Auckland and Wellington, New Zealand. Women were recruited at 14-16weeks gestation.
Intervention: Women were randomised to receive either placebo or HN001 daily from enrolment until 6months postpartum if breastfeeding.
Outcome measures: Modified versions of the Edinburgh Postnatal Depression Scale and State Trait Anxiety Inventory were used to assess symptoms of depression and anxiety postpartum.
Trial registration: Australia NZ Clinical Trials Registry: ACTRN12612000196842.
Findings: 423 women were recruited between December 2012 and November 2014. 212 women were randomised to HN001 and 211 to placebo. 380 women (89.8%) completed the questionnaire on psychological outcomes, 193 (91.0%) in the treatment group and 187 (88.6%) in the placebo group. Mothers in the probiotic treatment group reported significantly lower depression scores (HN001 mean=7·7 (SD=5·4), placebo 9·0 (6·0); effect size -1·2, (95% CI -2·3, -0·1), p=0·037) and anxiety scores (HN001 12·0 (4·0), placebo 13·0 (4·0); effect size -1·0 (-1·9, -0·2), p=0·014) than those in the placebo group. Rates of clinically relevant anxiety on screening (score>15) were significantly lower in the HN001 treated mothers (OR=0·44 (0·26, 0·73), p=0·002).
Interpretation: Women who received HN001 had significantly lower depression and anxiety scores in the postpartum period. This probiotic may be useful for the prevention or treatment of symptoms of depression and anxiety postpartum.
Funding source: Health Research Council of New Zealand (11/318) and Fonterra Co-operative Group Ltd.
Keywords: Anxiety; Depression; Microbiome-gut-brain axis; Probiotic; Randomised controlled trial.
Research Insights
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Lacticaseibacillus rhamnosus | Reduced Anxiety Scores | Beneficial | Small |
| Lacticaseibacillus rhamnosus | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lacticaseibacillus rhamnosus | Reduced Depression Symptoms | Beneficial | Small |
| Lacticaseibacillus rhamnosus R0011 | Reduced Clinically Relevant Postpartum Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus CLR1505 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus CLR1505 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus CLR1505 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus CRL 1505 | Reduced Clinically Relevant Postpartum Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus CRL 1505 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus DSM33560 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus DSM33560 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus DSM33560 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus DSM 6594 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus DSM 6594 | Reduced Clinically Relevant Postpartum Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus DSM 6594 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus GR-1 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus GR-1 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus GR-1 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus HA-111 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus HA-111 | Reduced Clinically Relevant Postpartum Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus HA-111 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus HA-114 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus HA-114 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus HA-114 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus HA-500 | Reduced Anxiety Scores | Beneficial | Small |
| Lactobacillus rhamnosus HA-500 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus HA-500 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus LBV 96 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus LBV 96 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus LBV 96 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus LBV96 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus LBV96 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus LBV96 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus MAK79L08R | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus MAK79L08R | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus MAK79L08R | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus NH001 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus NH001 | Reduced Clinically Relevant Postpartum Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus NH001 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus PXN 54 | Reduced Clinically Relevant Postpartum Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus PXN 54 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus R0011 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus R0011 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus R0011 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus R0343ND | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus R0343ND | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus R0343ND | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus SD-5217 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus SD-5217 | Reduced Depression Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus UALr-18 | Reduced Anxiety Symptoms | Beneficial | Small |
| Lactobacillus rhamnosus UALr-18 | Reduced Clinically Relevant Anxiety | Beneficial | Moderate |
| Lactobacillus rhamnosus UALr-18 | Reduced Depression Symptoms | Beneficial | Small |