Please select the eligibility criteria that correspond to the clinical trial below.
Title: Does EPA or DHA Prevent Depressive Symptoms in Pregnancy and Postpartum?
Brief Summary: This study is designed to test whether an alternative medicine treatment, fish oil, will prevent depressive symptoms in pregnant and postpartum women who have been found to be at risk for depression. Epidemiologists have observed that people who live in countries where people on average eat a diet high in fish have a lower risk of depression than people who live in populations that eat less fish. Postpartum depression is also less common in these countries. The omega-3 fatty acids found in fish oil are thought to be responsible for this beneficial effect of eating fish. The two major omega-3 fatty acids found in fish are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). DHA is an essential building block of the brain and nerve tissue. EPA may act to optimize the electrical signals between nerve cells and brain cells and may help the immune system to function well.

Some researchers have treated people who are already suffering from depression with fish oil. Some of these studies have shown a benefit for the fish oil treatment and others have not. These studies have tested EPA and DHA alone and in various combinations. Currently, it is not known whether EPA or DHA is more effective in preventing and treating depression. Some of the researchers involved in this study have learned how to identify mothers who are most at risk for developing depression during and after pregnancy. This study is designed to learn whether EPA-rich and DHA-rich fish oil supplements will prevent depressive symptoms in women who are at risk to develop depression.


Options:
A: Inclusion Criteria:

* Women who are more than 12 weeks pregnant but less than 20 weeks pregnant
* Women who are found to be at risk for depression
* Women who have been treated for depression in the past
* Women with depression after a previous pregnancy
* Women planning to deliver at University of Michigan Hospital

Exclusion Criteria:

* Women who have major depression or other psychiatric disorders (current substance abuse, schizophrenia, bipolar disorder) at the time of screening
* Women who are currently taking anti-depressant or other psychiatric medications
* Women who routinely eat more than 2 fish meals per week
* Women on anticoagulants (blood thinners)
* Women currently taking omega-3 fatty acid dietary supplements (fish oil, flaxseed oil or cod liver oil)
* Women with bleeding disorders such as von Willebrand's disease
* Women under the age of 18
* Women with a multiple gestation (twins, for example)
* Women planning to deliver at another hospital
* Women planning to move away before 6 weeks after delivery
B: Inclusion Criteria:

* ≤14 weeks gestational age at first prenatal visit
* Body mass index (BMI) \>30 Kg/m2 at first prenatal visit
* Have a singleton pregnancy
* Plan to deliver at the "Sotero del Rio Hospital".

Exclusion Criteria:

* Preexisting diabetes (known or diagnosed at first control (Fasting Plasma Glucose \> 126 mg/dl or 2h plasma glucose \> 200 mg/dl during an oral glucose tolerance test (OTTG))
* Insulin or metformin use
* Known medical or obstetric complications which restrict physical activity
* History of eating disorders
* High risk for hemorrhagic bleeding
* High risk pregnancy according to national guidelines
C: Inclusion Criteria (mother):

* Pregnant women
* Living in Sealand, Denmark
* Fluent in Danish Language
* Willing to let the newborn child participate in the study

Exclusion Criteria (mother):

* Participating in other clinical trial
D: Inclusion Criteria:

* singleton pregnancy
* gestation \<20 week at enrollment
* intention to deliver in one of the study centers
* body weight at time of enrollment from 50 kg to 92 kg

Exclusion Criteria:

* serious chronic illness (eg, diabetes, hepatitis)
* use fish oil supplements since the beginning of pregnancy
* use of folate or vitamin B-12 supplements after gestation week 16

Answer: A