Association between perinatal anemia and postpartum depression: A prospective cohort study of Japanese women.

Is there a relationship between anaemia and depression in the postpartum period? Certainly perioperative anaemia has been independently associated with increased morbidity and mortality across many different specialities in surgical and critical care. It has been linked to prolonged hospital length of stay, excessive health resource utilization and reduced disease-free survival.

Maternal iron deficiency anaemia has been associated with poor maternal and infant outcomes in observational studies and randomised trials. This report by Maeda and colleagues measures a very important quality of life outcome: postpartum depression.

The authors conducted a prospective cohort study of over 1100 pregnant women. The primary outcome was postpartum depression assessed using the Edinburgh Postpartum Depression Scale (EPDS) at postpartum week 4. Postpartum anaemia was significantly associated with increased postpartum depression risk (adjusted odds ratio 1.63, 95% confidence interval 1.17-2.26), the risk increasing with lower haemoglobin levels.

Therefore, according to this report (and others, e.g. Azami M et al. Caspian J Intern Med 2019;10:115-24; Wassef A et al. J Psychosom Obstet Gynaecol 2019;40:19-28), the association between anaemia and postpartum depression is a modifiable variable that should not be ignored.

– Susan M. Goobie (SABM reviewer)