Is iron deficiency a risk factor for postpartum depression? A case-control study in the Gaza Strip, Palestine

Public Health Nutr. 2022 Jun;25(6):1631-1638. doi: 10.1017/S1368980021003761. Epub 2021 Aug 31.

Abstract

Objective: This study aims to investigate the association between iron body status and postpartum depression (PPD) among mothers during the postpartum period.

Design: This is a case-control study.

Setting: Governmental primary health care centres in the Gaza Strip, Palestine.

Participants: This study involved 300 mothers a month after delivery, with one 150 mothers that were recruited in the cases group who were diagnosed with PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥ 10. The control group included 150 mothers did not have PPD (EPDS < 10). Body iron status is represented by the index of sTfR/log ferritin.

Results: Among PPD mothers, 43·3 % had low ferritin level v. 15·3 % for controls (P < 0·001) and cases v. controls difference in mean Hb level was -0·61 (95 % CI -0·86, -0·35). The results of the multiple logistic regression reported that there is a statistically significant association between PPD and the body iron status existed, as mothers who suffered from iron deficiency (ID) were three times more likely to have PPD (ORadj 3·25; P = 0·015). Furthermore, the results of the final regression model showed that the other factors that can lead to PPD are absence of psychological guidance services (ORadj 8·54; P = 0·001), suffering from undesired feeling in the last pregnancy (ORadj 1·77; P = 0·034), in addition to having one of the mental health disorders in the last pregnancy (P = 0·001).

Conclusion: Body iron status might be a risk factor for postpartum depression and other possibilities of reverse causality may worsen the condition.

Keywords: Depression; Iron; Micronutrient; Nutrition; Postpartum depression; Trace elements.

MeSH terms

  • Case-Control Studies
  • Depression, Postpartum* / epidemiology
  • Depression, Postpartum* / etiology
  • Female
  • Ferritins
  • Humans
  • Iron
  • Iron Deficiencies*
  • Middle East / epidemiology
  • Mothers / psychology
  • Pregnancy
  • Psychiatric Status Rating Scales
  • Risk Factors

Substances

  • Ferritins
  • Iron