Aim: Postpartum anemia and iron deficiency are reportedly involved in postpartum depression, but the association between perinatal depression and iron deficiency with or without anemia is poorly documented. This pilot study retrospectively investigated the relationship between non-anemic iron deficiency (NAID) in early pregnancy and perinatal depressive symptoms.
Methods: This study included 31 non-anemic women among patients who received perinatal care with preserved residual serum from routine antenatal checkups in Kyoto University Hospital. All participants gave informed consent for research. The ferritin concentration in their preserved serum was measured. The hemoglobin (Hb) and ferritin in early pregnancy, as well as the Edinburgh Postpartum Depression Scale (EPDS) at mid-pregnancy and 1 month after childbirth were analyzed. Iron deficiency was defined as a serum ferritin concentration < 30 ng/mL.
Results: Based on the ferritin level in early pregnancy, 13 women (41.9%) had NAID, whereas 18 were normal. The mean Hb and ferritin were 12.7 ± 0.6 g/dL and 18.5 ± 5.8 ng/mL in the NAID group and 12.8 ± 0.9 g/dL and 74.7 ± 39.2 ng/mL in the normal group, respectively. The median EPDS scores at mid-pregnancy and 1 month postpartum, respectively, were 2.0 (2.0-3.3) and 5.0 (4.0-6.6) in the NAID group and 4.5 (2.3-7.3) and 4.5 (2.3-5.7) in the normal group. EPDS scores increased significantly from mid-pregnancy to 1 month postpartum in the NAID group only.
Conclusion: NAID in early pregnancy was highly prevalent and was suggested to reduce resilience to depression during the perinatal period.
Keywords: anemia; early pregnancy; ferritin; non-anemic iron deficiency; postpartum depression.
© 2022 Japan Society of Obstetrics and Gynecology.