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

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.