Is anemia an independent risk factor for postpartum depression in women who have a cesarean section? - A prospective observational study

Nirmala Chandrasekaran, Leanne R De Souza, Marcelo L Urquia, Beverley Young, Anne Mcleod, Rory Windrim, Howard Berger, Nirmala Chandrasekaran, Leanne R De Souza, Marcelo L Urquia, Beverley Young, Anne Mcleod, Rory Windrim, Howard Berger

Abstract

Background: The symptoms of anemia and depression are very similar suggesting that there may be an association between the two entities. The aim of this study is to assess whether postpartum anemia (PPA) is an independent risk factor for de novo postpartum depression (PPD)in women undergoing elective cesarean section.

Methods: Women after an uncomplicated term cesarean section were recruited and their hemoglobin and iron status were measured on day 3-5 post section and again at 6 weeks. Postpartum depression was screened using the Edinburgh Postnatal Depression Scale (EPDS) and functional capacity was assessed with the RAND 12-item Health survey.

Results: One hundred and three women completed the study. The incidence of probable postpartum depression (PPD) as defined by EPDS score ≥ 10 was 17% at 6 weeks. There was no difference in hemoglobin or iron status in women who had PPD compared to those without (OR-0.69; 95% CI-0.15-2.49). Similarly, there was no significant association between low hemoglobin and maternal functional status (OR -1.03; 95% CI-0.34 - 2.94).

Conclusions: Neither anemia or low iron stores were found to be an independent risk factors for postpartum depression or decreased postpartum functional capacity in women who undergo an elective cesarean section.

Keywords: Anemia; Cesarean section; Functional status; Iron stores; Postpartum depression.

Conflict of interest statement

Ethics approval and consent to participate

Written informed consent was obtained from all the participants after approval from the Research Ethics Board of St Michaels Hospital. (REB #08–155).

Consent for publication

N/A

Competing interests

HB is a member of the editorial board (section editor) of the journal.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the recruitment process

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