Anemia in pregnancy has been associated with increased rates of low birth weight, preterm delivery, and perinatal mortality in several previous studies. Despite these complications, few have investigated the impact of anemia on postpartum women. This postpartum period can be extremely difficult for mothers as 19% of United States women experience postpartum depression (PPD). It is therefore imperative to investigate anemia as a possible physiologic risk factor for PPD.
This retrospective cohort study was conducted by collecting hematocrit and demographic data from medical records of patients meeting all criteria. Patients included were women ≥16 years old who received postpartum care at Women’s Ambulatory Health Services in Hartford, Connecticut from January 2014 to January 2017. Those excluded were patients <16 years old, those on psychiatric medications, those with disease disrupting iron metabolism, tobacco users, patients receiving blood transfusions, or those experiencing neonatal mortality. Records were categorized into anemic and non-anemic. Percentage of Edinburgh Postnatal Depression Scale (EPDS) ≥11 vs <11 were compared using Chi square test.
922 women fulfilled study requirements and completed the EPDS questionnaire. 9.2% of study patients screened positively for PPD (EPDS ≥11). 75.2% were anemic antenatally or immediately postpartum. The difference in PPD incidence for those anemic (10.8%) vs non-anemic (4.8%) was statistically different (P=.007). Anemic patients had an increased risk of screening positive for PPD (RR 2.25, 95% CI 1.22-4.16).
Anemia during pregnancy or peripartum is associated with an increased incidence of PPD and thus should be further investigated as a potential risk factor for PPD.