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Int J Gynaecol Obstet. 2019 Sep 26. doi: 10.1002/ijgo.12982. [Epub ahead of print]

Association between perinatal anemia and postpartum depression: A prospective cohort study of Japanese women.

Author information

1
Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
2
Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.
3
Department of Psychiatry, National Center for Child Health and Development, Tokyo, Japan.
4
Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.

Abstract

OBJECTIVE:

To clarify the association between postpartum depression (PPD) and anemia in each stage of pregnancy as well as in the postpartum period.

METHODS:

A prospective cohort study was conducted between May 2010 and November 2013 at a tertiary hospital in Japan. In total, 1128 women were assessed using the Edinburgh Postpartum Depression Scale (EPDS) at postpartum week 4 and a blood test was performed in the second trimester (24-28 weeks of gestation), third trimester (35-36 weeks of gestation), and postpartum week 1. The primary outcome was PPD, defined as an EPDS score of 9 or higher. Multivariate logistic regression analysis was used to elucidate the association between anemia and PPD for each period. Additionally, trend analysis was conducted to determine if there was a linear association between maternal hemoglobin concentration and PPD.

RESULTS:

Postpartum anemia was significantly associated with increased PPD risk (adjusted odds ratio 1.63, 95% confidence interval 1.17-2.26) whereas anemia in the second and third trimesters was not. Similarly, a significant inverse association was observed between the quintiles of maternal hemoglobin levels in the puerperium and the PPD risk (P value for trend 0.004).

CONCLUSION:

Postpartum anemia was associated with an increased risk of PPD.

KEYWORDS:

Anemia; Edinburgh Postpartum Depression Scale; Japanese; Postpartum depression; Postpartum hemorrhage; Pregnancy

PMID:
31556455
DOI:
10.1002/ijgo.12982

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