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 centers 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 represented by the index of sTfR/log Ferritin. Results: Among PPD mothers, 43.3% had low ferritin level vs. 15.3% for controls (P<0.001) and cases vs. controls difference in mean hemoglobin level was -0.61 (95% C.I -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.