Author/Authors :
Azami, Milad Faculty of Medicine - Ilam University of Medical Sciences, Ilam, Iran , Badfar, Gholamreza Department of Pediatrics - Behbahan Faculty of Medical Sciences, Behbahan, Iran , Khalighi, Zahra Biotechnology and Medicinal Plants Research Center - Ilam University of Medical Sciences, Ilam, Iran , Qasemi, Parvin Faculty of Allied Medical Sciences - Ilam University of Medical Sciences, Ilam, Iran , Shohani, Masoumeh Department of Nursing - Faculty of Nursing and Midwifery - Ilam University of Medical Sciences, Ilam, Iran , Soleymani, Ali Dezful University of Medical Sciences, Dezful, Iran , Abbasalizadeh, Shamsi Women’s Reproductive Health Research Center - School of Medicine - Tabriz University of Medical Sciences, Tabriz, Iran
Abstract :
Background: The association between anemia and postpartum depression (PPD) has been
reported to be controversial in different studies. Therefore, this study aimed to provide a
comprehensive assessment of anemia and PPD.
Methods: This review study was conducted according to the MOOSE protocol and results
have been reported according to the PRISMA guideline. We searched epidemiologic
studies published until January 2018 in nine English databases including Scopus,
PubMed/Medline, Science Direct, Embase, Web of Science, CINAHL, Cochrane Library,
EBSCO and Google Scholar using English MeSH keywords. The heterogeneity of the
studies was assessed using the Cochran’s Q test and I2 index. Data were analyzed using a
random effects model and comprehensive meta-analysis (CMA) software version 2.
Results: In the 10 studies, the association between postpartum anemia and PPD was
significant (heterogeneity test: P<0.001, I2=74.62%), and RR=1.887 (95%CI: 1.255-2.838,
P=0.002). In 8 studies, anemia during pregnancy significantly increased the risk of
postpartum depression (heterogeneity test: P=0.116, I2=36.422%), RR=1.240 (1.001-
1.536, P=0.048). The subgroup analysis of postpartum anemia and PPD was not significant
for the variables of quality of studies, study design, and the period of evaluating depression
and anemia. The subgroup analysis of anemia during pregnancy and PPD was not
significant for the period of evaluating depression. Publication bias did not affect the
results of the studies.
Conclusion: Meta-analysis results showed anemia during pregnancy and after pregnancy
that significantly increased the risk of postpartum depression. Therefore, prevention,
identification and treatment of anemia in pregnant women seem necessary.
