Journal Article

The efficacy of early iron supplementation on postpartum depression, a randomized double-blind placebo-controlled trial

Shariat, Mamak, Farahani, Zahra, Sheikh, Mahdi, Hantoushzadeh, Sedigheh, Ebrahiminasab, Ozra

2017

Overview

Evaluating early iron supplementation in non-anemic mothers with postpartum depression (PPD). This randomized, double-blind, placebo-controlled trial evaluated 70 mothers with PPD. One week after delivery, the mothers were randomly allocated in the iron-treated (50 mg elemental iron/daily) and placebo-treated groups. After 6 weeks, the improvement of PPD symptoms was compared between the groups. Ferritin significantly increased in the iron-treated group (p < 0.001), but not in the placebo group (p = 0.09). After intervention, ferritin was higher in the iron-treated group (medians: 78.2 vs. 37 mg/dl, p = 0.01). The rate of iron deficiency significantly decreased in the iron-treated group (p = 0.009), but not in the placebo group (p = 0.4). After intervention, the rate of iron deficiency was higher in the placebo group (31.4 vs. 8.5 %, p = 0.01). The Edinburgh Postnatal Depression Scale (EPDS) score significantly decreased in the iron-treated group (p < 0.001), but not in the placebo group (p = 0.13). After intervention, the EPDS score was lower in the iron-treated group (medians 9 vs. 12, p = 0.01). The improvement rate for PPD was significantly higher in the iron-treated group (42.8 vs. 20 %, p = 0.03). After intervention, mothers with continued PPD had lower ferritin than the improved mothers (41.8 vs. 67 mg/dl, p = 0.03). Mothers with continued depression had higher rate of iron deficiency compared to the improved mothers (27.1 vs. 4.5 %, p = 0.02). Early iron supplementation in mothers with PPD significantly improves the iron stores and causes a significant improvement in PPD with a 42.8 % improvement rate during 6 weeks. Continued PPD might be related to the lower postpartum ferritin levels in untreated mothers.

• Publisher: Springer Nature B.V
• Subject: Anemia, Iron-Deficiency - diagnosis / Anemia, Iron-Deficiency - diet therapy / Anemia, Iron-Deficiency - epidemiology / Anemia, Iron-Deficiency - psychology / Asymptomatic Diseases - psychology / Biomarkers - blood / Depression, Postpartum - epidemiology / Depression, Postpartum - etiology / Depression, Postpartum - prevention & control / Diagnostic and Statistical Manual of Mental Disorders / Dietary Supplements / Double-Blind Method / Early Diagnosis / Female / Ferritin / Ferritins - agonists / Ferritins - blood / Hematinics - therapeutic use / Humans / Incidence / Iran - epidemiology / Iron / Iron, Dietary - therapeutic use / Nutrient deficiency / Nutritional Status / Placebos / Postpartum / Postpartum depression / Postpartum Period / Psychiatric Status Rating Scales / Severity of Illness Index / Supplementation