This research was an ancillary study of the TRAAP trial (a multicentre French trial), and it determined the effect of early postpartum haemoglobinaemia on the risk of postpartum depression symptoms at two months. The population comprised women who experienced a singleton vaginal delivery beyond 35 weeks of gestation. Excluded from the population were women with pre-existing psychiatric disorders and those that were not responsive to the Edinburgh Postnatal Depression Scale (EPDS). Haemoglobin levels were measured routinely soon after delivery, and EPDS scores were measured at the two-month point in order to assess depressive symptoms.
The exposure measure was maternal haemoglobin at the time of delivery. Postpartum depression was ascertained with the EPDS, with a score ≥11 regarded as indicative of depressive symptoms. These symptoms were also classified as moderate (EPDS 11–12) and severe (EPDS ≥13). Statistical analysis involved multivariable models that were controlled for factors known to be of relevance, enabling the researchers to measure the association between haemoglobin and risk of depression while adjusting for confounders.
Key Findings
Of 2,672 women in the study:
1,115 women (43.6%) developed postpartum anaemia (haemoglobin <11 g/dL).
369 women (13.8%) had symptoms of postpartum depression at two months.
There was a linear correlation between haemoglobin concentrations and PPD symptoms.
A 1 g/dL higher haemoglobin level was associated with a 9% reduction in the risk of postpartum depression symptoms (adjusted Relative Risk [aRR] = 0.91; 95% Confidence Interval [CI]: 0.82–0.997).
Postpartum haemoglobin was strongly related to moderate depressive symptoms (aRR = 0.84; 95% CI: 0.72–0.98).
There was no statistically significant relation with severe depressive symptoms (aRR = 0.95; 95% CI: 0.84–1.07).
This research identifies a definite and quantifiable association between maternal haemoglobin concentration and risk of symptoms of postpartum depression in women giving birth vaginally. These results justify inclusion of standard haemoglobin screening and anaemia treatment in postpartum care guidelines, not merely for enhancing physical recovery but also for minimizing mental health complications among new mothers.
Reference:
Loussert, L., Sentilhes, L., Froeliger, A., Seco, A., Bonnet, M. P., Tebeka, S., Deneux-Tharaux, C., & TRAAP study group. (2025). Association between post-partum anaemia and depressive symptoms at two months after vaginal delivery: A secondary analysis of the TRAAP trial. BJOG: An International Journal of Obstetrics and Gynaecology, 1471-0528.18289.
https://doi.org/10.1111/1471-0528.18289
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