Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Back

Topical Area: Maternal, Perinatal and Pediatric Nutrition

Maternal, Perinatal and Pediatric Nutrition (II) (Poster Session)

(P18-043-23) Association Between Anemia and the Risk of Maternal Peripartum Depression: A Systematic Review and Meta-Analysis

Sunday, July 23, 2023

11:45 AM – 12:45 PM ET

Location: Poster Board 517

Presenting Author(s)

Nandita Perumal, PhD

Assistant Professor
Department of Epidemiology and Biostatistics, University of South Carolina; Institute for Health Metrics and Evaluation, University of Washington
Boston, Massachusetts, United States

Co-Author(s)

HT

Heather Taylor

University of Washington
DR

Dong Keun Rhee

University of Washington
HT

Heidi Tandiono

University of Washington
EC

Eunice Chung

University of Washington
KF

Kia Fuller

University of Washington
Nicholas J. Kassebaum, MD

Associate Professor
University of Washington & Seattle Children's Hospital
Seattle, Washington, United States

Disclosure(s):

Nandita Perumal, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Anemia, defined as hemoglobin concentration below a threshold value, remains a substantial global public health problem, particularly among pregnant women. We conducted a systematic review and meta-analysis to investigate whether low hemoglobin and/or anemia increased the risk of maternal peripartum depression.

Methods: We systematically searched PubMed, EMBASE, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SCIELO), Global Index Medicus (GIM), and PsycINFO for peer-reviewed studies published from 1980 onwards that investigated the relationship between low hemoglobin, anemia, or iron status and maternal depression. Studies were included if they measured hemoglobin or iron status; depression among pregnant, lactating or postpartum mothers up to one year after delivery; and quantified the association between hemoglobin, anemia, and/or iron status and peripartum depression. No restrictions were placed based on study design, language, or geographic location. We used conventional meta-analysis methods and a novel ‘burden-of-proof’ framework to estimate the pooled relationship between low hemoglobin and maternal peripartum depression. This review was registered with PROSPERO (CRD42022364816).

Results: Of the 535 titles and abstracts screened for eligibility, 33 studies from 23 different countries were included for full-text review. Studies were published between 1994 to 2022, with the majority (91%) being published after the year 2010. Most studies were cohorts (n=23; 70%), followed by cross-sectional (n=7; 21%) and case-control (n=6; 18%) study designs; only two studies were randomized controlled trials. Anemia during pregnancy was associated with a higher likelihood of maternal peripartum depression (pooled odds ratio [OR]: 1.36, 95% CI: 1.12, 1.65; n=16, I²=88%; Tau²=0.097). We examine the impact of heterogeneity in definitions of exposure and outcome, covariate adjustment, and study designs on the relationship between low hemoglobin/anemia and maternal depression using ‘burden-of-proof' risk function.

Conclusions: Anemia during pregnancy is associated with higher odds of peripartum depression; however, there is substantial heterogeneity in the observed association due to study design factors.

Funding Sources: Bill and Melinda Gates Foundation