IRON DEFICIENCY ANEMIA AND POSTPARTUM DEPRESSION – AN EVIDENCE-BASED REVIEW

Introduction and Objective: In Portugal, primary care plays an important role as the first contact of pregnant women with the health care system. Postpartum Depression (PPD) is a common psychiatric illness which affects mother's mental health, as well as the family relationship with the newborn. Recently, iron deficiency anemia has been considered a PPD risk factor. The objective is to show the relationship between anemia during pregnancy/postpartum period and PPD, as well as understanding if iron suplemmentation reduces the incidence of PPD. METHOD: Data were obtained through clinical guidelines, systematic reviews, meta-analysis and clinical trials published between February 2006 to February 2016, in Portuguese and in English, on Pubmed, NGClearinghouse, CMA Infobase, NICE, The Cochrane Library, Bandolier, USPTF, DARE and NEJM. Three MeSH terms were used: “anemia”, “iron” and “postpartum depression”. The "Strength of Recommendation Taxonomy Scale" of the "American Family Physician" was used to grade the evidence. RESULTS and CONCLUSIONS: 356 studies were found. Seven studies met the inclusion criteria: six randomized clinical trials and one systematic review. There is evidence that anemia during pregnancy/postpartum period might be a risk factor for PPD. Early supplementation of iron in women with PPD proved beneficial in some studies. In a clinical trial, there was no evidence of the existence of a relationship between maternal iron levels and the risk of PPD development. We conclude that there is scientific evidence of the benefit of iron supplementation during pregnancy and the postpartum period, on the reduction of PPD.