Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Anaemia and depression before and after birth: a cohort study based on linked population data

Authors: Fenglian Xu, Lynette Roberts, Colin Binns, Elizabeth Sullivan, Caroline S. E. Homer

Published in: BMC Psychiatry | Issue 1/2018

Login to get access

Abstract

Background

To investigate the rates of hospitalisation for anaemia and depression in women in the six-year period (3 years before and after birth). To compare hospital admissions for depression in women with and without anaemia.

Methods

This is a population-based cohort study. Women’s birth records (New South Wales (NSW) Perinatal Data Collection) were linked with NSW Admitted Patients Data Collection records between 1 January 2001 and 31 December 2010, so that hospital admissions for mothers could be traced back for 3 years before birth and followed up 3 years after birth. Setting: NSW Australia. Subjects: all women who gave birth to their first child in NSW between 1 January 2004 and 31 December 2008.

Results

Hospital admissions for both anaemia and depression were increased significantly in the year just before and after birth compared with the years before and after. Women with anaemia were more likely to be admitted to hospital for depression than those without (for principal diagnosis of depression, adjusted OR = 1.62, 95% CI = 1.25–2.11; for all diagnosis of depression, adjusted OR = 2.01, 95% CI = 1.70–2.38).

Conclusions

Depression was associated with anaemia in women before and after birth. This finding highlight the important role of primary care providers in assessing for both anaemia and depressive symptomatology together, given the relationship between the two. Treating or preventing anaemia may help to prevent postnatal depression.
Literature
1.
Chen M-H, Su T-P, Chen Y-S, Hsu J-W, Huang K-L, Chang W-H, Chen T-J, Bai Y-M. Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study. BMC Psychiatry. 2013;13(1):161.CrossRefPubMedPubMedCentral
2.
Korkmaz S, Yıldız S, Korucu T, Gundogan B, Sunbul ZE, Korkmaz H, Atmaca M. Frequency of anemia in chronic psychiatry patients. Neuropsychiatr Dis Treat. 2015;11:2737.CrossRefPubMedPubMedCentral
3.
World Health Organization. Mental health aspects of women’s reproductive health : a global review of the literature. Geneva: WHO Library Cataloguing-in-Publication Data; 2009.
4.
Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012;25(2):141–8.CrossRefPubMedPubMedCentral
5.
Muzik M, Bocknek E, Broderick A, Richardson P, Rosenblum K, Thelen K, Seng J. Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories. Arch Womens Ment Health. 2013;16(1):29–38.CrossRefPubMed
6.
O’Higgins M, Roberts I, Glover V, Taylor A. Mother-child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks. Arch Womens Ment Health. 2013;16(5):381–9.CrossRefPubMed
7.
Beestin L, Hugh-Jones S, Gough B. The impact of maternal postnatal depression on men and their ways of fathering: an interpretative phenomenological analysis. Psychol Health. 2014;29(6):717–35.CrossRefPubMed
8.
Letourneau NL, Dennis C-L, Benzies K, Duffett-Leger L, Stewart M, Tryphonopoulos PD, Este D, Watson W. Postpartum depression is a family affair: addressing the impact on mothers, fathers, and children. Issues Ment Health Nurs. 2012;33(7):445–57.CrossRefPubMed
9.
Apter-Levy Y, Feldman M, Vakart A, Ebstein RP, Feldman R. Impact of maternal depression across the first 6 years of life on the Child’s mental health, social engagement, and empathy: the moderating role of oxytocin. Am J Psychiatr. 2013;170(10):1161–8.CrossRefPubMed
10.
Pearson RM, Bornstein MH, Cordero M, Scerif G, Mahedy L, Evans J, Abioye A, Stein A. Maternal perinatal mental health and offspring academic achievement at age 16: the mediating role of childhood executive function. J Child Psychol Psychiatry. 2016;57(4):491-501.
11.
Buist AE, Austin M-PV, Hayes BA, Speelman C, Bilszta JL, Gemmill AW, Brooks J, Ellwood D, Milgrom J. Postnatal mental health of women giving birth in Australia 2002–2004: findings from the beyondblue National Postnatal Depression Program. Aust N Z J Psychiatry. 2008;42(1):66–73.CrossRefPubMed
12.
Eastwood JG, Phung H, Barnett B. Postnatal depression and socio-demographic risk: factors associated with Edinburgh depression scale scores in a metropolitan area of new South Wales, Australia. Aust N Z J Psychiatry. 2011;45(12):1040–6.CrossRefPubMed
13.
PANDA. The cost of perinatal depression in Australia: final report - post and antenatal depression association. Sydney Avenue: Deloitte Access Economics; 2012.
14.
Woolhouse H, Gartland D, Perlen S, Donath S, Brown SJ. Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study. Midwifery. 2014;30(3):378–84.CrossRefPubMed
15.
Xu F, Sullivan EA, Li Z, Burns L, Austin MP, Slade T. The increased trend in mothers’ hospital admissions for psychiatric disorders in the first year after birth between 2001 and 2010 in new South Wales, Australia. BMC Womens Health. 2014;14:119.CrossRefPubMedPubMedCentral
16.
Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, Peña-Rosas JP, Bhutta ZA, Ezzati M. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16-e25.CrossRefPubMedCentral
17.
Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002–2010 in Finland. BMJ Open. 2014;4(11):e004883.CrossRefPubMedPubMedCentral
18.
Albacar G, Sans T, Martín-Santos R, García-Esteve L, Guillamat R, Sanjuan J, Cañellas F, Gratacòs M, Cavalle P, Arija V. An association between plasma ferritin concentrations measured 48h after delivery and postpartum depression. J Affect Disord. 2011;131(1):136–42.CrossRefPubMed
19.
Corwin EJ, Murray-Kolb LE, Beard JL. Low hemoglobin level is a risk factor for postpartum depression. J Nutr. 2003;133(12):4139–42.CrossRefPubMed
20.
Armony-Sivan R, Shao J, Li M, Zhao G, Zhao Z, Xu G, Zhou M, Zhan J, Bian Y, Ji C. No relationship between maternal iron status and postpartum depression in two samples in China. J Pregnancy. 2012;2012:521431.CrossRefPubMedPubMedCentral
21.
National Centre for Classification in Health. The international statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM). Sydney: National Centre for Classification in Health; 1999.
22.
Australian Institute of Health and Welfare. Australian hospital statistics 2008–09. Health services series no. 17. Cat. no. HSE 84. Canberra: AIHW; 2010.
23.
Adhikari P. Socio-economic indexes for areas: introduction, use and future directions, vol. 1351.0.55.015. Canberra: Australian Bureau of Statistics; 2006.
24.
Almond P. Postnatal depression: a global public health perspective. Perspect Public Health. 2009;129(5):221–7.CrossRefPubMed
25.
Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol. 2011;90(11):1247–53.CrossRefPubMed
26.
27.
Shariatpanaahi MV, Shariatpanaahi ZV, Moshtaaghi M, Shahbaazi S, Abadi A. The relationship between depression and serum ferritin level. Eur J Clin Nutr. 2007;61(4):532–5.CrossRef
28.
Lever-van Milligen BA, Vogelzangs N, Smit JH, Penninx BW. Hemoglobin levels in persons with depressive and/or anxiety disorders. J Psychosom Res. 2014;76(4):317–21.CrossRefPubMed
29.
30.
31.
Willner P, Scheel-Krüger J, Belzung C. The neurobiology of depression and antidepressant action. Neurosci Biobehav Rev. 2013;37(10, Part 1):2331–71.CrossRefPubMed
32.
Haase J, Brown E. Integrating the monoamine, neurotrophin and cytokine hypotheses of depression—a central role for the serotonin transporter? Pharmacol Ther. 2015;147:1–11.CrossRefPubMed
33.
34.
Beard JL, Hendricks MK, Perez EM, Murray-Kolb LE, Berg A, Vernon-Feagans L, Irlam J, Isaacs W, Sive A, Tomlinson M. Maternal iron deficiency anemia affects postpartum emotions and cognition. J Nutr. 2005;135(2):267–72.CrossRefPubMed
35.
Maes M, Van de Vyvere J, Vandoolaeghe E, Bril T, Demedts P, Wauters A, Neels H. Alterations in iron metabolism and the erythron in major depression: further evidence for a chronic inflammatory process. J Affect Disord. 1996;40(1–2):23–33.CrossRefPubMed
36.
Schiepers OJ, Wichers MC, Maes M. Cytokines and major depression. Prog Neuro-Psychopharmacol Biol Psychiatry. 2005;29(2):201–17.CrossRef
37.
Maes M. Evidence for an immune response in major depression: a review and hypothesis. Prog Neuro-Psychopharmacol Biol Psychiatry. 1995;19(1):11–38.CrossRef
38.
Maes M, Song C, Lin A, De Jongh R, Van Gastel A, Kenis G, Bosmans E, De Meester I, Benoy I, Neels H, et al. The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and Th1-like response in stress-induced anxiety. Cytokine. 1998;10(4):313–8.CrossRefPubMed
39.
Young JJ, Bruno D, Pomara N. A review of the relationship between proinflammatory cytokines and major depressive disorder. J Affect Disord. 2014;169:15–20.CrossRefPubMed
40.
Miller AH, Maletic V, Raison CL. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry. 2009;65(9):732–41.CrossRefPubMedPubMedCentral
41.
42.
Kim Y-K, Na K-S, Myint A-M, Leonard BE. The role of pro-inflammatory cytokines in neuroinflammation, neurogenesis and the neuroendocrine system in major depression. Prog Neuro-Psychopharmacol Biol Psychiatry. 2016;64:277–84.CrossRef
43.
Rybka J, Kędziora-Kornatowska K, Banaś-Leżańska P, Majsterek I, Carvalho LA, Cattaneo A, Anacker C, Kędziora J. Interplay between the pro-oxidant and antioxidant systems and proinflammatory cytokine levels, in relation to iron metabolism and the erythron in depression. Free Radic Biol Med. 2013;63:187–94.CrossRefPubMed
44.
Taraz M, Khatami M-R, Gharekhani A, Abdollahi A, Khalili H, Dashti-Khavidaki S. Relationship between a pro-and anti-inflammatory cytokine imbalance and depression in haemodialysis patients. Eur Cytokine Netw. 2012;23(4):179–86.PubMed
45.
Jones I, Heron J, Blackmore ER, Craddock N. Incidence of hospitalization for postpartum psychotic and bipolar episodes. Arch Gen Psychiatry. 2008;65(3):356.CrossRefPubMed
46.
Matthey S, Ross-Hamid C: The validity of DSM symptoms for depression and anxiety disorders during pregnancy. J Affect Disord. 2011;133(3):546-52.
47.
Di Florio A, Meltzer-Brody S. Is postpartum depression a distinct disorder? Curr Psychiatry Rep. 2015;17(10):1–6.CrossRef
48.
Hoertel N, López S, Peyre H, Wall MM, González-Pinto A, Limosin F, Blanco C. Are symptom features of depression during pregnancy, the postpartum period and outside the Peripartum period distinct? Results from a nationally representative sample using item response theory (IRT). Depress Anxiety. 2015;32(2):129–40.CrossRefPubMed
49.
Giallo R, Gartland D, Woolhouse H, Brown S. Differentiating maternal fatigue and depressive symptoms at six months and four years post partum: considerations for assessment, diagnosis and intervention. Midwifery. 2015;31(2):316–22.CrossRefPubMed
50.
NICE. Antenatal and postnatal mental health: clinical management and service guidance. 2015.
51.
Goodman JH, Tyer-Viola L. Detection, treatment, and referral of perinatal depression and anxiety by obstetrical providers. J Women's Health. 2010;19(3):477–90.CrossRef
52.
National Blood Authority. The national blood authority’s patient blood management guideline: module 5 - obstetrics and maternity. 2015.
53.
Beyondblue. Clinical practice guidelines for depression and related disorders – anxiety, bipolar disorder and puerperal psychosis – in the perinatal period. A guideline for primary care health professionals. Melbourne: Beyondblue: The National Depression Initiative; 2011.
54.
Khambalia AZ, Collins CE, Roberts CL, Morris JM, Powell KL, Tasevski V, Nassar N. Iron deficiency in early pregnancy using serum ferritin and soluble transferrin receptor concentrations are associated with pregnancy and birth outcomes. Eur J Clin Nutr. 2016;70(3):358–63.CrossRefPubMed
55.
Vliegen N, Casalin S, Luyten P. The course of postpartum depression: a review of longitudinal studies. Harv Rev Psychiatry. 2014;22(1):1–22.CrossRefPubMed
Metadata
Title
Anaemia and depression before and after birth: a cohort study based on linked population data
Authors
Fenglian Xu
Lynette Roberts
Colin Binns
Elizabeth Sullivan
Caroline S. E. Homer
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1796-6

Other articles of this Issue 1/2018

BMC Psychiatry 1/2018 Go to the issue

Research article

What might affect acceptability of online positive psychology interventions for depression: a qualitative study on patient expectations’

Study protocol

B-positive: a randomized controlled trial of a multicomponent positive psychology intervention for euthymic patients with bipolar disorder - study protocol and intervention development

Research article

Medication review plus person-centred care: a feasibility study of a pharmacy-health psychology dual intervention to improve care for people living with dementia

Correction

Correction to: Effectiveness of aripiprazole once-monthly in schizophrenia patients pretreated with oral aripiprazole: a 6-month, real-life non-interventional study

Debate

Adapted psychotherapy for suicidal geriatric patients with depression

Research article

Predictors of quality of life among inpatients in forensic mental health: implications for occupational therapists