title: The efficacy of early iron supplementation on postpartum depression, a randomized double-blind placebo-controlled trial.
abstract: OBJECTIVE
  Evaluating early iron supplementation in non-anemic mothers with postpartum depression (PPD).
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Maternal, Fetal and Neonatal Research Center, Vali-asr Hospital, Imam Khomeini Hospital Complexes, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, 1419733141, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sheikh
authors.affiliation: Maternal, Fetal and Neonatal Research Center, Vali-asr Hospital, Imam Khomeini Hospital Complexes, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, 1419733141, Iran.|Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Hantoushzadeh
authors.affiliation: Maternal, Fetal and Neonatal Research Center, Vali-asr Hospital, Imam Khomeini Hospital Complexes, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, 1419733141, Iran.|Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
authors.affiliation: Maternal, Fetal and Neonatal Research Center, Vali-asr Hospital, Imam Khomeini Hospital Complexes, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, 1419733141, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Farahani
authors.affiliation: Maternal, Fetal and Neonatal Research Center, Vali-asr Hospital, Imam Khomeini Hospital Complexes, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, 1419733141, Iran. dr.med.tums@gmail.com.
authors.forename: Ozra
authors.initials: O
authors.lastname: Ebrahiminasab
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology / Q000523:psychology; D058070:Asymptomatic Diseases / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D019052:Depression, Postpartum / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019587:Dietary Supplements; D004311:Double-Blind Method; D042241:Early Diagnosis; D005260:Female; D005293:Ferritins / Q000819:agonists / Q000097:blood; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D019266:Iron, Dietary / Q000627:therapeutic use*; D009752:Nutritional Status; D049590:Postpartum Period; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006397:Hematinics; D019266:Iron, Dietary; D005293:Ferritins
keywords: Anemia; Deficiency; Depressed; Ferritin; Postnatal