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Multicenter Study
. 2025 Oct;132(11):1644-1654.
doi: 10.1111/1471-0528.18289. Epub 2025 Jul 14.

Association Between Post-Partum Anaemia and Depressive Symptoms at Two Months After Vaginal Delivery: A Secondary Analysis of the TRAAP Trial

Lola Loussert  1   2 , Loïc Sentilhes  3 , Alizée Froeliger  1   3 , Aurélien Seco  4 , Marie Pierre Bonnet  1   5 , Sarah Tebeka  6   7 , Catherine Deneux-Tharaux  1 ; TRAAP study group
Collaborators, Affiliations
Multicenter Study

Association Between Post-Partum Anaemia and Depressive Symptoms at Two Months After Vaginal Delivery: A Secondary Analysis of the TRAAP Trial

Lola Loussert et al. BJOG. 2025 Oct.

Abstract

Objective: To assess the association between maternal haemoglobinaemia in the immediate post-partum period and PPD symptoms 2 months after vaginal delivery.

Design: Ancillary cohort study of the TRAAP trial, a multicentre trial.

Setting: In France, 2015-2016.

Population: Women with a singleton pregnancy and vaginal delivery ≥ 35 weeks. We excluded women with known psychiatric conditions and those who were non-respondent to the Edinburgh Post-partum Depression Scale (EPDS) questionnaire.

Methods: The exposure was immediate post-partum haemoglobinemia (systematically collected in TRAAP trial) as a continuous variable.

Main outcome: PPD symptoms at 2 months post-partum, defined as an EPDS score ≥ 11. We also differentiated two levels of PPD symptom severity: moderate (11 ≤ EPDS < 13) and severe (EPDS ≥ 13) depressive symptoms.

Results: Amongst the 2672 women included, 1115 (43.6%) had post-partum anaemia (haemoglobin < 11 g/dL) in the immediate post-partum and 369 (13.8%) had PPD symptoms at 2 months. The relation between haemoglobin and PPD symptoms was linear. In the multivariable analysis, each 1 g/dL increase in haemoglobin level was associated with a 9% decrease in the risk of post-partum depression symptoms (adjusted Relative Risk 0.91; 95% CI 0.82-0.997). Post-partum haemoglobin was specifically associated with moderate depressive symptoms (adjusted Relative Risk 0.84; 95% CI, 0.72-0.98) but not with severe depressive symptoms (aRR 0.95; 95% CI, 0.84-1.07).

Conclusions: In women with vaginal delivery, each 1 g/dL increase in haemoglobin level was associated with a 9% decrease in the risk of post-partum depression symptoms.

Keywords: maternal mental health; post‐partum anaemia; post‐partum depression; post‐partum haemoglobin level; vaginal delivery.

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Conflict of interest statement

L.S. performed consultancy work and was a lecturer for Ferring Laboratories, GlaxoSmithKline, and Bayer. Moreover, L.S. has been a lecturer for Norgine for 3 years. M.P.B. has received honoraria from Novonordisk and 3 M Health Care. The other authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Study population. EPDS, Edinburgh Postpartum Depression Scale.
See this image and copyright information in PMC

References

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