Iron Deficiency and Risk of Maternal Depression in Pregnancy: An Observational Study

J Obstet Gynaecol Can. 2018 Jun;40(6):698-703. doi: 10.1016/j.jogc.2017.09.027. Epub 2018 Jan 4.


Objective: Maternal depression during pregnancy can affect both the mother and her family. Although research has suggested that iron deficiency is associated with depression in the general population, this link has not been examined during the antenatal period. Our objective was to determine whether iron deficiency is associated with maternal depression during middle to late pregnancy.

Methods: A retrospective study was conducted using the medical records of patients seen at the Women's Health Concerns Clinic at St. Joseph's Healthcare Hamilton in Hamilton, Ontario between 2009 and 2016. Women with serum ferritin data during middle to late pregnancy (>20 weeks' gestation) (N = 142) were categorized as either iron deficient (ferritin <12 µg/L) or iron sufficient. Edinburgh Postnatal Depression Scale (EPDS) scores and the odds of developing antenatal depression (EPDS ≥12) between the two groups were compared.

Results: Iron deficient pregnant women scored significantly higher on the EPDS (10.14 ± 5.69 vs. 7.87 ± 5.75; P = 0.03) and were more likely to develop antenatal depression (45% vs. 25%; P = 0.02) compared with women who were not. The odds of developing antenatal depression were two and one half times higher among iron deficient women (adjusted OR 2.51; 95% CI 1.14-5.52).

Conclusion: These findings suggest that iron deficiency is associated with higher levels of depression during pregnancy. Although these results require replication, iron deficiency may be an important risk factor for maternal depression during pregnancy.

Keywords: Depression; antenatal; iron deficiency; pregnancy; screening.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Depression / complications
  • Depression / epidemiology*
  • Female
  • Ferritins / blood
  • Gestational Age
  • Humans
  • Iron / deficiency*
  • Odds Ratio
  • Ontario
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / psychology
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Risk Factors


  • Ferritins
  • Iron