Résumé
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.