(515) Can the supplementation of ferric-carboxymaltose improve postpartum depression after birth? a randomized, controlled clinical trial

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Jeong-won Oh, N/A

Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine
Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine/Seoul, Seoul-t'ukpyolsi, Republic of Korea

Coauthor(s)

EL

Eun Sil Lee

Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul
Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
KC

Kyu Yeon Choi

Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul
Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
Subeen Hong, MD, PhD

Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Hyun Sun Ko, MD, PhD

Department of Obstetrics and Gynecology, Catholic University College of Medicine/ Seoul
Catholic University College of Medicine/ Seoul, Seoul-t'ukpyolsi, Republic of Korea
GC

Geun Joon Cho, MD

Department of Obstetrics and Gynecology, Korea University College of Medicine/ Seoul, Seoul-t'ukpyolsi, Republic of Korea
JL

Jeong Jae Lee

Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul
Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea

Objective: This study aims to compare the efficacy of intravenous(IV) ferric-carboxymaltose(FCM) administration versus conventional oral iron supplementation in improving postpartum depression(PPD) in postpartum women with iron-deficiency anemia(IDA).

Study Design: A randomized, open-label, controlled clinical trial was conducted at three centers in South Korea between 2021 and 2023. Postpartum women with (i)moderate IDA, diagnosed with hemoglobin(Hb) levels of 8≤ Hb< 11g/dL and ferritin< 30ng/mL or transferrin saturation(TSAT) < 20%, and with (ii)a high risk of PPD based on the Edinburgh Postnatal Depression Scale(EPDS) score of ≥ 8 within the first three days after delivery, were enrolled. Following randomization, participants received either IV FCM(500-1000 mg) or oral iron(20-400 mg). The primary endpoint was the change in EPDS score from baseline to 8 weeks postpartum. Hematologic parameters, presence of PPD (EPDS score > 11), and maternal fatigue were evaluated at ten days, 4, 6, and 8 weeks.

Results: Among 96 patients, 90 were analyzed, with 45 in each group. The aggregated change in EPDS scores over 8 weeks postpartum did not differ between the groups, while the mean EPDS score(±SD) for the entire study population significantly decreased from 11.5 ± 3.2 initially to 8.6±5.0 at 8 weeks(p-value for trend < 0.001). The prevalence of PPD at 8 weeks was 22.2 %(10/45) in each group, with no significant difference. Variables such as Hb changes and type of iron therapy did not affect the risk of PPD, except for fatigue at 8 weeks (adjusted odds ratio 1.05, 95% confidence interval 1.01–1.09; P=0.016). Hb levels increased well in both groups, but changes in Hb, ferritin, and TSAT levels at 8 weeks (p < 0.001) and fatigue scores at 6 weeks(p = 0.03) were significantly improved in the IV iron group compared to the conventional group.

Conclusion: While the administration of FCM did not show significant benefits over placebo in improving EPDS scores, the study`s findings demonstrated that IV iron was more effective than conventional oral iron in correcting postpartum IDA, iron stores and reducing fatigue.