Does recombinant human erythropoietin not only treat anemia but reduce postpartum (emotional) distress as well?

Abstract

Based on the established rhEPO treatment of anemia in endstage renal failure, which results in improved quality of life, and on the clinical observation that patients with postpartum anemia treated with rhEPO seemed to gain a more stable mood, we inferred that there is a beneficial side-effect of rhEPO on postpartum blues. The aim of this study was to test the hypotheses 1) that postpartum anemia aggravates, and 2) that treatment of postpartum anemia with rhEPO reduces maternity blues. The results show that on the fifth day postpartum anemic patients score consistently worse than nonanemic women on the Symptom Checklist SCL-90-R, indicating more symptoms and distress in general, and also more symptoms characteristic of maternity blues (p < 0.05). On a "Blues Questionnaire," postpartum anemia expresses itself with a reduced "well-being" (p < 0.001). Thus, our first hypothesis was verified. There were no differences by the fifth day postpartum between anemic patients receiving either rhEPO or placebo. Our second hypothesis was thus not confirmed within this limited time. We conclude as clinicians that postpartum anemia should be treated effectively to reduce distress and hence the risk for postpartum affective disorders. Follow-up studies after rhEPO treatment beyond the first week post partum are needed. In addition, in investigations on postpartum affective disorders, the hemoglobin concentration should be considered.

No Relationship between Maternal Iron Status and Postpartum Depression in Two Samples in China

“…These negative findings are similar to results in one other large observational study [12] but differ from several studies that found an association [8, 13–15]. There are no obvious or consistent differences between our study and, previous ones in study design, timing, and measures of iron status or PPD.…”

“…One of the earliest studies reported that low Hb was associated with such postnatal symptoms as low energy, faintness/dizziness, painful perineal sutures, and tingling of fingers and toes but not with PPD [12]. In contrast, several subsequent studies found that anemia and/or iron deficiency were associated with increased symptoms of postpartum blues and depression [8, 13–15]. Although postpartum depression was assessed in most of these studies by the Edinburgh Postnatal Depression Scale (EPDS) [16], differences in iron measures make direct comparisons difficult.…”

Effectiveness of recombinant erythropoietin and iron sucrose vs. iron therapy only, in patients with postpartum anaemia and blunted erythropoiesis

“…Patients with postpartum anaemia show more symptoms on the so called symptom checklist SCL-90-R, more symptoms of 'maternity blues' and a reduced sense of well-being compared to nonanaemic patients [45,46]. Effective treatment of anaemia reduces cardiovascular distress and the risk for affective disorders.…”

Erythropoietin: a candidate treatment for mood symptoms and memory dysfunction in depression

“…In contrast, short-term (5 days) EPO vs. placebo treatment of anemic women showed no effect on postpartum blues (Meyer et al 1995). Until recently, the beneficial effects of EPO on mood and cognition were therefore simply attributed to reversal of patients' anemic state with longterm EPO treatment (Jelkmann 1992;Pickett et al 1999).…”