Maternal iron status and depressive symptoms in rural Bangladesh

Iron deficiency and maternal depression are prevalent in developing countries like Bangladesh. Our aim was two‐fold: 1) determine the relationship between iron status and maternal depressive symptoms; 2) assess the Center for Epidemiological Studies Depression Scale (CESD) in women of rural Bangladesh. Mother‐infant dyads taken from a larger RCT (Chang et al., 2010) to improve diarrhea and anemia in rural Bangladesh were analyzed. Depressive symptoms were collected at baseline (n=113), 3 mo (n=319), and 6 mo (n=328). Maternal ferritin and transferrin receptor were collected between baseline and 3 mo (n=307) and at 6 mo (n=108). Factor analysis of CESD structure resulted in a 3‐factor solution: interpersonal difficulty/somatic inhibition, depressed affect, and well‐being. We found a 70.3% prevalence of high depressive symptoms (CESD ≥ 16) but low prevalence (11.2%) of iron depletion (ferritin < 20 ng/mL). Nonetheless, iron depleted (ID) women had higher depressive symptoms than iron sufficient (IS) women at every time point (ANOVA, p<0.04). Multivariate regression adjusted for covariates (child age & sex, WAZ, assets), revealed that body iron at 6 mo (assessed with Cook's equation) was related to the “depressed affect” factor scores at 6 mo (p<0.048). This relationship between iron depletion and CESD symptomatology warrants validation of CESD factor structure and cutoff point in Bangladesh. Grant Funding Source : USAID to the Johns Hopkins Global Research Activity Cooperative Agreement