The Effectiveness of Iron Supplementation on Postpartum Depression in Low- and Middle-Income Countries: A Systematic Review

Abstract

Introduction: Postpartum depression (PPD) is a significant mental health challenge among women in low- and middle-income countries (LMICs), with iron deficiency recognized as a potential risk factor. Objective: This systematic review aimed to evaluate the effectiveness of iron supplementation in reducing postpartum depression among women in low- and middle-income countries. Method: Following PRISMA 2020 guidelines, PubMed, Scopus, ScienceDirect, and Google Scholar were searched for English-language randomized controlled trials, clinical trials, and quasi-experimental studies on iron supplementation in postpartum women published from 2015–2026. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Results and Discussion: Eleven studies involving 8,337 participants met the inclusion criteria, showing mixed evidence: two reported significant reductions in depressive symptoms following supplementation, while most found no significant difference versus comparators. Variations likely reflect differing participant characteristics, interventions, duration, and PPD's multifactorial nature. Conclusion: Iron supplementation may contribute to reducing postpartum depressive symptoms in some women; however, current evidence remains inconclusive. Further well-designed randomized controlled trials are required to clarify its effectiveness