Impact of third-trimester maternal iron parameters and vitamin D status on early postpartum depression, fatigue, and breastfeeding self-efficacy

Abstract Background This study aims to investigate the associations between hemoglobin, hematocrit, serum ferritin, and vitamin D levels and postpartum depression, fatigue, and breastfeeding self-efficacy in the early postpartum period. Methods The study was designed as a descriptive, cross-sectional investigation. This study was conducted between July 2025 and November 2025 with 200 pregnant women who attended routine third-trimester prenatal follow-up visits at the obstetrics and gynecology outpatient clinics of a university hospital located in the Marmara region of Türkiye. Study data were collected using a Descriptive Information Form, the Visual Analogue Scale for Fatigue (VAS-F), the Edinburgh Postpartum Depression Scale (EPDS), and the Postpartum Breastfeeding Self-Efficacy Scale (BSES-SF). Results During the last-trimester prenatal follow-up, with 66.27% of the women having Hb levels < 11.0 g/dL, 64.50% had ferritin levels < 12 µg/L, only 15.98% of the women had serum 25(OH)D levels > 20 ng/mL and postpartum depression risk (EPDS ≥ 12) was identified in 30.5% of the participants. The mean scores of the VAS-F, BSES-SF and EPDS were 84.50 ± 19.47, 57.64 ± 9.05 and 7.28 ± 4.62 respectively. A strong positive correlation was observed between the VAS-F total score and the Edinburgh Postnatal Depression Scale (EPDS) total score ( r = 0.720, p < 0.001, 95% CI [0.643–0.783]). Finally, a strong negative correlation was found between the Postpartum Breastfeeding Self-Efficacy Scale and the EPDS total score ( r = − 0.714, p < 0.001, 95% CI [− 0.780–−0.636]). Conclusion Our findings underscore the importance of early screening for postpartum depression and breastfeeding self-efficacy within routine postpartum care, as well as the need to develop individualized preventive interventions targeting fatigue and anemia.