Influence of Perceived Stress on Hemoglobin Concentration

High rate of anemia and stress is reported in medical students. Experimental studies in animals have indicated that psychological stress may lead to iron deficiency anemia. Therefore we investigated the association between perceived stress and hemoglobin concentration in medical students. 84 medical students aged between 19-21 years were studied. The main parameters measured were hemoglobin concentration, perceived stress and diet. The perceived stress was measured using Cohen's perceived stress scale. Diet was estimated by a dietician's questionnaire. Hemoglobin was measured by digital hemoglobin meter using capillary blood. In male subjects, hemoglobin concentration below 13.5 gm% and in female subjects below 11.5 gm% was taken as low (group A) and the rest were considered as with normal hemoglobin (group B). Data analysis included unpaired t test, Mann- Whitney U test and Chi-square test. Level of significance was taken at p value less than 0.05. Hemoglobin concentration was negatively correlating with perceived stress score and positively correlating with diet score (r = - 0. 26, p = 0.015; r = 0.25, p = 0.018 respectively). Mean perceived stress score of group A was higher compared to group B (Mann-Whitney U-statistic = 614.00, p = 0.0376). Frequency of subjects with high perceived stress score in group A was higher compared to group B (Chi-square = 8.0188, p = 0.00463). The diet score did not differ significantly between group A and group B. High perceived stress may contribute to development of iron deficiency anemia in undergraduate medical students.