Postpartum anemia remains common and undermines early recovery. We aimed to identify risk factors for postpartum anemia among immediate postpartum women at a Peruvian Air Force hospital.

We conducted a retrospective case-control study at the Central Hospital of the Peruvian Air Force (Lima, Peru) from January to December 2024, including 120 immediate postpartum women (55 cases with postpartum anemia; 65 controls without). Data were abstracted from standardized medical records and analyzed using bivariate tests and logistic regression.

Postpartum anemia occurred in 45.8% of women. In bivariate analyses, fewer prenatal visits (median 9 vs. 10; p = 0.030) and antenatal anemia (25.5% vs. 0.0%; p < 0.001) were associated with postpartum anemia. In the adjusted model, prenatal visits showed a marginal inverse association (adjusted odds ratio [aOR] = 0.86; 95% confidence intervals [CI]: 0.74–1.01; p = 0.060). No significant associations were found for education, marital status, parity, mode of delivery, body mass index (BMI), or gestational weight gain. Antenatal anemia was excluded from the multivariable model because of perfect prediction.

In this cohort, fewer prenatal visits showed a marginal association with immediate postpartum anemia, while antenatal anemia was the dominant risk factor. Practice should prioritize timely third-trimester hemoglobin screening and correction of antenatal anemia, reliable iron-folate supply with adherence support, and immediate postpartum testing with structured discharge counseling, with targeted counseling for women with antenatal anemia or fewer prenatal visits.