Anemia in pregnancy: a systematic review and meta-analysis of prevalence, determinants, and health impacts in Egypt.
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Authors
Azzam, Ahmed
Khaled, Heba
Alrefaey, Alrefaey K
Basil, Amar
Ibrahim, Sarah
Elsayed, Mohamed S
Khattab, Muhammad
Nabil, Nashwa
Abdalwanees, Esraa
Halim, Hala Waheed Abdel
Issue Date
2025-01-14
Type
Journal Article
Systematic Review
Meta-Analysis
Systematic Review
Meta-Analysis
Language
en
Keywords
Anemia , Apgar , Complications , Determinants , Egypt , Meta-analysis , Pregnancy
Alternative Title
Abstract
Background: The WHO considers anemia in pregnancy a severe public health issue when prevalence surpasses 40%. In response, we conducted a systematic review and meta-analysis to examine anemia among pregnant women in Egypt, focusing on its prevalence, determinants, and associated complications.
Methods: We conducted a systematic literature search for studies published between January 1, 2010, and August 18, 2024, to identify studies from Egypt reporting on anemia in pregnant women, including its prevalence, associated determinants, and complications. A meta-analysis was conducted using a random-effects model to estimate pooled prevalence, odds ratios (OR), and standardized mean differences (SMD). Sensitivity analyses and publication bias were performed. All statistical analyses were conducted using R software.
Results: Eighteen studies met the eligibility criteria with a total sample size of 14,548. The overall prevalence of anemia among pregnant women was 49% (95% CI: 42-57), with no significant difference between Upper and Lower Egypt (P = 0.66). The sensitivity analysis demonstrated the absence of influential outliers and Egger's test indicated no evidence of publication bias (P = 0.17). Anemia prevalence was significantly higher in the third trimester (65%) compared to the second trimester (47%) (P = 0.03). Among anemic pregnant women, most cases were mild (47%) and moderate (47%). The determinants of anemia among pregnant women included being over 30 years old (OR: 1.95), residing in rural areas (OR: 1.76), illiteracy (OR: 1.93), birth spacing < 2 years (OR: 2.04), lack of iron supplementation (OR: 2.59), presence of intestinal parasites (OR: 1.38), antenatal visits < 5 (OR: 5.27), multiparity, and low income, all with statistical significance (p < 0.05). Regarding dietary determinants, a low intake of meat, vegetables, fruits, and high tea consumption was consistently associated with a higher risk of anemia. For neonatal complications, infants born to anemic mothers had significantly lower Apgar scores, gestational ages, and birth weights (P < 0.05), with birth weight being the most adversely impacted (SMD = -1.3).
Conclusions: This meta-analysis shows 49% anemia prevalence in pregnant Egyptian women, indicating severe health concern. The findings highlight the urgent need for targeted interventions aimed at addressing the key determinants identified in this study.
Description
© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Citation
Azzam, A. et al. (2025) 'Anemia in pregnancy: a systematic review and meta-analysis of prevalence, determinants, and health impacts in Egypt', BMC Pregnancy and Childbirth 25(1) 29. Available At: https://doi.org/10.1186/s12884-024-07111-9
Publisher
BMC
License
© 2024. The Author(s).
Journal
BMC pregnancy and childbirth
Volume
25
Issue
1
PubMed ID
ISSN
1471-2393