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Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis

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Abstract

Background

Anemia is one of the most critical health conditions affecting people worldwide. The disease is silent, with a slow progression and a few physical symptoms. Anemia during pregnancy carries the risk of premature birth, low birth weight, and fetus malformations and can impose additional costs on society and families. Therefore, the aim of this study is to conduct a systematic review and meta-analysis on the prevalence of anemia in pregnant women worldwide.

Methods

In this work, we have conducted a systematic review and meta-analysis of the studies that have examined the prevalence of anemia in pregnant women globally. The Google Scholar, Cochrane, ScienceDirect, Medline (PubMed), and Web of Science (WoS) databases were searched for articles published between 1991 and 2021. The search keywords were anemia, pregnancy, prevalence, and meta-analysis. In order to analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies was examined using the I2 index. Data analysis was performed within the Comprehensive Meta-Analysis software (Version 2).

Results

The search resulted in 338 deduplicated studies, of which 52 studies with a total sample size of 1,244,747 people were included in this review. According to the results of the meta-analysis, the overall prevalence of anemia in pregnant women is 36.8% (95% confidence interval: 31.5–42.4%). The highest prevalence of anemia is mild at 70.8 (95% CI 58.1–81) and highest in the third trimester of pregnancy with the prevalence of 48.8 (95% CI 38.7–58.9), while the highest prevalence of anemia in pregnant women was in Africa with the prevalence of 41.7 (95% CI 32.3–49.4).

Conclusion

The results of this study show a high prevalence of anemia among pregnant women worldwide, and the highest of this prevalence is mild anemia. The prevalence of anemia in the third trimester was higher than in the first and second trimesters. Anemia in pregnant women in developing countries is significantly higher than in developed countries due to pregnancy’s economic, sociological, and health factors.

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Abbreviations

WoS:

Web of science

WHO:

World Health Organization

AIP:

Anemia during pregnancy

STROBE:

Strengthening the reporting of observational studies in epidemiology

PRISMA:

Preferred reporting items for systematic reviews and meta-analysis

References

  • Abdelgadir, M. A., et al. (2012). Epidemiology of anaemia among pregnant women in Geizera, central Sudan. Journal of Obstetrics and Gynaecology, 32(1), 42–44.

    Article  CAS  PubMed  Google Scholar 

  • Abdelhafez, A. M., & El-Soadaa, S. S. (2012). Prevalence and risk factors of anaemia among a sample of pregnant females attending primary health care centers in Makkah, Saudi Arabia. Pakistan Journal of Nutrition, 11, 1113–1120.

    Article  Google Scholar 

  • Abdelrahim, I. I., Adam, G. K., Mohmmed, A. A., Salih, M. M., Ali, N. I., Elbashier, M. I., et al. (2009). Anaemia, folate, and vitamin B12 deficiency among pregnant women in an area of unstable malaria transmission in eastern Sudan. Transactions of Royal Society Tropical Medicine and Hygiene, 103, 493–496.

    Article  CAS  Google Scholar 

  • Abdelrahman, E. G., Gasim, G. I., Musa, I. R., Elbashir, L. M., & Adam, I. (2012). Red blood cell distribution width and iron deficiency anemia among pregnant Sudanese women. Diagnostic Pathology, 7, 168.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Abou Zahr, C., & Royston, E. (1991). Maternal mortality. A global factbook. WHO.

    Google Scholar 

  • Abriha, A., et al. (2014). Prevalence and associated factors of anemia among pregnant women of Mekelle town: A cross-sectional study. BMC Research Notes, 7, 888.

    Article  PubMed  PubMed Central  Google Scholar 

  • Adam, I., et al. (2005b). Prevalence and risk factors for anaemia in pregnant women of eastern Sudan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 99(10), 739–743.

    Article  PubMed  Google Scholar 

  • Adam, I., Khamis, A. H., & Elbashir, M. I. (2005a). Prevalence and risk factors for anaemia in pregnant women of eastern Sudan. Transactions of Royal Society Tropical Medicine and Hygiene, 99, 739–743.

    Article  Google Scholar 

  • Adanikin, A. I., & Awoleke, J. O. (2016). Sociodemographic factors associated with anaemia in pregnancy at booking for antenatal care. Journal of Obstetrics and Gynaecology, 36(1), 44–47.

    Article  CAS  PubMed  Google Scholar 

  • Agarwal, K. N., Agarwal, D. K., Sharma, A., Sharma, K., Prasad, K., Kalita, M. C., et al. (2006). Prevalence of anaemia in pregnant and lactating women in India. Indian Journal of Medical Research, 124, 173–184.

    CAS  PubMed  Google Scholar 

  • Aikawa, R., et al. (2006). Risk factors for iron-deficiency anaemia among pregnant women living in rural Vietnam. Public Health Nutrition, 9(4), 443–448.

    Article  PubMed  Google Scholar 

  • Alem, M., Enawgaw, B., Gelaw, A., Kena, T., Seid, M., & Olkeba, Y. (2013). Prevalence of anemia and associated risk factors among pregnant women attending antenatal care in Azezo Health Center Gondar town, Northwest Ethiopia. Journal of Interdisciplinary Histopathology, 1(3), 137–144.

    Article  Google Scholar 

  • Ali, A. A., Rayis, D. A., Abdallah, T. M., Elbashir, M. I., & Adam, I. (2011). Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala Hospital, Eastern Sudan. BMC Research Notes, 4, 311.

    Article  PubMed  PubMed Central  Google Scholar 

  • Allen, L. H. (1997a). Pregnancy and iron deficiency: Unresolved issues. Nutrition Reviews, 55, 91–101.

    Article  CAS  PubMed  Google Scholar 

  • Allen, L. H. (1997b). Pregnancy and iron deficiency: Unresolved issues. Nutrition Reviews., 55(4), 91–101. https://doi.org/10.1111/j.1753-4887.1997.tb06460.x

    Article  CAS  PubMed  Google Scholar 

  • Allen, L., de Benoist, B., Dary, O., & Hurrel, R. (2006). Guidelines on food fortification with micronutrients. World Health Organization.

    Google Scholar 

  • Andrews, N. C. (2004). Anemia of inflammation: The cytokine-hepcidin link. The Journal of Clinical Investigation, 113(9), 1251–1253.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Anlaakuu, P., & Anto, F. (2017). Anaemia in pregnancy and associated factors: A cross-sectional study of antenatal attendants at the Sunyani Municipal Hospital, Ghana. BMC Research Notes, 10(1), 402.

    Article  PubMed  PubMed Central  Google Scholar 

  • Antelman, G., Msamanga, G. I., Spiegelman, D., Urassa, E. J. N., Narh, R., Hunter, D. J., & Fawzi, W. W. (2000). Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania. Journal of Nutrition, 130(8), 1950–1957.

    Article  CAS  PubMed  Google Scholar 

  • Ayoya, M. A., Spiekermann-Brouwer, G. M., Traor é, A. K., Stoltzfus, R. J., & Garza, C. (2006). Determinants of anaemia among pregnant women in Mali. Food and Nutrition Bulletin, 27, 3–11.

    Article  PubMed  Google Scholar 

  • Baig-Ansari, N., et al. (2008). Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food and Nutrition Bulletin, 29(2), 132–139.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baingana, R. K., et al. (2015a). The aetiology of anemia during pregnancy: A study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women. Public Health Nutrition, 18(8), 1423–1435.

    Article  PubMed  Google Scholar 

  • Baingana, R. K., et al. (2015b). The aetiology of anaemia during pregnancy: A study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women. Public Health Nutrition, 18(8), 1423–1435.

    Article  PubMed  Google Scholar 

  • Baker, W. F., Jr. (2000). Iron deficiency in pregnancy, obstetrics, and gynecology. Hematology/oncology Clinics of North America, 14, 1061–1077.

    Article  PubMed  Google Scholar 

  • Bakhtiar, U. J., Khan, Y., & Nasar, R. (2007). Relationship between maternal haemoglobin and perinatal outcome. Rawal Medical Journal, 32(2), 102–104.

    Google Scholar 

  • Balarajan, Y., Ramakrishnan, U., Zaltin, A., Shankar, A. H., & Subramanian, S. V. (2013). Anaemia in low-income and middle-income countries. Lancet, 378, 0140–6736.

    Google Scholar 

  • Bekele, A., Tilahun, M., & Mekuria, A. (2016). Prevalence of anemia and its associated factors among pregnant women attending antenatal care in health institutions of Arba Minch Town, Gamo Gofa Zone, Ethiopia: A cross-sectional study. Hindawi Publ Corp., 2016, 1–9.

    Google Scholar 

  • Bencaiova, G., et al. (2012). Anemia–prevalence and risk factors in pregnancy. European Journal of Internal Medicine, 23(6), 529–533.

    Article  PubMed  Google Scholar 

  • Bencaiova, G., & Breymann, C. (2014). Mild anemia and pregnancy outcome in a Swiss collective. Journal of Pregnancy, 2014, 307535.

    Article  PubMed  PubMed Central  Google Scholar 

  • Berhe, B., et al. (2019). Prevalence of anemia and associated factors among pregnant women in Adigrat General Hospital, Tigrai, northern Ethiopia, 2018. BMC Research Notes, 12(1), 310.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bodeau-Livinec, F., et al. (2011). Maternal anemia in Benin: Prevalence, risk factors, and association with low birth weight. American Journal of Tropical Medicine and Hygiene, 85(3), 414–420.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brabin, B. J., Hakimi, M., & Pelletier, D. (2001). An analysis of anemia and pregnancy-related maternal mortality. Journal of Nutrition, 131, 604–614.

    Article  Google Scholar 

  • Bukar, M., et al. (2008). Anaemia in pregnancy at booking in Gombe, North-eastern Nigeria. Journal of Obstetrics and Gynaecology, 28(8), 775–778.

    Article  CAS  PubMed  Google Scholar 

  • Bushra, M., Elhassan, E. M., Ali, N. I., Osman, E., Bakheit, K. H., & Adam, I. I. (2010). Anaemia, zinc, and copper deficiencies among pregnant women in central Sudan. Biological Trace Elements Researches, 137, 255–261.

    Article  CAS  Google Scholar 

  • Chaparro, C. M. (2008). Setting the stage for child health and development: Prevention of iron deficiency in early infancy. Journal of Nutrition, 138, 2529–2533.

    Article  CAS  PubMed  Google Scholar 

  • Charles, A. M., et al. (2010). Predictors of anemia among pregnant women in Westmoreland, Jamaica. Health Care for Women International, 31(7), 585–598.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chowdhury, H. A., et al. (2015). Factors associated with maternal anaemia among pregnant women in Dhaka city. BMC Women’s Health, 15, 77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Christensen, R. D., Ohls, R. K. (2004) Anaemias unique to a pregnancy and the perinatal period. Wintrobe's clinical hematology. In J.P. Greer, J. Foerster, N.J. Lukens, G.M. Rodgers, F. Paraskevas, B. Glader, USA: Lippincott Williams and Wilkins. 2: 1467–1486. 11

  • Delil, R., et al. (2018). Dietary diversity and its association with anemia among pregnant women attending public health facilities in South Ethiopia. Ethiopian Journal of Health Sciences, 28(5), 625–634.

    PubMed  PubMed Central  Google Scholar 

  • Dewey, K. G., & Chaparro, C. M. (2007). Iron status of breast-fed infants. The Proceedings of the Nutrition Society, 66, 412–422.

    Article  CAS  PubMed  Google Scholar 

  • Edward, B. (2010). Regular vitamin C supplementation during pregnancy reduces hospitalization: Outcomes of a Ugandan rural cohort study. The Pan African Medical Journal, 5, 15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Engmann, C., et al. (2008). Anemia and iron deficiency in pregnant Ghanaian women from urban areas. International Journal of Gynaecology and Obstetrics, 101(1), 62–66.

    Article  CAS  PubMed  Google Scholar 

  • Farda, W., Shams, S., & Ansari, S. (2019). Prevalence of anemia among pregnant women in their 3rd trimester: Results from a tertiary hospital in Kabul. Medical Journal (GMJ), 23.

  • Fishman, S. M., Christian, P., & West, K. P. (2000). The role of vitamins in the prevention and control of anaemia. Public Health Nutrition, 3, 125–150.

    Article  CAS  PubMed  Google Scholar 

  • Gebre, A., & Mulugeta, A. (2015). Prevalence of anemia and associated factors among pregnant women in north western zone of Tigray, Northern Ethiopia: A cross-sectional study. J Nutr Metab, 2015, 165430.

    Article  PubMed  PubMed Central  Google Scholar 

  • Getahun, W., Belachew, T., & Wolide, A. D. (2017). Burden and associated factors of anemia among pregnant women attending antenatal care in southern Ethiopia: A cross-sectional study. BMC Research Notes, 10, 276.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gopalan, C. (1996). Current food and nutrition situation in south Asian and south-east Asian countries. Biomedical and Environmental Sciences, 9, 102–116.

    CAS  PubMed  Google Scholar 

  • H¨am¨al¨ainen, H., Hakkarainen, K., & Heinonen, S. (2003). Anaemia in the first but not in the second or third trimester is a risk factor for low birth weight. Clinical Nutrition, 22(3), 271–275.

    Article  Google Scholar 

  • Haq, H. S., & Asif, M. (2014). Prevalence of anemia in pregnant women in muzaffarabad division of azad jammu and kashmir. Annals of Pakistan Institute of Medical Sciences, 10(1), 39–42.

    Google Scholar 

  • Herzog, S. A., et al. (2019). Prevalence of anemia in pregnant women in Styria, Austria-A retrospective analysis of mother-child examinations 2006–2014. PLoS ONE, 14(7), e0219703.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hesham, M. S., Edariah, A. B., & Norhayati, M. (2004). Intestinal parasitic infections and micronutrient deficiency: A review. Medical Journal of Malaysia, 59, 284–293.

    CAS  PubMed  Google Scholar 

  • Hess, S. Y., & King, J. C. (2009). Effects of maternal zinc supplementation on pregnancy and lactation outcomes. Food and Nutrition Bulletin, 30(Suppl 1), S60–S78.

    Article  PubMed  Google Scholar 

  • Hinderaker, S. G., et al. (2001). Anemia in pregnancy in the highlands of Tanzania. Acta Obstetricia Et Gynecologica Scandinavica, 80(1), 18–26.

    Article  CAS  PubMed  Google Scholar 

  • Hurrell, R., & Egli, I. (2010). Iron bioavailability and dietary reference values. American Journal of Clinical Nutrition, 91(5), 1461S-1467S.

    Article  CAS  PubMed  Google Scholar 

  • Idowu, O. A., et al. (2005). Anaemia in pregnancy: A survey of pregnant women in Abeokuta, Nigeria. African Health Sciences, 5(4), 295–299.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Jackson, D. J., et al. (1991). Severe anaemia in pregnancy: A problem of primigravidae in rural Zaire. Transactions of the Royal Society of Tropical Medicine and Hygiene, 85(6), 829–832.

    Article  CAS  PubMed  Google Scholar 

  • Jin, L., et al. (2010). Prevalence of anaemia among pregnant women in South-East China, 1993–2005. Public Health Nutrition, 13(10), 1511–1518.

    Article  PubMed  Google Scholar 

  • Johnson-Wimbley, T. D., & Graham, D. Y. (2011). Diagnosis and management of iron deficiency anemia in the 21st century. Therapeutic Advances in Gastroenterology, 4(3), 177–184. https://doi.org/10.1177/1756283X11398736

    Article  PubMed  PubMed Central  Google Scholar 

  • Kagu, M. B., et al. (2007b). Anaemia in pregnancy: A cross-sectional study of pregnant women in a Sahelian tertiary hospital in Northeastern Nigeria. Journal of Obstetrics and Gynaecology, 27(7), 676–679.

    Article  CAS  PubMed  Google Scholar 

  • Kagu, M. B., Kawuwa, M. B., & Gadzama, G. B. (2007a). Anaemia in pregnancy: A cross-sectional study of pregnant women in a Sahelian tertiary hospital in Northeastern Nigeria. Journal of Obstetrics and Gynecology, 27, 676–679.

    Article  CAS  Google Scholar 

  • Karaoglu, L., Pehlivan, E., Egri, M., Deprem, C., Gunes, G., Genc, M., et al. (2010). The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey. BMC Public Health, 10(329), 1–12.

    Google Scholar 

  • Khader, A., et al. (2009). Anaemia among pregnant Palestinian women in the Occupied Palestinian Territory. Public Health Nutrition, 12(12), 2416–2420.

    Article  CAS  PubMed  Google Scholar 

  • Kidanto, H. L., Mogren, I., Lindmark, G., Massawe, S., & Nystrom, L. (2009). Risks for preterm delivery and low birth weight are independently increased by the severity of anemia. South African Medical Journal, 99(2), 98–102.

    CAS  PubMed  Google Scholar 

  • Latifzadeh, S. Z., & Kazemi, A. (1998). The prevalence of iron deficiency in pregnant women. Razi Journal of Medical Sciences, 5(1), 56–62.

    Google Scholar 

  • Lebso, M., et al. (2017). Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community-based cross-sectional study. PLoS ONE, 12(12), e0188783.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Leonard, D., et al. (2018). Anaemia in pregnancy among Aboriginal and Torres Strait Islander women of Far North Queensland: A retrospective cohort study. Nutrition and Dietetics, 75(5), 457–467.

    Article  PubMed  Google Scholar 

  • Levy a Fraser, D., Katz, M., Mazor, M., & Sheiner, E. (2005). Maternal anemia during pregnancy is an independent risk factor for low birth weight and preterm delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology, 122(2), 182–186.

    Article  Google Scholar 

  • Levy, A., Fraser, D., Katz, M., Mazor, M., & Sheiner, E. (2005). Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 122, 182–186.

    Article  PubMed  Google Scholar 

  • Li, S., Tang, Y., & Wu, S. (1994). Analysis of anemia causes during pregnancy and its effects on mothers and fetus. Journal of Clinical Hematology, 7, 54–56.

    Google Scholar 

  • Lindström, E., Hossain, M. B., Lönnerdal, B., Raqib, R., El Arifeen, S., & Ekström, E. C. (2011). Prevalence of anemia and micronutrient deficiencies in early pregnancy in rural Bangladesh, the MINIMat trial. Acta Obstetricia Et Gynecologica Scandinavica, 90(1), 47–56.

    Article  PubMed  Google Scholar 

  • Liu, L. J., Lai, Y. H., Hu, Z. H., Ji, W., Wu, Y. J., & Liu, C. Q. (1998). Investigation of anemia of 158 pregnant women in Jilin city. JiLin YiXueYuan XueBao, 18, 45–47.

    Google Scholar 

  • Lone, F. W., Qureshi, R. N., & Emmanuel, F. (2004). Maternal anaemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan. Eastern Mediterranean Health Journal, 10(6), 801–807.

    Article  CAS  PubMed  Google Scholar 

  • Lops, V. R., Hunter, L. P., & Dixon, L. R. (1995). Anemia in pregnancy. American Family Physician, 51(5), 1189–1197.

    CAS  PubMed  Google Scholar 

  • Ma, A. G., et al. (2009). Anemia prevalence among pregnant women and birth weight in five areas in China. Medical Principles and Practice, 18(5), 368–372.

    Article  CAS  PubMed  Google Scholar 

  • MacLeod, M., & Rhode. (1998). Retrospective follow-up of maternal deaths and their associated risk factors in a rural district of Tanzania. Tropical Medicine & International Health, 3, 130–137.

    Article  CAS  Google Scholar 

  • Mahande, A. M., & Mahande, M. J. (2016). Prevalence of parasitic infections and associations with pregnancy complications and outcomes in northern Tanzania: A registry-based cross-sectional study. BMC Infectious Diseases, 16(1), 78.

    Article  PubMed  PubMed Central  Google Scholar 

  • Marchant, T., Armstrong, S., Edgar, T., et al. (2002). Anemia during pregnancy in Southern Tanzania. Annals Trop Ted Parasit, 96, 477–478.

    Article  CAS  Google Scholar 

  • Mardani, M., et al. (2017). Prevalence of anemia and its risk factors among pregnant women in Khorramabad (Iran) 2010–2014. The Journal of Maternal-Fetal & Neonatal Medicine, 30(7), 826–829.

    Article  CAS  Google Scholar 

  • Massot, C., & Vanderpas, J. (2003). A survey of iron deficiency anaemia during pregnancy in Belgium: Analysis of routine hospital laboratory data in Mons. Acta Clinica Belgica, 58(3), 169–177.

    Article  CAS  PubMed  Google Scholar 

  • Mbule, M. A., Byaruhanga, Y. B., Kabahenda, M., Lubowa, A., & Mbule, M. (2013a). Determinants of anemia among pregnant women in rural Uganda. Rural and Remote Health, 13(2259), 15–49.

    Google Scholar 

  • Mbule, M. A., Byaruhanga, Y. B., Kabahenda, M., Lubowa, A., & Mbule, M. (2013b). Determinants of anaemia among pregnant women in rural Uganda. Rural and Remote Health, 13(2259), 15–49.

    Google Scholar 

  • McLean, E., Cogswell, M., Egli, I., Wojdyla, D., & de Benoist, B. (2009). Worldwide prevalence of anemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutrition, 12(4), 444.

    Article  PubMed  Google Scholar 

  • McMullin, M. F., White, R., Lappin, T., Reeves, J., & MacKenzie, G. (2003). Haemoglobin during pregnancy: Relationship to erythropoietin and haematinic status. European Journal of Haematology, 71(1), 44–50.

    Article  CAS  PubMed  Google Scholar 

  • Micronutrient deficiencies iron deficiency anaemia. [http://www.who.int/nutrition/topics/ida/en/index.html]

  • Milman, N. (2008). Prepartum anaemia: Prevention and treatment. Annals of Hematology, 87, 949–959.

    Article  CAS  PubMed  Google Scholar 

  • Mohamed, A. A., Ali, A. A., Ali, N. I., Abusalama, E. H., Elbashir, M. I., & Adam, I. (2011). Zinc, parity, infection, and severe anaemia among pregnant women in Kassala, Eastern Sudan. Biological of Trace Elements Researches, 137, 225–230.

    Google Scholar 

  • Molloy, A. M., Kirke, P. N., Brody, L. C., Scott, J. M., Mills, J. L. (2008). Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food and Nutrition Bulletin. 29(Suppl 2): S101–11; discussion S12–5.

  • Monsen, E. R. (1988). Iron nutrition and absorption: Dietary factors which impact iron bioavailability. Journal of the American Dietetic Association, 88, 786–790.

    Article  CAS  PubMed  Google Scholar 

  • Msuya, S. E., et al. (2011). Anaemia among pregnant women in northern Tanzania: Prevalence, risk factors, and effect on perinatal outcomes. Tanzania Journal of Health Research, 13(1), 33–39.

    Article  PubMed  Google Scholar 

  • Muhangi, L., Woodburn, P., Omara, M., Omoding, N., Kizito, D., Mpairwe, H., et al. (2007). Associations between mild-to-moderate anaemia in pregnancy and helminth, malaria, and HIV infection in Entebbe, Uganda. Transactions of Royal Society Tropical Medicine and Hygiene, 10, 899–907.

    Article  Google Scholar 

  • Murphy, J. F., O’Riordan, J., Newcombe, R. G., Coles, E. C., & Pearson, J. F. (1986). Relation of haemoglobin levels in the first and second trimesters to pregnancy outcomes. Lancet, 8488, 992–995.

    Article  Google Scholar 

  • Nandlal, V., et al. (2014). Anaemia in pregnancy is associated with advanced HIV disease. PLoS ONE, 9(9), e106103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nonterah, E. A., et al. (2019). Descriptive epidemiology of anaemia among pregnant women initiating antenatal care in rural Northern Ghana. African Journal of Primary Health Care & Family Medicine, 11(1), e1–e7.

    Article  Google Scholar 

  • Notice from the Children and Families Bureau, Ministry of Health and Welfare “Promotion of the provision of appropriate information about folic acid intake in women of childbearing age to reduce the risk of developing impairment of neural tube closure” (No.72, No.78), Dec 28, 2000 (in Japanese).

  • Nutritional anaemia. [http://www.sightandlife.org/pdf/NAbook.pdf]

  • Oboro, V. O., et al. (2002). Prevalence and risk factors for anaemia in pregnancy in South Southern Nigeria. Journal of Obstetrics and Gynaecology, 22(6), 610–613.

    Article  CAS  PubMed  Google Scholar 

  • Obse, N., Mossie, A., Fau-Gobena, T., Gobena, T. (2013). Magnitude of anemia and associated risk factors among pregnant women attending antenatal care in Shalla Woreda, West Arsi Zone, Oromia Region, Ethiopia. 1029–1857 (Print).

  • Okoh, D. A., et al. (2016). A retrospective study of the prevalence of anaemia in pregnancy at booking in Niger Delta, Nigeria. Journal of Obstetrics and Gynaecology, 36(5), 594–597.

    Article  PubMed  Google Scholar 

  • Ononge, S., et al. (2014). Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda. BMC Research Notes, 7, 712.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Öztürk, M., et al. (2017). Anemia prevalence at the time of pregnancy detection. Turkish Journal of Obstetrics and Gynecolo, 14(3), 176–180.

    Article  Google Scholar 

  • Prakash, S., Yadav, K. (2015) Maternal anemia in pregnancy: An overview. IjpprHuman. 4(3):164–179.

    CAS  Google Scholar 

  • Prakash, S. A., et al. Prevalence and outcome of anaemia in pregnancy.

  • Preeti, J., Kural, M., & Tulika, J. (2013). Maternal and fetal outcome in cases of severe anaemia with pregnancy in rural setup. International Journal of Medical and Applied Science, 2(3), 318–333.

    Google Scholar 

  • Prynne, C. J., McCarron, A., Wadsworth, M. E., & Stephen, A. M. (2010). Dietary fibre and phytate: A balancing act: Results from three-time points in a British birth cohort. British Journal of Nutrition, 103(2), 274–280.

    Article  CAS  PubMed  Google Scholar 

  • Rajgopala, K., Arogya Prakash, S., & Rasquinha, S. (2016). Prevalance and outcome of anaemia in pregnancy. International Journal of Innovative Research and Advanced Studies (IJIRA), 3(8), 131–134.

    Google Scholar 

  • Rasmussen, K. (2001). Is there a causal relationship between iron deficiency or iron-deficiency anemia and weight at birth, length of gestation, and perinatal mortality? Journal of Nutrition, 131, 590S-603S.

    Article  CAS  PubMed  Google Scholar 

  • Ren, A., Wang, J., Ye, R. W., Li, S., Liu, J. M., & Li, Z. (2007). Low first-trimester hemoglobin and low birth weight, preterm birth and small for gestational age newborns. International Journal of Gynaecology and Obstetrics, 98, 124–128.

    Article  CAS  PubMed  Google Scholar 

  • Rezk, M., et al. (2015). Prevalence and risk factors of iron-deficiency anaemia among pregnant women in rural districts of Menoufia governorate, Egypt. Journal of Obstetrics and Gynaecology, 35(7), 663–666.

    Article  CAS  PubMed  Google Scholar 

  • Routine iron supplementation during pregnancy. Review article. US Preventive Services Task Force. JAMA (1993). 270(23):2848-54

  • Rusia, U., Madan, N., Agarwal, N., Sikka, M., & Sood, S. K. (1995). Effect of maternal iron deficiency anemia on foetal outcome. Indian Journal of Pathology & Microbiology, 38, 273–279.

    CAS  Google Scholar 

  • Samuel, S., et al. (2020). Socio-economic and dietary diversity characteristics are associated with anemia among pregnant women attending antenatal care services in public health centers of Kembata Tembaro Zone, Southern Ethiopia. Food Science & Nutrition, 8(4), 1978–1986.

    Article  Google Scholar 

  • Sarin, A. R. (1995). Severe anaemia of pregnancy, recent experience. International Journal of Gynaecology and Obstetrics, 50, S45–S49.

    Article  PubMed  Google Scholar 

  • Sekhavat, L., Davar, R., & Hosseinidezoki, S. (2011). Relationship between maternal hemobglobin concentration and neonatal birth weight. Hematology, 16, 373–376.

    Article  CAS  PubMed  Google Scholar 

  • Siega-Riz, A. M., Hartzema, A. G., Turnbull, C., Thorp, J., McDonald, T., & Cogswell, M. E. (2006). The effects of prophylactic iron given in prenatal supplements on iron status and birth outcomes: A randomized controlled trial. American Journal of Obstetrics and Gynecology, 194, 512–519.

    Article  CAS  PubMed  Google Scholar 

  • Singh, P., et al. (2013). Anemia during pregnancy in the women of western Nepal. Bali Medical Journal, 2(1), 14–16.

    Google Scholar 

  • Smith, C., et al. (2019). Maternal and Perinatal Morbidity and Mortality Associated With Anemia in Pregnancy. Obstetrics and Gynecology, 134(6), 1234–1244.

    Article  PubMed  Google Scholar 

  • Steer, P. J. (2000). Maternal hemoglobin concentration and birth weight. The American Journal Clinical Nutrition, 71(5), 1285S-1287S.

    Article  CAS  Google Scholar 

  • Stoltzfus, R. (2001). Defining iron-Deficiency anemia in public health terms: A time for reflection. Journal of Nutrition, 131(2S-2), 565S-567S.

    Article  CAS  PubMed  Google Scholar 

  • Stoltzfus, R., Mullany, L., & Black, R. E. (2004). Iron deficiency anaemia. In M. Ezzati, A. Lopez, A. Rodgers, & C. J. L. Murray (Eds.), Comparative quantification of health risks: Global and regional disease burden attributable to selected major risk factors (pp. 163–210). World Health Organization.

    Google Scholar 

  • Taylor, D. J., & Lind, T. (1979). Red cell mass during and after r normal pregnancy. British Journal of Obstetrics and Gynaecology, 86, 364–370.

    Article  CAS  PubMed  Google Scholar 

  • Tomashek, K. M., Ananth, C. V., & Cogswell, M. E. (2006). Risk of stillbirth in relation to maternal haemoglobin concentration during pregnancy. Maternal & Child Nutrition, 2, 19–28.

    Article  Google Scholar 

  • Tunkyi, K., & Moodley, J. (2018). Anemia and pregnancy outcomes: A longitudinal study. The Journal of Maternal-Fetal & Neonatal Medicine, 31(19), 2594–2598.

    Article  CAS  Google Scholar 

  • Uche-Nwachi, E. O., et al. (2010). Anaemia in pregnancy: Associations with parity, abortions and child spacing in primary healthcare clinic attendees in Trinidad and Tobago. African Health Sciences, 10(1), 66–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  • United Nations Children’s Fund, United Nations University, WHO. Iron-deficiency anemia: assessment, prevention, and control. A guide forprogramme managers.

  • Vakili, M., Mardani, Z., & Mirzaei, M. (2016). Prevalence of anemia in pregnant women referred to comprehensive health centers in Yazd (2016–2017). Iranian Journal of Obstetrics and Gynecology, 21(2):9–15.

    Google Scholar 

  • van den Broek, N. (1998). Anaemia in pregnancy in developing countries. British Journal of Obstetrics and Gynaecology, 105, 385–390.

    Article  PubMed  Google Scholar 

  • Van den Broek, N. R., & Letsky, E. A. (2000). Etiology of anemia in pregnancy in South Malawi. American Journal of Clinical Nutrition, 72, 247–256.

    Article  Google Scholar 

  • Vural, T., Toz, E., Ozcan, A., Biler, A., Ileri, A., & Inan, A. (2016). Can anemia predict perinatal outcomes in different stages of pregnancy? Pak J Med Sci, 32, 1354–1359.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wemakor, A. (2019). Prevalence and determinants of anaemia in pregnant women receiving antenatal care at a tertiary referral hospital in Northern Ghana. BMC Pregnancy and Childbirth, 19(1), 495.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • WHO. Prevention and Management of Severe Anaemia in Pregnancy. WHO 1993 WHO/FHEMSM/93.5.

  • WHO (2007) Centers for Disease Control and Prevention. Assessing the iron status of populations. www.who.int.http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/9789241596107.pdf

  • WHO. The Global Prevalence of Anaemia in 2011a. Geneva, Switzerland.

  • WHO. The Global Prevalence Of Anaemia In 2011c. Geneva, Switzerland. www.who.int/nutrition/publications/.../global_prevalence_anaemia_2011c/en/

  • WHO. Micronutrient deficiencies. Iron deficiency anaemia. Retrieved 2011b, from www.who.int/nutrition/topics/ida/en/index.html

  • WHO, Centers for Disease Control and Prevention Atlanta. Worldwide prevalence of anemia 1993–2005.

  • WHO. (2004). United Nations Children’s Fund. Focusing on anaemia. Towards an integrated approach for effective anaemia control. https://www.who.int/publications/m/item/focusing-on-anaemia-towards-an-integrated-approach-for-effective-anaemia-control

  • WHO. (2001). Iron Deficiency Anemia. Assessment, Prevention, and Control. In A Guide for Program Managers Geneva: World Health Organization

  • World Health Organization (1992) The prevalence of anemia in women: A tabulation of available information. WHO/NUT/MCM/92.2. Geneva, WHO

  • World Health Organization. (2008a). Worldwide prevalence of anemia 1993–2005. World Health Organization.

    Google Scholar 

  • Xing, Y., et al. (2009). Hemoglobin levels and anemia evaluation during pregnancy in the highlands of Tibet: A hospital-based study. BMC Public Health, 9, 336.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Xiong, X., Buekens, P., Fraser, W. D., et al. (2003). Anemia during pregnancy in a Chinese population. International Journal of Gynecology & Obstetrics, 83, 159–164.

    Article  CAS  Google Scholar 

  • Xu, X., et al. (2016). Prevalence and sociodemographic and lifestyle determinants of anemia during pregnancy: a cross-sectional study of pregnant women in China. International Journal of Environmental Research and Public Health, 13(9).

  • Zhang, Q., et al. (2009). Prevalence and risk factors for anaemia in pregnant women: A population-based prospective cohort study in China. Paediatric and Perinatal Epidemiology, 23(4), 282–291.

    Article  PubMed  Google Scholar 

  • Zhou, L. M., Yang, W. W., Hua, J. Z., et al. (1998). Relation of hemoglobin measured at different times in pregnancy to preterm birth and low birth weight in Shanghai, China. American Journal of Epidemiology, 148, 998–1006.

    Article  CAS  PubMed  Google Scholar 

  • Zijp, I. M., Korver, O., & Tijburg, L. B. (2000). Effect of tea and other dietary factors on iron absorption. Critical Reviews in Food Science and Nutrition, 40(5), 371–398.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

By Student Research Committee of Kermanshah University of Medical Sciences.

Funding

By Deputy for Research and Technology, Kermanshah University of Medical Sciences (IR) (3010318) and it had no role in the study process.

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Authors and Affiliations

  1. Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Mohammadmahdi Karami & Maryam Chaleshgar

  2. Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Nader Salari

  3. Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran

    Hakimeh Akbari & Masoud Mohammadi

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  1. Mohammadmahdi Karami
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NS and MMK and MM contributed to the design, MM statistical analysis, participated in most of the study steps. MCH and MM and HA prepared the manuscript. All authors have read and approved the content of the manuscript.

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Correspondence to Masoud Mohammadi.

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Karami, M., Chaleshgar, M., Salari, N. et al. Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis. Matern Child Health J 26, 1473–1487 (2022). https://doi.org/10.1007/s10995-022-03450-1

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