Association of Iron Deficiency Anemia and Febrile Seizure in Asia: A Systematic Review and Meta-Analysis

Abstract

Background: Current findings suggest that iron deficiency anemia (IDA) may be a predisposing factor for febrile seizure (FS), while some studies show the lower prevalence of IDA in the children with FS.The present systematic review and meta-analysis aimed to elucidate the association between IDA and FS. Methods: A comprehensive search was performed using MeSH keywords in databases such as PubMed, Scopus, Embase, ScienceDirect, Web of Science, and Google Scholar without time limit until 2017. Cochrane test and I2 index were used for the evaluation of heterogeneity among the retrieved studies. Data analysis was performed in Comprehensive Meta-Analysis (CMA) software version 2. Results: In total, 38 studies conducted on 3,738 cases and 3,720 controls were reviewed in this meta-analysis. Considering the significant heterogeneity (I2=87.981; P<0.001), the odds ratio (OR) was combined using the random effects model. The pooled results indicated that IDA significantly increased the risk of FS (OR=2.36; 95% confidence interval [CI]: 1.72-3.24; P<0.0001). Meta-analysis was performed based on the simple febrile convulsion (FC) and first febrile convulsion (FFC), and OR was estimated at 2.98 (95% CI: 1.67-5.31; P<0.001) and 2.23 (95% CI: 1.33-3.73; P<0.001), respectively. In the subgroup analysis of the studies conducted in Iran, India, and Pakistan, OR was determined at 1.06 (95% CI: 0.71-1.58), 4.21 (95% CI: 2.97-5.97), and 2.22 (95% CI: 1.70-2.90), respectively, which revealed significant differences in this regard (P<0.001). Conclusion: According to the results, IDA is a predisposing factor for FC. Therefore, children with FS must be examined for the risk of IDA