Abstract
Objective: To systematically analyze the relationship between maternal anemia and low birth weight. Methods: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles. Cohort and case-control studies that met the eligibility criteria were included in the review. There was no limitation on the language or date of publication. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects, subgroup analyses and meta-regressions were performed. Publication bias was measured using Egger regression and visual funnel plot inspection. Results: A total of 7243 articles were found, of which 71 comprised the systematic review and 68 were included in the meta-analyses. Maternal anemia was associated with low birth weight with an adjusted OR: 1.23 (95% CI: 1.06–1.43) and I2: 58%. The meta-regressions confirmed that the sample size and the methodological quality may partially explain the statistical heterogeneity. Conclusions: Maternal anemia was considered a risk factor for low birth weight.
Highlights
Worldwide, approximately 7–15% of all live births each year are of low birth weight, a gestational outcome that is considered a major public health problem and is more prevalent in countries with fewer financial resources [1].Children born weighing less than 2500 g are more prone to infant morbidity and mortality [2,3].Inadequate biological, social, economic, environmental, and lifestyle factors, either prior to or during pregnancy, may favor low birth weight [2,4,5]
The main findings of this systematic review show that maternal anemia is a risk factor for low birth weight
These results were confirmed through a meta-analysis of the mean difference in birth weight, which showed that the children of women with maternal anemia had a reduction in birth weight compared with those whose mothers did not develop anemia
Summary
Approximately 7–15% of all live births each year are of low birth weight, a gestational outcome that is considered a major public health problem and is more prevalent in countries with fewer financial resources [1]. Inadequate biological, social, economic, environmental, and lifestyle factors, either prior to or during pregnancy, may favor low birth weight [2,4,5]. Despite the need to investigate maternal anemia and low birth weight, two relevant public health problems, there are few robust reviews which include women from diverse countries and socioeconomic conditions. Another systematic review on maternal anemia and gestational outcomes published in 2013 was identified; it used both cohort and case-control investigations conducted up to 2010 [13]. In view of the scarcity of recent review studies regarding the association between maternal anemia and low birth weight that include information from different continents and diverse socioeconomic conditions, this article aimed to systematically assess the relationship between maternal anemia and low birth weight through cohort and case-control studies carried out in several countries around the world
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