Background Iron deficiency anemia is a common public health issue among women of reproductive age (WRA) because it can result in adverse maternal and birth outcomes. Although studies are undertaken to assess iron efficacy, some gaps and limitations in the existing literature need to be addressed. To fill the gaps, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the role of iron in reducing anemia among WRA in low-middle-income countries (LMICs). Methods A comprehensive search strategy was used to search Medline through PubMed, Embase, and Science Direct for RCTs published between 2000 and 2020. The primary outcome was the mean change in hemoglobin level. We used standardized mean differences and their respective 95% CI to estimate the pooled effect. We used I2 statistics and Egger’s test to assess heterogeneity and publication bias, respectively. This review was carried out in accordance with revised guidelines based on the Preferred Reporting Items for Systematic Review and Meta-analysis. Results The findings showed that iron therapy improved hemoglobin and ferritin levels, though the results varied across studies. An overall pooled effect estimate for the role of iron therapy in improving the hemoglobin levels among WRA was -0.71 (95% CI: -1.27 to -0.14) (p = 0.008). Likewise, the overall pooled effect estimate for the role of iron therapy in improving the ferritin levels among WRA was -0.76 (95% CI: -1.56 to 0.04) (p = 0.04). The heterogeneity (I2) across included studies was found to be statistically significant for studies assessing hemoglobin (Q = 746.93, I2 = 97.59%, p = 0.000) and ferritin level (Q = 659.95, I2 = 97.88%, p = 0.000). Conclusion Iron therapy in any form may reduce anemia’s burden and improve hemoglobin and ferritin levels, indicating improvement in iron-deficiency anemia. More evidence is required, however, to assess the morbidity associated with iron consumption, such as side effects, work performance, economic outcomes, mental health, and adherence to the intervention, with a particular focus on married but non-pregnant women planning a pregnancy in the near future. Trial registration Registered with PROSPERO and ID is CRD42020185033.
BackgroundIron deficiency anemia is a common public health problem problem among women of reproductive age (WRA) as it is can lead to unfavorable maternal and birth outcomes. Although studies are undertaken to assess the efficacy of iron, there are some gaps and limitations in the existing studies that need to be addressed. To address the gaps, we undertook a systematic review and meta-analysis to assess the existing evidence regarding the role of iron in decreasing anemia among WRA in low-middle-income countries.MethodsPubMed, Embase, and Science Direct were systematically searched using a comprehensive search strategy for randomized controlled trials published between 2000 to 2020. Mean change in hemoglobin level was assessed as a primary outcome. We performed a meta-analysis to estimate the pooled effect of all studies using standardized mean differences and their respective 95% CI. We assessed heterogeneity and publication bias using I2 statistics and Egger’s test respectively. This review was conducted with the help of updated guidelines based on the Preferred Reporting Items for Systematic Review and Meta-analysisResultsGenerally, the results demonstrated a favorable effect of iron therapy in improving hemoglobin levels with variation across studies. An overall pooled effect estimate for the role of iron therapy in decreasing the burden of anemia among WRA was -0.51 (95% CI: -1.03 to 0.01) (p = 0.04). Likewise, iron therapy improved ferritin levels and decreased the prevalence of anemia. The heterogeneity across included studies was found to be statistically significant as indicated by the parameters of heterogeneity (Q = 1191.60, I2 = 98.24%, p = 0.000). ConclusionIron therapy in any form may reduce the burden of anemia and improve the hemoglobin and ferritin levels, indicating improvement in iron-deficiency anemia. However, more evidence is needed to assess the morbidity associated with iron consumption such as side effects, work performance, economic outcomes, mental health, and compliance to the intervention with a special focus on married but non-pregnant women planning a pregnancy in near future. A systematic review and Meta-analysis registration: Registered with PROSPERO and ID is CRD42020185033
Background Iron deficiency anemia is a major public health issue among women of reproductive age (WRA), as it leads to high maternal and infant morbidity and mortality. The WHO recommends the distribution of iron supplements to all women in populations in which the prevalence of anemia (in women) exceeds 20%. Interventional studies have been carried out in developing countries regarding the efficacy and safety of iron in reducing anemia among women of reproductive age. However, the findings from randomized controlled trials have not been systematically synthesized. Therefore, we performed a systematic review and meta-analysis of RCTs to both qualitatively and quantitatively assess the evidence for the efficacy and effectiveness of iron as an intervention for reducing anemia among women of reproductive age in developing countries. Methods This review and meta-analysis will focus on assessing the efficacy and effectiveness of iron as an intervention for reducing anemia among women of reproductive age. PubMed, Google Scholar, and Science Direct will be explored using a detailed search strategy. A study will be considered eligible if it is a randomized controlled trial determining the efficacy and effectiveness of iron in anemia reduction among WRA (15-49 years) in developing countries and published in the English language in a peer-reviewed local or international journal from 2000 to 2020. We will perform a meta-analysis to measure the effect of individual studies as well as the pooled effect of all studies by generating forest plots. Heterogeneity will be assessed using I 2 statistics and a funnel plot will be developed to assess the publication bias. Discussion This systematic review will provide an opportunity to synthesize and critically appraise the findings from individual studies on the efficacy and effectiveness of iron as an intervention for reducing anemia among women of reproductive age to generate a comprehensive summary. These aggregated findings, in turn, can guide clinical practice and help clinicians, researchers and policymakers make evidence-based decisions to address this pressing health concern among women of reproductive age residing in developing countries. The findings of the review will be disseminated through presentations and peer-reviewed publications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.