Kassa Getachew Mullu, Muche Achenef Asmamaw, Berhe Abadi Kidanemariam, Fekadu Gedefaw Abeje
College of health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
BMC Hematol. 2017 Oct 17;17:17. doi: 10.1186/s12878-017-0090-z. eCollection 2017.
Anemia during pregnancy is one of the most common indirect obstetric cause of maternal mortality in developing countries. It is responsible for poor maternal and fetal outcomes. A limited number of studies were conducted on anemia during pregnancy in Ethiopia, and they present inconsistent findings. Therefore, this review was undertaken to summarize the findings conducted in several parts of the country and present the national level of anemia among pregnant women in Ethiopia.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, and African Journals Online. Search terms used were; anemia, pregnancy related anemia and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled Meta logistic regression was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence interval (CI).
Twenty studies were included in the meta-analysis with a total of 10, 281 pregnant women. The pooled prevalence of anemia among pregnant women in Ethiopia was 31.66% (95% CI (26.20, 37.11)). Based on the pooled prevalence of the subgroup analysis result, the lowest prevalence of anemia among pregnant women was observed in Amhara region, 15.89% (95% CI (8.82, 22.96)) and the highest prevalence was in Somali region, 56.80% (95% CI (52.76, 60.84)). Primigravid (RR: 0.61 (95% CI: 0.53, 0.71)) and urban women (RR: 0.73 (95% CI: 0.60, 0.88)) were less likely to develop anemia. On the other hand, mothers with short pregnancy interval (RR: 2.14 (95% CI: 1.67, 2.74)) and malaria infection during pregnancy (RR: 1.94 (95% CI: 1.33, 2.82)) had higher risk to develop anemia.
Almost one-third of pregnant women in Ethiopia were anemic. Statistically significant association was observed between anemia during pregnancy and residence, gravidity, pregnancy interval, and malaria infection during pregnancy. Regions with higher anemia prevalence among pregnant women should be given due emphasis. The concerned body should intervene on the identified factors to reduce the high prevalence of anemia among pregnant women.
孕期贫血是发展中国家孕产妇死亡最常见的间接产科原因之一。它会导致不良的母婴结局。埃塞俄比亚针对孕期贫血开展的研究数量有限，且结果不一致。因此，本综述旨在总结该国多个地区的研究结果，并呈现埃塞俄比亚孕妇的全国贫血水平。
本系统综述和荟萃分析遵循系统评价与荟萃分析的首选报告项目（PRISMA）指南。使用的数据库有：PUBMED、考科蓝图书馆、谷歌学术、护理学与健康领域数据库（CINAHL）以及非洲期刊在线。使用的检索词为：贫血、妊娠相关贫血和埃塞俄比亚。采用乔安娜·布里格斯循证卫生保健中心统计学评估与综述工具（JBI-MAStARI）对研究进行严格评价。使用STATA 14软件进行荟萃分析。计算合并的Meta逻辑回归以呈现决定因素的合并患病率和相对风险（RRs）及其95%置信区间（CI）。
荟萃分析纳入了20项研究，共涉及10281名孕妇。埃塞俄比亚孕妇贫血的合并患病率为31.66%（95%CI（26.20，37.11））。根据亚组分析结果的合并患病率，孕妇贫血患病率最低的是阿姆哈拉地区，为15.89%（95%CI（8.82，22.96）），最高的是索马里地区，为56.80%（95%CI（52.76，60.84））。初产妇（RR：0.61（95%CI：0.53，0.7））和城市女性（RR：0.73（95%CI：0.60，0.88））患贫血的可能性较小。另一方面，妊娠间隔短的母亲（RR：2.14（95%CI：1.67，2.74））和孕期感染疟疾的母亲（RR：1.94（95%CI：1.33，2.82））患贫血风险更高。
埃塞俄比亚近三分之一的孕妇贫血。孕期贫血与居住地、妊娠次数、妊娠间隔和孕期疟疾感染之间存在统计学显著关联。应适当重视孕妇贫血患病率较高的地区。相关机构应针对已确定的因素采取干预措施，以降低孕妇贫血的高患病率。
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