Ministry of Health, 385, Ven. Baddegama Wimalawansa Thero Mawatha, Colombo, 10, Sri Lanka.
Centre for Health Science, University of the Highland and Islands, Old Perth Road, Inverness, IV2 3JH, UK.
BMC Pediatr. 2018 May 4;18(1):150. doi: 10.1186/s12887-018-1118-7.
Although antenatal iron supplementation is beneficial to mothers, its impact on the neurodevelopment of offspring is controversial. A systematic review and meta-analysis was undertaken to assess whether routine maternal antenatal iron supplementation confers later neurodevelopmental benefit to offspring.
Electronic databases were searched using MESH terms or key words and identified papers were reviewed by two independent reviewers. The study quality was assessed using the Cochrane risk of bias assessment tool. The review was registered in the PROSPERO CRD data base.
Seven publications were identified, based on four randomised trials published between 2006 and 2016. Three of the trials were in the Asian sub-continent. A range of tools were used to evaluate neurodevelopment. Meta-analysis of outcomes from the three RCTs meeting our inclusion criteria showed minimal effect of antenatal iron supplementation on the neurodevelopment of offspring, which was not statistically significant: weighted mean difference of 0.54 (95% CI: -0.67 to 1.75); test for overall effect Z = 0.87; p = 0.38; and heterogeneity 48%. Meta-analysis of outcomes of these RCTs at later stages of development produced similar results.
The benefit of routine antenatal iron supplementation on neurodevelopment in offspring was not statistically significant in this relatively limited set of trials, and some benefit cannot be excluded in areas with a high prevalence of maternal anaemia. A large randomized controlled trial showing significant benefit would be required to modify our conclusions.
虽然产前铁补充对母亲有益，但它对后代神经发育的影响仍存在争议。本系统评价和荟萃分析旨在评估常规产前铁补充是否能使后代获得更好的神经发育获益。
使用 MESH 术语或关键词检索电子数据库，并由两位独立评审员对已识别的论文进行评审。使用 Cochrane 偏倚风险评估工具评估研究质量。该综述已在 PROSPERO CRD 数据库中注册。
基于 2006 年至 2016 年发表的四项随机试验，确定了 7 篇出版物。其中三项试验在亚洲次大陆进行。评估神经发育的工具种类繁多。荟萃分析符合纳入标准的三项 RCT 的结果表明，产前铁补充对后代神经发育的影响极小，且无统计学意义：加权均数差为 0.54（95%CI：-0.67 至 1.75）；总效应检验 Z 值为 0.87；p 值为 0.38；异质性为 48%。对这些 RCT 更晚期发育结果的荟萃分析得出了类似的结果。
在这组相对有限的试验中，常规产前铁补充对后代神经发育的获益无统计学意义，在母亲贫血患病率较高的地区，也不能排除一些获益。需要开展一项大型随机对照试验以证明其具有显著获益，才能改变我们的结论。
