Adam Ishag, Ibrahim Yassin, Elhardello Osama
1Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan.
2Faculty of Medicine, University of Tabuk, P.O. Box 741, Tabuk, Saudi Arabia.
BMC Hematol. 2018 Nov 8;18:31. doi: 10.1186/s12878-018-0124-1. eCollection 2018.
Anemia during pregnancy is a public health problem especially in developing countries and it is associated with maternal and perinatal adverse outcomes. There is no meta-analysis on anemia during pregnancy in Sudan. The current systemic review and meta-analysis was conducted to assess the prevalence, types and determinant of anemia during pregnancy in Sudan.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases (PubMed, Cochrane Library, Google Scholar, CINAHL, and African Journals Online) were searched using; anemia, pregnancy related anemia and Sudan. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and Modified Newcastle - Ottawa quality assessment scale were used for critical appraisal of studies. The pooled Meta logistic regression was computed using OpenMeta Analyst software.
Sixteen cross-sectional studies included a total of 15, 688 pregnant women were analyzed. The pooled prevalence of anemia among pregnant women in Sudan was 53.0% (95%, CI = 45.9-60.1). The meta-analysis showed no statistical significant between the age (mean difference = 0.143, 95 CI = - 0.033 - 0.319, = 0.112), parity (mean difference = 0.021, 95% CI = - 0.035 - 0.077, = 0.465) between the anemic and no anemic women. Malaria was investigated in six studies. Pregnant women who had malaria infection during pregnancy were 1.94 times more likely to develop anemia than women who had no malaria infection (OR = 1.94, 95% CI =1.33-2.82). Six (37.5%) studies investigated type of anemia. The pooled prevalence of iron deficiency anemia (IDA) among pregnant women in Sudan was 13.6% (95% CI = 8.9-18.2).
There is a high prevalence of anemia among pregnant in the different region of Sudan. While age and parity have no association with anemia, malaria infection was associated with anemia. Interventions to promote the strengthening of antenatal care, and access and adherence to nutrition, and malaria preventive measures are needed to reduce the high level of anemia among pregnant women in Sudan.
孕期贫血是一个公共卫生问题，在发展中国家尤为突出，且与孕产妇和围产期不良结局相关。苏丹尚未对孕期贫血进行荟萃分析。本系统评价和荟萃分析旨在评估苏丹孕期贫血的患病率、类型及决定因素。
遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。使用贫血、妊娠相关贫血和苏丹等关键词检索数据库（PubMed、Cochrane图书馆、谷歌学术、CINAHL和非洲在线期刊）。采用乔安娜·布里格斯研究所统计评估与综述工具（JBI-MAStARI）和改良的纽卡斯尔-渥太华质量评估量表对研究进行严格评价。使用OpenMeta Analyst软件计算合并的Meta逻辑回归。
纳入16项横断面研究，共分析了15688名孕妇。苏丹孕妇贫血的合并患病率为53.0%（95%置信区间=45.9-60.1）。荟萃分析显示，贫血孕妇与非贫血孕妇在年龄（平均差=0.143，95%置信区间=-0.033-0.319，P=0.112）、产次（平均差=0.021，95%置信区间=-0.035-0.077，P=0.465）方面无统计学显著差异。六项研究调查了疟疾情况。孕期感染疟疾的孕妇患贫血的可能性是未感染疟疾孕妇的1.94倍（比值比=1.94，95%置信区间=1.33-2.82）。六项（37.5%）研究调查了贫血类型。苏丹孕妇缺铁性贫血（IDA）的合并患病率为13.6%（95%置信区间=8.9-18.2）。
苏丹不同地区孕妇贫血患病率较高。年龄和产次与贫血无关，但疟疾感染与贫血有关。需要采取干预措施加强产前护理，增加并提高营养摄入的依从性，以及采取疟疾预防措施，以降低苏丹孕妇的高贫血水平。
