Athe Ramesh, Dwivedi Rinshu, Pati Sanghamitra, Mazumder Anindita, Banset Udit
Department of Humanities and Science (Mathematics), Indian Institute of Information Technology, Dharwad, Hubbali, Karnataka, India.
Department of Humanities and Science (Economics), Indian Institute of Information Technology, Tiruchirapalli, Tamil Nadu, India.
J Family Med Prim Care. 2020 Feb 28;9(2):513-519. doi: 10.4103/jfmpc.jfmpc_817_19. eCollection 2020 Feb.
Micronutrients' deficiency is a common phenomenon among a majority of the population residing in the low- and middle-income countries (LMICs) especially among women and children. Given the widespread prevalence of micronutrients' deficiency in LMICs, iron-fortified foods could be of potential benefits for both the mother and the development of fetus. Present study aims to provide the evidence on the impact of iron fortification on hemoglobin (Hb) concentration during pregnancy and evaluates the specific maternal and pregnancy outcomes. We conducted systematic review by using search engines such as PubMed, Cochrane Library, Medline, EMbase, and secondary references. Meta-analyses were performed to calculate summary estimates on Hb during pregnancy, low birth weight (LBW), and preterm births. The weighted mean difference (WMD) and relative risk (RR) were calculated using random-effects models. Sources of heterogeneity were explored through meta-regression. Eight studies were included for the final analysis. The overall pooled estimate of Hb showed a significant increase in the fortification group compared with the control group [WMD = 4.45 g/L; 95% confidence interval (CI) = 2.73, 6.17 g/L; = 83%, τ = 6.80, ρ <0.00001]. There has been a notable reduction in iron deficiency anemia (IDA) among pregnant women with substantial heterogeneity. Meta-regression suggests that the duration of feeding was positively associated with the effect size. Present review provides an evidence for the substantial benefits of iron fortification during pregnancy for reducing preterm births and risk of LBW. The safety, efficacy, and effective delivery of iron fortification need further research. Systematic review registration: PROSPERO International prospective register of systematic reviews - CRD42018116931.
在大多数低收入和中等收入国家（LMICs）的人群中，微量营养素缺乏是一种常见现象，尤其是在妇女和儿童中。鉴于微量营养素缺乏在低收入和中等收入国家广泛流行，铁强化食品可能对母亲和胎儿发育都有潜在益处。本研究旨在提供关于铁强化对孕期血红蛋白（Hb）浓度影响的证据，并评估具体的孕产妇和妊娠结局。我们通过使用搜索引擎如PubMed、Cochrane图书馆、Medline、EMbase以及二次参考文献进行了系统评价。进行荟萃分析以计算孕期血红蛋白、低出生体重（LBW）和早产的汇总估计值。使用随机效应模型计算加权平均差（WMD）和相对风险（RR）。通过元回归探索异质性来源。八项研究纳入最终分析。与对照组相比，强化组Hb的总体合并估计值显示出显著增加[WMD = 4.45 g/L；95%置信区间（CI）= 2.73，6.17 g/L；I² = 83%，τ = 6.80，ρ <0.00001]。缺铁性贫血（IDA）在孕妇中显著减少，但存在很大异质性。元回归表明喂养持续时间与效应大小呈正相关。本综述为孕期铁强化对减少早产和低出生体重风险的显著益处提供了证据。铁强化的安全性、有效性和有效递送需要进一步研究。系统评价注册：PROSPERO国际前瞻性系统评价注册库 - CRD42018116931。
