Shokri Mehdi, Karimi Parviz, Zamanifar Hadis, Kazemi Fatemeh, Azami Milad, Badfar Gholamreza
Department of Pediatrics, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
School of Nursing and Midwifery, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran.
Heliyon. 2020 May 22;6(5):e03787. doi: 10.1016/j.heliyon.2020.e03787. eCollection 2020 May.
Low birth weight (LBW) is an important general health indicator. The present study was conducted to evaluate the prevalence and risk factors of LBW in Iran.
This meta-analysis was reported based on the PRISMA guidelines. All stages were independently performed by two authors. This review is registered with PROSPERO (CRD42020163446). We searched epidemiological studies at international databases of Scopus, Embase, Science Direct, PubMed/Medline, CINAHL, EBSCO, Cochrane Library, Web of Science, and Google Scholar search engine, as well as Iranian databases of SID, IranDoc, Iranian National Library, Barakat Knowledge Network System, RICST and Magiran using MeSH keywords without time limit until 2019. After selecting the studies, applying the inclusion and exclusion criteria, data extraction and qualitative assessment, the data were analyzed based on random effects model using Comprehensive Meta-Analysis Software version 2. P < 0.05 was considered significant.
The prevalence of LBW in Iran was 7.95% (95% confidence interval [CI]: 7.36-8.58) in 62 studies with a sample size of 301,839 newborns. The prevalence of LBW in girls and boys was 8.41% (95%CI: 7.47-9.45) and 6.67% (95%CI: 5.86-7.59), respectively. The girls-to-boys odds ratio of LBW was 1.25 (95%CI: 1.13-1.39, P < 0.001) very LBW and extremely LBW prevalence was estimated to be 0.61% (95%CI: 0.40-0.93) and 0.29% (95% CI: 0.18-0.45), respectively. The risk factors for LBW were age of >35 versus [vs.] ≤35 (P = 0.024), age of <18 vs. ≥18 (P < 0.001), education of middle school and lower vs. high school and higher (P < 0.001), weight under 50 kg (P = 0.001), employed vs. housekeeper (P < 0.001), inadequate prenatal care (P = 0.046), interval with previous pregnancy <2 vs. >2 (P < 0.001), prematurity (P < 0.001), history of LBW (P < 0.001), multiple birth (P < 0.001), abortion (P < 0.001), vaginal bleeding (P < 0.001), hypertension (P = 0.001) and preeclampsia (P < 0.001).
The results of this meta-analysis showed that LBW is prevalent in Iran. This study can be a national database for LBW that would be of interest to Iranian health policy-makers and planners.
低出生体重是一项重要的总体健康指标。本研究旨在评估伊朗低出生体重的患病率及危险因素。
本荟萃分析依据PRISMA指南进行报告。所有阶段均由两位作者独立完成。本综述已在PROSPERO（CRD42020163446）注册。我们在国际数据库Scopus、Embase、Science Direct、PubMed/Medline、CINAHL、EBSCO、Cochrane图书馆、科学网以及谷歌学术搜索引擎中检索流行病学研究，同时在伊朗数据库SID、IranDoc、伊朗国家图书馆、巴拉卡特知识网络系统、RICST和Magiran中使用医学主题词（MeSH）进行检索，检索时间截至2019年，无时间限制。在选定研究、应用纳入和排除标准、进行数据提取和定性评估后，使用综合荟萃分析软件2.0基于随机效应模型对数据进行分析。P<0.05被认为具有统计学意义。
在62项研究中，样本量为301839名新生儿，伊朗低出生体重的患病率为7.95%（95%置信区间[CI]：7.36 - 8.58）。女孩和男孩低出生体重的患病率分别为8.41%（95%CI：7.47 - 9.45）和6.67%（95%CI：5.86 - 7.59）。女孩与男孩低出生体重的比值比为1.25（95%CI：1.13 - 1.39，P<0.001），极低出生体重和超低出生体重的患病率估计分别为0.61%（95%CI：0.40 - 0.93）和0.29%（95%CI：0.18 - 0.45）。低出生体重的危险因素包括年龄>35岁与≤35岁（P = 0.024）、年龄<18岁与≥18岁（P<0.001）、初中及以下学历与高中及以上学历（P<0.001）、体重低于50千克（P = 0.001）、就业与家庭主妇（P<0.001）、产前护理不足（P = 0.046）、上次妊娠间隔<2年与>2年（P<0.001）、早产（P<0.001）、低出生体重史（P<0.001）、多胎妊娠（P<0.001）、流产（P<0.001）、阴道出血（P<0.001）、高血压（P = 0.001）和先兆子痫（P<0.001）。
本荟萃分析结果表明，低出生体重在伊朗较为普遍。本研究可为伊朗卫生政策制定者和规划者提供一个有关低出生体重的国家数据库。
