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孕期口服铁和叶酸补充剂是否能预防非洲低出生体重和早产?系统评价和荟萃分析。

Is Oral Iron and Folate Supplementation during Pregnancy Protective against Low Birth Weight and Preterm Birth in Africa? A Systematic Review and Meta-Analysis.

机构信息

School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.

School of Public Health, Bahir Dar University, Bahir Dar 79, Ethiopia.

出版信息

Nutrients. 2024 Aug 22;16(16):2801. doi: 10.3390/nu16162801.

Abstract

BACKGROUND

Despite recent evidence demonstrating iron and folate supplementation reduces the risk of low birth weight and preterm births, synthesis of the evidence is not sufficient to understand their impacts in Africa.

METHOD

MEDLINE, PsycINFO, Embase, Scopus, CHINAL, Web of Science, Cochrane databases, and Google Scholar were searched for the published and grey literature. Either iron-only, folate-only, or iron-folic acid (IFA) oral supplementation during pregnancy was the primary exposure/intervention. The focus of this review was low birth weight and preterm births in the African region. Qualitative synthesis, meta-analysis, and subgroup analysis were employed.

RESULTS

In the qualitative synthesis ( = 4), IFA supplementation showed a positive impact on reducing preterm birth. Additionally, the meta-analysis showed that IFA and iron-only supplementation reduced the odds of low birth weight by 63% (OR 0.37; 95% CI: 0.29, 0.48) and 68% (OR 0.32; 95% CI: 0.21 to 0.50), respectively.

CONCLUSION

Both iron-only and IFA supplementation are effective in reducing the risk of low birth weight in Africa. There is also promising evidence suggesting a potential reduction in preterm births. Consequently, further research is needed, particularly targeting high-risk groups such as women residing in rural areas with limited support and low levels of literacy.

摘要

背景

尽管最近有证据表明铁和叶酸补充剂可降低低出生体重和早产的风险,但综合证据还不足以了解它们在非洲的影响。

方法

检索 MEDLINE、PsycINFO、Embase、Scopus、CHINAL、Web of Science、Cochrane 数据库和 Google Scholar,以获取已发表和灰色文献。本综述的重点是非洲地区的低出生体重和早产。采用定性综合、荟萃分析和亚组分析。

结果

在定性综合分析中(n=4),IFA 补充剂显示出对降低早产的积极影响。此外,荟萃分析表明,IFA 和铁补充剂分别将低出生体重的几率降低了 63%(OR 0.37;95%CI:0.29,0.48)和 68%(OR 0.32;95%CI:0.21 至 0.50)。

结论

铁补充剂和 IFA 补充剂均能有效降低非洲低出生体重的风险。也有有希望的证据表明,补充 IFA 和铁可能降低早产的风险。因此,需要进一步研究,特别是针对居住在农村地区、支持有限和文化程度较低的高风险妇女等群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54bc/11356927/5452146e4b9f/nutrients-16-02801-g001.jpg

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