Oktarina Caroline, Dilantika Charisma, Sitorus Nova Lidia, Basrowi Ray Wagiu
Faculty of Medicine, Universitas Indonesia, Depok 16424, Jawa Barat, Indonesia.
Danone Specialized Nutrition Indonesia, South Jakarta 12930, Indonesia.
Children (Basel). 2024 Oct 19;11(10):1268. doi: 10.3390/children11101268.
BACKGROUND/OBJECTIVES: Iron deficiency anemia (IDA) and stunting are prevalent global health issues, particularly in developing countries, where previous studies have suggested a potential relationship between them. This systematic review aims to analyze the relationship between iron deficiency anemia and stunting in pediatric populations in developing countries.
Literature searches were conducted on PubMed, EMBASE, Cochrane Library, and EBSCO Host. The primary outcome was the association between IDA and stunting. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Effective Public Health Practice Project (EPHPP) for other observational studies. Meta-analysis was performed with a random-effects model and heterogeneity assessment. A Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment was performed to determine the certainty and importance of the study.
Out of 19,095 articles, 15 studies were included in the systematic review, and 4 studies were included in the meta-analysis, encompassing 21,936 subjects aged 0 to 12 years. IDA prevalence ranged from 3.6 to 58.8%, while stunting prevalence varied from 6.6 to 44.5%. Nine articles supported a significant relationship between IDA and stunting, revealing that stunted children had a 1.31-6.785 times higher risk of developing IDA. The odds ratio of children with IDA to be stunted was 2.27 (95% CI = 1.30-3.95). All studies exhibited a moderate risk of bias. GRADE assessment suggested that the evidence's certainty is low but important.
The high IDA prevalence in developing countries, including Indonesia, is associated with stunting in children, suggesting a synergistic relationship.
背景/目的：缺铁性贫血（IDA）和发育迟缓是全球普遍存在的健康问题，尤其是在发展中国家，此前的研究表明它们之间可能存在关联。本系统评价旨在分析发展中国家儿童人群中铁缺铁性贫血与发育迟缓之间的关系。
在PubMed、EMBASE、Cochrane图书馆和EBSCO主机上进行文献检索。主要结局是缺铁性贫血与发育迟缓之间的关联。使用队列研究的纽卡斯尔-渥太华量表（NOS）和其他观察性研究的有效公共卫生实践项目（EPHPP）评估偏倚风险。采用随机效应模型和异质性评估进行荟萃分析。进行了推荐分级、评估、制定和评价（GRADE）评估，以确定研究的确定性和重要性。
在19095篇文章中，15项研究纳入系统评价，4项研究纳入荟萃分析，涵盖21936名0至12岁的受试者。缺铁性贫血患病率在3.6%至58.8%之间，发育迟缓患病率在6.6%至44.5%之间。9篇文章支持缺铁性贫血与发育迟缓之间存在显著关系，表明发育迟缓儿童患缺铁性贫血的风险高出1.31至6.785倍。缺铁性贫血儿童发育迟缓的优势比为2.27（95%CI=1.30-3.95）。所有研究均显示出中度偏倚风险。GRADE评估表明，证据的确定性较低但很重要。
包括印度尼西亚在内的发展中国家缺铁性贫血的高患病率与儿童发育迟缓有关，提示存在协同关系。
