The Association of Maternal Anemia during Pregnancy and Small for Gestational Age: A Systematic Review and Meta-Analysis

Background and Objective: Small for gestational age (SGA) newborns are those who are smaller in size than normal for the gestational age, most commonly defined as a weight below the 10th percentile for the gestational age. The relationship between anemia and SGA was not significant in some studies, while some studies have shown significant relationship between maternal anemia and SGA. The present systematic review and meta-analysis was conducted to determine the relationship between maternal anemia during pregnancy and small for gestational age. Search Method: The present study was conducted based on health care preferred reporting items for systematic review and meta-analysis (PRISMA-P). All methodology procedures were independently conducted by two researchers. The search was conducted to find related studies without time limit until April 2017. MeSH keywords were searched in Cochrane, Scopus, Web of Science (ISI), Pubmed, Embase, Science Direct and Google Scholar search engines. These keywords include: Anemia, Pregnant Women, Gestational Age, and Pregnancy. The relative risk (RR) and 95% confidence interval were estimated regarding to the significance of the I2 index based on the random effects model. Data were analyzed using Comprehensive Meta-Analysis Software version 2. Findings: Ten studies with a sample size including 620 080 pregnant women entered the meta-analysis process. The overall relationship between maternal anemia during pregnancy and SGA was not significant (RR = 1/11 [95%CI: 0/99-1/24, p = 0/74]). The relationship between anemia during pregnancy and SGA based on pregnancy trimester showed that maternal anemia was significant in the first trimester, (RR = 1/11 [95%CI: 1-1/22, p = 0/44]), but this relationship was not significant in the second trimester (RR = 1/11 [95%CI: 0.85-1/18, p = 0/91]). Conclusion: Maternal anemia in the first trimester of pregnancy can be considered as a risk factor for negative pregnancy outcomes such as small for gestational age.

کلیدواژه ها:

Anemia ، Pregnancy ، Small for Gestational Age ، Meta-Analysis