آنمی در مادران باردار و ریسک وزن کم هنگام تولد نوزاد: یک مطالعه مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استاد، مرکز تحقیقات مامایی و بهداشت باروری، گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 دکترای بهداشت باروری، مرکز توسعه تحقیقات بالینی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

4 دانشجوی کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

10.22038/ijogi.2024.82324.6190

چکیده

مقدمه: وزن هنگام تولد نوزاد، یکی از شاخص ­های شناخت وضعیت بهداشتی و سلامتی دوران بارداری است و تأثیر زیادی بر بروز عوارض نوزادی و همچنین سلامت وی در بزرگسالی دارد. مطالعه حاضر با هدف بررسی ارتباط آنمی در بارداری و ریسک وزن کم هنگام تولد به‌صورت مرور سیستماتیک و متاآنالیز انجام شد.
روش‌کار: تمام مطالعات مشاهده‌ای منتشر شده در بازه سال‌های 2000 تا 2024 در پایگاه اطلاعاتی Web of Science،Scopus ، PubMed و Google Scholar مورد جستجو قرار گرفتند. کلمات کلیدی بر اساس مش شامل Birth weight, Pregnancy، Pregnant Women و Anemia بودند که با عملگرهای بولین OR و AND با هم ترکیب شدند. در نهایت مقالات جهت ارزیابی کیفیت (مقیاس نیوکاسل- اتاوا) و استخراج یافته­ های اصلی آنها مورد بررسی جداگانه توسط دو فرد مستقل از هم قرار گرفتند. متاآنالیز با نرم‌افزار stata انجام شد. ارزیابی هتروژنیتی مطالعات با استفاده از شاخص I2 و آزمون کوکران انجام شد. از روش نمودار قیفی و آزمون‌های Begg &Egger جهت ارزیابی سوگیری انتشار استفاده شد.
یافته­ ها: در نهایت 22 مطالعه با حجم نمونه کلی 321231 نفر وارد این مطالعه شدند. بیشتر مطالعات از نظر ارزیابی کیفیت دارای سطح بالای کیفیت متدولوژی بودند. ارتباط بین آنمی بارداری و وزن کم هنگام تولد بر اساس شاخص نسبت شانس تعدیل شده با مقدار (39/2 to 06/1 :95%CI) 59/1=Adjusted OR نشان داد که در زنان با آنمی بارداری، احتمال نوزاد با وزن کم هنکام تولد 59/1 برابر بیشتر می‌باشد. سوگیری انتشار در نتایج به‌دست آمده تأثیری نداشت و در تحلیل حساسیت نیز مطالعه­ ای تأثیرگذار یافت نشد.
نتیجه­ گیری: در صورت وقوع آنمی در بارداری، احتمال تولد نوزاد کم وزن افزایش می­ یابد. در نتیجه، پیگیری مادران از اوایل بارداری و تشخیص مشکلات و درمان آنها می‌تواند به‌طور جدی در سلامت مادر و نوزاد، تأثیر به‌سزایی داشته باشد و میزان هزینه­ های بهداشتی را کاهش دهد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Anemia in pregnant mothers and the risk of low birth weight: a systematic review and meta-analysis

نویسندگان [English]

  • Atena Hakimzadeh 1
  • Mahrokh Dolatian 2
  • Marzieh Bagherinia 3
  • Kimia Hosseinpour 4
1 M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Professor, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 PhD of Reproductive Health, Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
4 M.Sc. student of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: A baby's birth weight is one of the indicators of knowing the hygiene and health status of pregnancy period and greatly impacts the occurrence of neonatal complications as well as his health in adulthood. The present study was conducted with aim to evaluate the relationship between anemia in pregnancy and the risk of low birth weight as systematic review and meta-analysis.
Methods: All observational studies published between 2000 and 2024 were searched in Web of Science, Scopus, PubMed, and Google Scholar databases. The keywords based on the MeSh included “Birth weight,” Pregnancy, “Pregnant Women,” and Anemia, combined with the Boolean operators OR and AND. Finally, the articles were reviewed separately by two independent reviewers to assess their quality (Newcastle-Ottawa scale) and extract their main findings. Meta-analysis was performed with Stata software. The heterogeneity of studies was assessed using the I2 index and Cochrane test. The funnel plot method and Begg & Egger tests were used to evaluate publication bias.
Results: Finally, 22 studies with a total sample size of 321,231 people were included in this study. Most of the studies had a high level of methodological quality in terms of quality assessment. The association between pregnancy anemia and low birth weight based on the adjusted odds ratio with the value OR = 1.59 (95%CI: 1.06 to 2.39) showed that in women with anemia pregnancy, the probability of having a low birth weight baby is 1.59 times higher. Publication bias did not affect the results and no influential studies were found in the sensitivity analysis.
Conclusion: If anemia occurs during pregnancy, the likelihood of having a baby with a low birth weight increases. As a result, monitoring mothers from early pregnancy and diagnosing and treating problems can significantly impact the health of both mother and baby and reduce healthcare costs.

کلیدواژه‌ها [English]

  • Anemia
  • Birth weight
  • Pregnancy
  • Systematic review

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 10
دی 1403
صفحه 93-121

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