Effectiveness of Dietary Interventions in Prevention and Treatment of Iron-Deficiency Anemia in Pregnant Women: A Systematic Review of Randomized Controlled Trials

Abstract

Pregnant women are among the population groups most vulnerable to the development of anemia, as the overall iron requirement during pregnancy is significantly higher than in non-pregnant women. The aim of the systematic review was to assess the effectiveness of dietary interventions in the prevention and treatment of iron-deficiency anemia in pregnant women based on randomized-controlled trials. The systematic review was based on the PRISMA guidelines and is registered in the PROSPERO database (CRD42021261235). The search was conducted within PubMed and Web of Science databases for the period until June 2021. The included randomized controlled trials presented effectiveness of dietary interventions in prevention and treatment of iron-deficiency anemia in pregnant women. From the total number of 7825 screened records, the final number of seven studies were included in the systematic review. The procedure of screening, inclusion, reporting, and assessment of the risk of bias while using the revised Cochrane risk of bias tool for randomized trials was conducted by two independent researchers. The studies included in the systematic review were conducted in populations of anemic pregnant women, or mixed populations of anemic and non-anemic pregnant women. The interventions described within the studies were associated with including fortified products, regular products, or dietary counselling. They were based on providing an increased amount of iron, providing an increased amount of multiple nutrients, or general counselling only, while effectiveness was compared with effectiveness of the placebo, supplementation, or control group. The study duration was diversified from a few weeks to half a year or longer. The major biochemical measure assessed within the included studies was hemoglobin. All applied dietary interventions, based on providing increased amount of iron, providing increased amount of multiple nutrients, or general counselling only, were effective. The majority of included studies were assessed as ones of a medium risk of bias. For some studies a high risk of bias was indicated, which resulted from a risk of bias arising from the randomization process, due to deviations from the intended interventions, and in selection of the reported result. Considering this fact, more randomized controlled trials should be planned and conducted in a rigorous manner to confirm the formulated observations of effectiveness of the studied interventions based on providing an increased amount of iron, providing an increased amount of multiple nutrients, or general counselling only.

Effect of and Interventions in Prevention and Management of Maternal Anemia in the Advent of COVID-19

“…This may not be due to the best practices though, as the prevalence of maternal anemia is higher in Sub-Saharan Africa [3], [49]- [51], however, this fact may be supported by the more interventions used to control anemia in Africa. Data collected from multiple center studies showed a more predictive effect (16%) of maternal anemia intervention as compared to single center studies Similar findings exist from other similar reviews although not during the COVID-19 pandemic [30], [52], [53]. In this context, the single center studies signified a major heterogeneity as compared to multiple center studies.…”

The Impact of Moringa oleifera Supplementation on Anemia and other Variables during Pregnancy and Breastfeeding: A Narrative Review

“…This is due to the increase in plasma volume during pregnancy, which leads to a physiological decrease in haemoglobin concentration. Iron supplementation is known to increase the red cell mass, thereby increasing the oxygen-carrying capacity of pregnant woman [ 16 ]. Moringa supplementation has also been shown to increase haemoglobin levels, as well as other haematological parameters such as haematocrit, MCH, MCHC, and MCV values [ 9 ].…”

An Exploration of Determinants of Anemia in Pregnant Women at Buakayu Community Health Center Tana Toraja Regency

“…In some cultures, or traditions, there are prohibitions or taboos against consuming certain foods during pregnancy, which can result in iron deficiency and cause anemia. Examples of dietary restrictions such as a ban on eating red meat, eggs, or other types of food rich in iron can reduce the nutritional intake needed to prevent anemia in pregnant women (3,6,7). The study found that food restriction was associated with anemia incidence on pregnant women (p-value = 0.005) < 0.05).…”

“…According to the World Health Organization (WHO), anemia is a major global health problem affecting nearly two billion people worldwide (2). The population groups most vulnerable to this condition are women of childbearing age and pregnant women (3). Given these serious health consequences, WHO has indicated that one of its Global Nutrition Targets is to reduce the frequency of anemia on women of childbearing age by 50% by 2025 (4).…”