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REVIEW article

Front. Glob. Womens Health
Sec. Maternal Health
Volume 6 - 2025 | doi: 10.3389/fgwh.2025.1502585

Anemia during Pregnancy and Adverse Pregnancy Outcomes： A Systematic Review and Meta-analysis of Cohort Studies

Provisionally accepted
Rui Wang Rui Wang 1Shan Xu Shan Xu 1Xiaoyu Hao Xiaoyu Hao 1Xingyi Jin Xingyi Jin 1Da Pan Da Pan 1Hui Xia Hui Xia 1Wang Liao Wang Liao 1Ligang Yang Ligang Yang 1Shaokang Wang Shaokang Wang 1,2*
  • 1 Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
  • 2 Clinical Medical Research Center for Plateau Gastroenterological Disease of Xizang Autonomous Region, and School of Medicine, Xizang Minzu University, Xianyang, Shaanxi Province, China

The final, formatted version of the article will be published soon.

    Anemia in pregnancy has been a topic of interest for researchers due to its potential impact on various adverse pregnancy outcomes. This study aims to explore the relationship between anemia and adverse pregnancy outcomes such as preterm birth, low birth weight, and maternal mortality.We conducted both a systematic review and a meta-analysis on the associations between anemia during pregnancy and adverse pregnancy outcomes. We searched Chinese databases (CNKI, Wanfang, CBM, VIP) and English ones (Cochrane Library, PubMed, Embase, Web of Science). Two researcher-authors independently assessed study quality with the Newcastle-Ottawa Scale. After extracting data, we analyzed heterogeneity and used a random-effects model for higher heterogeneity and a fixed-effects model for low heterogeneity in the meta-analysis while also systematically synthesizing and narratively describing findings in the systematic review. A total of 31 cohort studies were included. Meta-analysis showed that the risk of postpartum hemorrhage (RR [95% CI], 2. 76 [1.63, 4.66]), premature rupture of membranes (PROM) (1.94 [1.26, 3.00]), preterm delivery (1.51 [1.33, 1.72]), low birth weight (LBW) (1.40 [1.19, 1.63]), cesarean section(1.33 [1.02, 1.74]), gestational hypertension(1. 28 [1.14, 1.44]) and neonatal asphyxia(1.21 [1.07, 1.37]) was higher in the group of anemia in pregnancy than in the control group.Maternal anemia is associated with an increased risk of seven adverse pregnancy outcomes: postpartum hemorrhage, PROM, preterm delivery, LBW, cesarean section, gestational hypertension and neonatal asphyxia. Appropriate nutritional supplementation and screening for anemia before and during pregnancy are recommended to improve maternal health and manage adverse pregnancy outcomes.

    Keywords: Anemia, Anemia in pregnancy, Pregnancy Outcome, cohort study, Maternal health

    Received: 27 Sep 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Wang, Xu, Hao, Jin, Pan, Xia, Liao, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shaokang Wang, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.