TY - JOUR
T1 - Moderate to severe, but not mild, maternal anemia is associated with increased risk of small-for-gestational-age outcomes
AU - Kozuki, Naoko
AU - Lee, Anne C.
AU - Katz, Joanne
PY - 2012/2/1
Y1 - 2012/2/1
N2 - Anemia is highly prevalent globally, estimated at 40-50% in women of reproductive age. Prior studies have produced inconclusive evidence as to the association between maternal anemia and intrauterine growth restriction (IUGR). We conducted a systematic review of the literature containing associations between maternal anemia and small for gestational age (SGA) outcomes (as a proxy for IUGR). A meta-analysis was performed to pool associations, categorized by the hemoglobin cutoffs presented by the authors. We identified 12 studies reporting associations between maternal anemia and SGA. For the metaanalysis, there were 7 associations with a hemoglobin cutoff < 110 g/L, 7 with a cutoff < 100 g/L, and 5 with a cutoff < 90 or < 80 g/L. Although the < 110- and < 100-g/L categories showed no significant relationship with SGA, the <90- or <80-g/L category was associated with a 53% increase in risk of the newborn being SGA [pooled OR = 1.53 (95% CI: 1.24-1.87); P < 0.001]. Moderate to severe, but not mild, maternal anemia appears to have an association with SGA outcomes, but the findingsmust be viewed with caution due to the great heterogeneity of the studies. Further examination should be conducted using datasets with better standardized definitions and measurements of exposure and outcome.
AB - Anemia is highly prevalent globally, estimated at 40-50% in women of reproductive age. Prior studies have produced inconclusive evidence as to the association between maternal anemia and intrauterine growth restriction (IUGR). We conducted a systematic review of the literature containing associations between maternal anemia and small for gestational age (SGA) outcomes (as a proxy for IUGR). A meta-analysis was performed to pool associations, categorized by the hemoglobin cutoffs presented by the authors. We identified 12 studies reporting associations between maternal anemia and SGA. For the metaanalysis, there were 7 associations with a hemoglobin cutoff < 110 g/L, 7 with a cutoff < 100 g/L, and 5 with a cutoff < 90 or < 80 g/L. Although the < 110- and < 100-g/L categories showed no significant relationship with SGA, the <90- or <80-g/L category was associated with a 53% increase in risk of the newborn being SGA [pooled OR = 1.53 (95% CI: 1.24-1.87); P < 0.001]. Moderate to severe, but not mild, maternal anemia appears to have an association with SGA outcomes, but the findingsmust be viewed with caution due to the great heterogeneity of the studies. Further examination should be conducted using datasets with better standardized definitions and measurements of exposure and outcome.
UR - http://www.scopus.com/inward/record.url?scp=84858170910&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858170910&partnerID=8YFLogxK
U2 - 10.3945/jn.111.149237
DO - 10.3945/jn.111.149237
M3 - Article
C2 - 22190028
AN - SCOPUS:84858170910
SN - 0022-3166
VL - 142
SP - 358
EP - 362
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 2
ER -