Prevalence and risk factors of anemia in first, second and third trimesters of pregnancy in Iran: A systematic review and meta-analysis

Anemia is a common health problem during pregnancy worldwide that has many short-term and long-term effects on women. This study examined the Prevalence and Risk factors of anemia in first, second and third trimesters of pregnancy in Iran between 2000 and 2021. PubMed, Medline, Scopus, Google Scholar, and national databases of Magiran and SID were searched for articles, which were then subjected to PRISMA-compliant screening. A systematic review and meta-analysis (using a random-effects model in STATA version 17) were conducted on the 18 eligible cross-sectional studies (published between July 23, 2000 and September 1, 2021) that revealed significant data on the prevalence of anemia in pregnant women. This study included 18 reports with a total of 25,831 individuals in which 15% of study subjects had anemia (95% CI: 12–19%). The pooled prevalence of anemia was 13% in people older than 26 years old (95% CI: 9–17%) compared to 22% in people younger than 26 years old (95% CI: 15–29). It was 18% (95% CI: 11–27%) for pregnant women having their second child in comparison to 20% (95% CI: 11–32%) for women who have had three or more children. Anemia was thought to affect 11% of housewives (95% CI: 2–26%) and 10% of working women (95% CI: 6–16%). Anemia frequency was 22%, 17% and 13% amongst first (22%), second (17%), and third (13%) trimesters, respectively. Nevertheless, it happened much less often after the second trimester. Moreover, poor education, a history of low birth weight in children, and a low socioeconomic level within women were associated with the prevalence of anemia. The pooled prevalence of anemia in pregnant women is marginally lower than in earlier report. However, it seems to be a health problem in developing countries including Iran currently. Therefore, the study suggest that health system should design comprehensive preventive and control measurements such as more effective treatments to minimize anemia in vulnerable segments of society, particularly mothers, and improve their health through increasing access to services for mothers.