Prevalence of Iron Deficiency Anemia among ... - ResearchGate
Prevalence of Iron Deficiency Anemia among ... - ResearchGate Prevalence of Iron Deficiency Anemia among ... - ResearchGate
JRI Iron Deficiency Anemia during Pregnancy in Irannot statistically significant, we may conclude thatlifestyle modifications and health care interventionsin rural area have been of good results.Similarly, the overall prevalence of anemia inpregnant women was 58% with no significantdifferences between rural and urban populationsin a study carried out in China (19).In WHO categorization, the prevalence ofanemia in ranges between 5% and 19.9% isconsidered as a minor health problem (3).In our research, the highest research qualitybelonged to the study by Safavi et al. who hadassessed the prevalence of anemia and irondeficiency in 11 different geographical areas ofIran in 2001. They had reported the prevalence ofanemia and iron deficiency in Iran to be 21.5%and 42.7%, respectively. Based on that study, thehighest (44%) prevalence rates had been seen insouthern Kerman, southern Khorasan, and Sistan-Baluchestan, the three eastern provinces of Iran;and the lowest (9%) prevalence had been reportedto be in Isfahan, Yazd, Kohkilooye-and-Boyerahmad, and northern Kerman, mostly centralprovinces of Iran (4). However, in the presentreview, we found some academic thesis andcongress abstracts which estimated the prevalenceof anemia as high as 40% (20), but they wereexcluded from our systematic review because oftheir low research quality or study in some targetsubgroups.It seems that the differences in geographicalareas, life style, and diet in different parts of Iran,to be the main reason for the wide spectrum of thereported results in various studies.The prevalence of anemia in a region depends onnumerous factors such as socio-economic status,iron intake, and prevalence of parasitic andinfectious diseases (21-23). Moreover, the prevalenceof anemia is higher in women in fertileyears, due to menstrual bleeding and pregnancy.IDA is more challenging in developing countries,because of inadequate intake of iron and folic acidsupplements and unhealthier diets (10, 24).However, it must be kept in mind that thepopulations in the included studies had beenmostly the medical care seeking pregnant womenwho had attended health care centers, whichroutinely provide pregnant women with iron andfolic acid supplements and the coverage of thisprogram is very high in Iran. In addition, nationalnutritional programs for the fortification of flourwith iron and folic acid may also help reduce theprevalence of anemia.Based on our findings, it seems that Iranianpregnant women are in a better situationcompared to the prevalence of anemia in pregnantwomen in the Eastern Mediterranean Region(EMRO). The prevalence of anemia in pregnantwomen in some of these countries are reported asfollows: Bahrain 33%, Egypt 26%, Jordan 35%,and the United Arab Emirates 14% (25). Studiesin India and Pakistan have reported the prevalenceof anemia as high as 80% to 90% (10, 24). Lackof standard frameworks for evaluating anemia andpoor reporting characteristics in published studiesin this region seem to be another important issue.Therefore, use of a unified methodology andpublishing format for these types of studies arerecommended.There were a few studies employing standardmethods and criteria in Iran, but the absence of anational health care strategy for surveys on thesesubjects, create numerous challenges for planningand intervening in this field.Promoting national health standards andreducing the rate of diseases and their mortalityrates are some of the most important goals ofhealth systems. Improvement of health indices ina community need interventions that are based onaccurate analysis of risk factors and efficientmarkers (26).ConclusionMaternal anemia is an important public healthproblem, not only in the East MediterraneanRegion but also in many other countriesworldwide. The results of the present systematicreview suggest that prevalence of anemia duringpregnancy in Iran is less than what has beenreported by WHO; however, there seems to be theneed to implement programmes to reach an idealstate of the disease.Regarding the increasing rate of research ondifferent health issues and the varieties in theirmethods and results, it would be impossible toevaluate the present status or forecast the futureprospects of any disease if directed and definedefforts such as secondary studies, amongst themsystematic reviews, meta-analysis, and modelingstudies, are not carried out. However, like primaryDownloaded from http://www.jri.ir22J Reprod Infertil, Vol 11, No 1, Apr/Jun 2010
Barooti E, et al. JRIstudies, these kinds of studies also have inevitablelimits, biases, and misdirections. In order to getmore accurate and reliable figures, uniform andstandard methods and study designs are alsorecommended for primary studies at the nationallevel.AcknowledgementThis study was a part of an approved andfinancially supported project by Women’s AffairsOffice at Iran's Ministry of Health and MedicalEducation. The authors appreciate all the researcherswhose articles were included in the study. Inaddition, the authors appreciate Dr. AbtinHeidarzade for reviewing the present article andproviding great guidance.References1. Gautam CS, Saha L, Sekhri K, Saha PK. Iron deficiencyin pregnancy and the rationality of iron supplementsprescribed during pregnancy. Medscape JMed. 2008;10(12):283.2. Malee M. Anemia in Pregnancy. Obstet Gynecol.2008; 112(1):201-7.3. De Benoist B, McLean E, Egli I, Cogswell M.Worldwide prevalence of anaemia 1993–2005,WHO Global Database on Anemia. Geneva: WorldHealth Organization; 2008. p. 21.4. Safavi M, Sheykh Aleslam R, Naghavi M, AbdollahiZ, Sadeghian Sharif S, Sadegh zadeh E, et al.[Prevalence of Iron deficiency anemia amongIranian Pregnant woman, Spring 2001]. Iran JEpidemiol. 2006;1(4):1-10. Persian.5. Khademi Z, Shahi A, Farshid Far GhR, Zare Sh,Vaziri F. [Prevalence of iron deficiency anemia inpregnant women referred to Shariati hospital inBandar Abbas, Iran]. Hormozgan Med J. 2004;8(1):27-31. Persian.6. Navidian A, Ebrahimi Tabas E, Sarani H, Ghalge M,Yaghobinia F. [The prevalence of Iron-deficiencyanemia in the pregnant women referring to healthcenters in Zahedan]. J Reprod Infertil. 2006;7(2):132-8. Persian.7. Borna S, Borna H, Ghanbari Z, Khezrdoost S.Anemia and factors that affect it in pregnancy.Tehran Univ Med J. 2005;63(6):448-52.8. Davaritanha F, Kaveh M, Salehi B. [Incidence ofanemia in pregnancy and its relationship withmaternal characteristics and pregnancy outcome].Hayat. 2005;11(24,25):23-31. Persian.9. Haghdoost AA, Sadeghirad B, Hajarizadeh B,Mirzazadeh A. The Application of SystematicReview and Meta-analysis Concepts in Summarizingthe Findings of Observational Studies. Iran JPsychiatry. 2007;2(4):132-6.10. Baig-Ansari N, Badruddin SH, Karmaliani R,Harris H, Jehan I, Pasha O, et al. Anemia prevalenceand risk factors in pregnant women in anurban area of Pakistan. Food Nutr Bull. 2008;29(2):132-9.11. Khosla AH, Dahiya P, Dahiya K. Burden ofchronic severe anemia in obstetric patients in ruralnorth India. Indian J Med Sci. 2002;56(5):222-4.12. Stroup DF, Berlin JA, Morton SC, Olkin I,Williamson GD, Rennie D, et al. Meta-analysis ofobservational studies in epidemiology: a proposalfor reporting. JAMA. 2000;283(15):2008-12.13. Moher D, Tetzlaff J, Tricco AC, Sampson M,Altman DG. Epidemiology and reporting characteristicsof systematic reviews. PLoS Med. 2007;4(3):e78.14. Heidarnia MA, Entezari A, Moein M, Mehrabi Y,Pourpak Z. [Prevalence of asthma symptom inIran: a meta-analysis]. J Res Med Sci. 2007;31(3):217-25. Persian.15. Haghdoost AA, Rezazadeh-Kermani M, SadghiradB, Baradaran HR. Prevalence of type 2 diabetes inthe Islamic Republic of Iran: systematic review andmeta-analysis. East Mediterr Health J. 2009;15(3):591-9.16. Haghdoost AA, Sadeghirad B, RezazadehkermaniM. Epidemiology and heterogeneity of hypertensionin Iran: a systematic review. Arch Iran Med.2008;11(4):444-52. Review.17. Mirzazadeh A, Sadeghirad B, Haghdoost AA,Bahrein F, Rezazadeh Kermani M. The prevalenceof obesity in Iran in recent decade; a systematicreview and meta-analysis study. Iran J PublicHealth. 2009;38(3):1-11.18. Entezari A, Mehrabi Y, Varesvazirian M, PourpakZ, Moin M. A systematic review of recent asthmasymptom surveys in Iranian children. Chron RespirDis. 2009;6(2):109-14.19. Ma AG, Schouten E, Wang Y, Xu RX, Zheng MC,Li Y, et al. Anemia prevalence among pregnantwomen and birth weight in five areas in China.Med Princ Pract. 2009;18(5):368-72.20. Ebrahimi Tabarsi A. [Prevalence of iron deficiencyanemia in Zahedan pregnant women referred tohealth centers of Zahedan University of medicalscience] [Medical Doctor's thesis]. Kerman (Iran):Downloaded from http://www.jri.irJ Reprod Infertil, Vol 11, No 1, Apr/Jun 201023
Barooti E, et al. JRIstudies, these kinds <strong>of</strong> studies also have inevitablelimits, biases, and misdirections. In order to getmore accurate and reliable figures, uniform andstandard methods and study designs are alsorecommended for primary studies at the nationallevel.AcknowledgementThis study was a part <strong>of</strong> an approved andfinancially supported project by Women’s AffairsOffice at Iran's Ministry <strong>of</strong> Health and MedicalEducation. The authors appreciate all the researcherswhose articles were included in the study. Inaddition, the authors appreciate Dr. AbtinHeidarzade for reviewing the present article andproviding great guidance.References1. Gautam CS, Saha L, Sekhri K, Saha PK. <strong>Iron</strong> deficiencyin pregnancy and the rationality <strong>of</strong> iron supplementsprescribed during pregnancy. Medscape JMed. 2008;10(12):283.2. Malee M. <strong>Anemia</strong> in Pregnancy. Obstet Gynecol.2008; 112(1):201-7.3. De Benoist B, McLean E, Egli I, Cogswell M.Worldwide prevalence <strong>of</strong> anaemia 1993–2005,WHO Global Database on <strong>Anemia</strong>. Geneva: WorldHealth Organization; 2008. p. 21.4. Safavi M, Sheykh Aleslam R, Naghavi M, AbdollahiZ, Sadeghian Sharif S, Sadegh zadeh E, et al.[<strong>Prevalence</strong> <strong>of</strong> <strong>Iron</strong> deficiency anemia <strong>among</strong>Iranian Pregnant woman, Spring 2001]. Iran JEpidemiol. 2006;1(4):1-10. Persian.5. Khademi Z, Shahi A, Farshid Far GhR, Zare Sh,Vaziri F. [<strong>Prevalence</strong> <strong>of</strong> iron deficiency anemia inpregnant women referred to Shariati hospital inBandar Abbas, Iran]. Hormozgan Med J. 2004;8(1):27-31. Persian.6. Navidian A, Ebrahimi Tabas E, Sarani H, Ghalge M,Yaghobinia F. [The prevalence <strong>of</strong> <strong>Iron</strong>-deficiencyanemia in the pregnant women referring to healthcenters in Zahedan]. J Reprod Infertil. 2006;7(2):132-8. Persian.7. Borna S, Borna H, Ghanbari Z, Khezrdoost S.<strong>Anemia</strong> and factors that affect it in pregnancy.Tehran Univ Med J. 2005;63(6):448-52.8. Davaritanha F, Kaveh M, Salehi B. [Incidence <strong>of</strong>anemia in pregnancy and its relationship withmaternal characteristics and pregnancy outcome].Hayat. 2005;11(24,25):23-31. Persian.9. Haghdoost AA, Sadeghirad B, Hajarizadeh B,Mirzazadeh A. The Application <strong>of</strong> SystematicReview and Meta-analysis Concepts in Summarizingthe Findings <strong>of</strong> Observational Studies. Iran JPsychiatry. 2007;2(4):132-6.10. Baig-Ansari N, Badruddin SH, Karmaliani R,Harris H, Jehan I, Pasha O, et al. <strong>Anemia</strong> prevalenceand risk factors in pregnant women in anurban area <strong>of</strong> Pakistan. Food Nutr Bull. 2008;29(2):132-9.11. Khosla AH, Dahiya P, Dahiya K. Burden <strong>of</strong>chronic severe anemia in obstetric patients in ruralnorth India. Indian J Med Sci. 2002;56(5):222-4.12. Stroup DF, Berlin JA, Morton SC, Olkin I,Williamson GD, Rennie D, et al. Meta-analysis <strong>of</strong>observational studies in epidemiology: a proposalfor reporting. JAMA. 2000;283(15):2008-12.13. Moher D, Tetzlaff J, Tricco AC, Sampson M,Altman DG. Epidemiology and reporting characteristics<strong>of</strong> systematic reviews. PLoS Med. 2007;4(3):e78.14. Heidarnia MA, Entezari A, Moein M, Mehrabi Y,Pourpak Z. [<strong>Prevalence</strong> <strong>of</strong> asthma symptom inIran: a meta-analysis]. J Res Med Sci. 2007;31(3):217-25. Persian.15. Haghdoost AA, Rezazadeh-Kermani M, SadghiradB, Baradaran HR. <strong>Prevalence</strong> <strong>of</strong> type 2 diabetes inthe Islamic Republic <strong>of</strong> Iran: systematic review andmeta-analysis. East Mediterr Health J. 2009;15(3):591-9.16. Haghdoost AA, Sadeghirad B, RezazadehkermaniM. Epidemiology and heterogeneity <strong>of</strong> hypertensionin Iran: a systematic review. Arch Iran Med.2008;11(4):444-52. Review.17. Mirzazadeh A, Sadeghirad B, Haghdoost AA,Bahrein F, Rezazadeh Kermani M. The prevalence<strong>of</strong> obesity in Iran in recent decade; a systematicreview and meta-analysis study. Iran J PublicHealth. 2009;38(3):1-11.18. Entezari A, Mehrabi Y, Varesvazirian M, PourpakZ, Moin M. A systematic review <strong>of</strong> recent asthmasymptom surveys in Iranian children. Chron RespirDis. 2009;6(2):109-14.19. Ma AG, Schouten E, Wang Y, Xu RX, Zheng MC,Li Y, et al. <strong>Anemia</strong> prevalence <strong>among</strong> pregnantwomen and birth weight in five areas in China.Med Princ Pract. 2009;18(5):368-72.20. Ebrahimi Tabarsi A. [<strong>Prevalence</strong> <strong>of</strong> iron deficiencyanemia in Zahedan pregnant women referred tohealth centers <strong>of</strong> Zahedan University <strong>of</strong> medicalscience] [Medical Doctor's thesis]. Kerman (Iran):Downloaded from http://www.jri.irJ Reprod Infertil, Vol 11, No 1, Apr/Jun 201023
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