The benefits and harms of oral iron supplementation in non-anaemic pregnant women: A systematic review and meta-analysis
Notice bibliographique
Résumé
Abstract Objective Iron deficiency during pregnancy poses a significant risk to both maternal and foetal health. Despite increased iron requirements during pregnancy, current UK NICE guidelines do not give clear advice on antenatal iron supplementation for non-anaemic women. We aimed to assess whether the benefits of routine antenatal supplementation outweigh potential harms for non-anaemic women. Methods The Cochrane Library, MEDLINE, Embase and clinical trial registries were searched for randomised control trials (RCTs) and observational studies comparing oral iron supplementation with placebo or no supplement in non-anaemic pregnant women. The relevant data were extracted, and the risk of bias for included studies was assessed using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale. Where appropriate, meta-analysis was conducted using ‘R’. Results 23 eligible studies were identified including 4492 non-anaemic women who were followed through pregnancy. Haemoglobin and ferritin levels were consistently higher in individuals receiving iron compared with control groups, although both findings were associated with a high degree of heterogeneity (I 2 = 92% and 87% respectively) and therefore did not warrant a pooled analysis. Iron supplementation was associated with a significant reduction in rate of maternal anaemia (OR = 0.36; 95% CI = 0.22 - 0.61, p<.001; I 2 = 54%; moderate certainty, NNT 8). There was no significant effect of intervention on birth weight (MD = 22.97g, 95% CI = -56.27 to 102.22, p = 0.57; I 2 = 64%; very low certainty). Of the 18 studies reporting adverse effects, none found a significant influence of supplementation on GI disturbance, caesarean sections or preterm births. Conclusions Prophylactic iron supplementation reduces the risk of maternal anaemia in pregnancy. Limited evidence was found relating to the harms of supplementation in non-anaemic pregnant women, highlighting the need for further research to inform practice guidelines and support clinical decision making. Registration The study protocol was registered on the Open Science Framework (DOI 10.17605/OSF.IO/HKZ4C). Key Points What is this research focused on exploring, validating, or solving? Antenatal iron supplementation is known to benefit pregnant women with iron deficiency anaemia, resulting in improved maternal and foetal outcomes. We explored whether these beneficial effects extend to non-anaemic pregnant women and whether they outweigh potential harms of supplementation. What conclusions did this research draw through design, method, and analysis? We have shown that supplementation of non-anaemic women helps prevent maternal anaemia and increases maternal haemoglobin. We have also identified a significant paucity in available evidence surrounding side effects of iron supplementation. What is the value, meaning and impact of your research? Is there any followup study based on this research? By clarifying the benefits of supplementation, we hope to assist decision making in primary care. This is particularly relevant given the current discrepancies in international guidelines. Our findings strengthen the evidence base in favour of universal supplementation, but focused research into side effects is still required to better qualify risk.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,022 | 0,037 |
| Bibliométrie | 0,006 | 0,005 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».