Association Between the Anemia During Pregnancy and Maternal Intensive Care Unit Admissions: A Systematic Review and Meta-Analysis

IF 0.9 4区医学

Indian Journal of Hematology and Blood Transfusion Pub Date : 2024-08-25 DOI:10.1007/s12288-024-01849-0

Tejaswini B. Darukaradhya, Asmitha Bhateja, Sujata Siwatch, Muhammad Aaqib Shamim, Prakasini Satapathy, Aravind P. Gandhi

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Abstract

Anemia during pregnancy is one of the most common conditions that may have adverse consequences on maternal and fetal health. Current evidence is inconsistent with regards to the effects of anemia on maternal ICU admissions. This meta-analysis aimed to examine the overall effect of anemia during pregnancy on maternal ICU admissions. We searched PubMed, Embase, Cochrane Library, and Web of Science for observational studies that compared the risk of ICU admission between anemic and non-anemic pregnant women. We pooled the odds ratios (ORs) for ICU admission using a random-effects model. Heterogeneity among studies was assessed using prediction intervals (PIs), Tau² and I² statistics. Sensitivity analysis by excluding outlier studies, meta-regression by sample size and age, and publication bias detection by LFK index and Doi plot was undertaken. Eight studies with a total of 21,997,574 participants in both anemic and non-anemic groups were included. Of them, meta-analysis was conducted in seven studies which yielded a pooled OR for anemia and ICU admission as 1.32 (95% CI 0.62–2.81). There was also a very high level of heterogeneity among studies (PI: 0.10–18.16, I² = 100%). When an influential study was omitted, the pooled OR 1.16 (95% CI − 1.13; 1.20) for ICU admission was significant. The LFK index was − 3.64, indicating publication bias. Anemia in pregnant women might be associated with a higher risk of ICU admission, but it is essential to interpret this cautiously due to significant heterogeneity and potential publication bias.

Registration: PROSPERO database (CRD42023466529).

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孕期贫血与产妇入住重症监护室之间的关系：系统回顾与元分析

孕期贫血是最常见的疾病之一，可能会对孕产妇和胎儿的健康造成不利影响。关于贫血对孕产妇入住重症监护病房的影响，目前的证据并不一致。本荟萃分析旨在研究孕期贫血对孕产妇入住重症监护病房的总体影响。我们在 PubMed、Embase、Cochrane Library 和 Web of Science 上搜索了比较贫血和非贫血孕妇入住 ICU 风险的观察性研究。我们采用随机效应模型对入住 ICU 的几率比 (OR) 进行了汇总。使用预测区间（PI）、Tau2 和 I2 统计量评估了各研究之间的异质性。通过排除离群研究、按样本大小和年龄进行元回归、用 LFK 指数和 Doi 图检测发表偏倚等方法进行了敏感性分析。共纳入了 8 项研究，贫血组和非贫血组共有 21,997,574 名参与者。对其中 7 项研究进行了荟萃分析，得出贫血与入住重症监护室的合计 OR 为 1.32（95% CI 0.62-2.81）。各研究之间的异质性也非常高（PI：0.10-18.16，I2 = 100%）。如果省略一项有影响的研究，则入住重症监护室的汇总 OR 1.16（95% CI - 1.13; 1.20）具有显著性。LFK指数为-3.64，表明存在发表偏倚。孕妇贫血可能与入住ICU的风险较高有关，但由于存在明显的异质性和潜在的发表偏倚，必须谨慎解释：注册：PROSPERO数据库（CRD42023466529）。

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来源期刊

Indian Journal of Hematology and Blood Transfusion Medicine-Hematology

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期刊介绍： Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale. The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.