Caroline Oktarina, Charisma Dilantika, Nova Lidia Sitorus, Ray Wagiu Basrowi
{"title":"Relationship Between Iron Deficiency Anemia and Stunting in Pediatric Populations in Developing Countries: A Systematic Review and Meta-Analysis.","authors":"Caroline Oktarina, Charisma Dilantika, Nova Lidia Sitorus, Ray Wagiu Basrowi","doi":"10.3390/children11101268","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/objectives: </strong>Iron deficiency anemia (IDA) and stunting are prevalent global health issues, particularly in developing countries, where previous studies have suggested a potential relationship between them. This systematic review aims to analyze the relationship between iron deficiency anemia and stunting in pediatric populations in developing countries.</p><p><strong>Methods: </strong>Literature searches were conducted on PubMed, EMBASE, Cochrane Library, and EBSCO Host. The primary outcome was the association between IDA and stunting. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Effective Public Health Practice Project (EPHPP) for other observational studies. Meta-analysis was performed with a random-effects model and heterogeneity assessment. A Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment was performed to determine the certainty and importance of the study.</p><p><strong>Results: </strong>Out of 19,095 articles, 15 studies were included in the systematic review, and 4 studies were included in the meta-analysis, encompassing 21,936 subjects aged 0 to 12 years. IDA prevalence ranged from 3.6 to 58.8%, while stunting prevalence varied from 6.6 to 44.5%. Nine articles supported a significant relationship between IDA and stunting, revealing that stunted children had a 1.31-6.785 times higher risk of developing IDA. The odds ratio of children with IDA to be stunted was 2.27 (95% CI = 1.30-3.95). All studies exhibited a moderate risk of bias. GRADE assessment suggested that the evidence's certainty is low but important.</p><p><strong>Conclusions: </strong>The high IDA prevalence in developing countries, including Indonesia, is associated with stunting in children, suggesting a synergistic relationship.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505671/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Children-Basel","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/children11101268","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background/objectives: Iron deficiency anemia (IDA) and stunting are prevalent global health issues, particularly in developing countries, where previous studies have suggested a potential relationship between them. This systematic review aims to analyze the relationship between iron deficiency anemia and stunting in pediatric populations in developing countries.
Methods: Literature searches were conducted on PubMed, EMBASE, Cochrane Library, and EBSCO Host. The primary outcome was the association between IDA and stunting. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Effective Public Health Practice Project (EPHPP) for other observational studies. Meta-analysis was performed with a random-effects model and heterogeneity assessment. A Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment was performed to determine the certainty and importance of the study.
Results: Out of 19,095 articles, 15 studies were included in the systematic review, and 4 studies were included in the meta-analysis, encompassing 21,936 subjects aged 0 to 12 years. IDA prevalence ranged from 3.6 to 58.8%, while stunting prevalence varied from 6.6 to 44.5%. Nine articles supported a significant relationship between IDA and stunting, revealing that stunted children had a 1.31-6.785 times higher risk of developing IDA. The odds ratio of children with IDA to be stunted was 2.27 (95% CI = 1.30-3.95). All studies exhibited a moderate risk of bias. GRADE assessment suggested that the evidence's certainty is low but important.
Conclusions: The high IDA prevalence in developing countries, including Indonesia, is associated with stunting in children, suggesting a synergistic relationship.
背景/目的:缺铁性贫血(IDA)和发育迟缓是全球普遍存在的健康问题,尤其是在发展中国家,以往的研究表明两者之间存在潜在的关系。本系统综述旨在分析发展中国家儿童缺铁性贫血与发育迟缓之间的关系:方法:在 PubMed、EMBASE、Cochrane Library 和 EBSCO Host 上进行文献检索。主要结果是IDA与发育迟缓之间的关系。对队列研究采用纽卡斯尔-渥太华量表(NOS)评估偏倚风险,对其他观察性研究采用有效公共卫生实践项目(EPHPP)评估偏倚风险。采用随机效应模型和异质性评估进行了 Meta 分析。对研究的确定性和重要性进行了建议、评估、发展和评价分级(GRADE)评估:在19,095篇文章中,15项研究被纳入系统综述,4项研究被纳入荟萃分析,涉及21,936名0至12岁的受试者。IDA发病率从3.6%到58.8%不等,而发育迟缓发病率则从6.6%到44.5%不等。九篇文章证实了 IDA 与发育迟缓之间的重要关系,显示发育迟缓儿童患 IDA 的风险比正常儿童高 1.31-6.785 倍。患有 IDA 的儿童发育迟缓的几率比为 2.27(95% CI = 1.30-3.95)。所有研究均存在中度偏倚风险。GRADE 评估表明,证据的确定性较低,但很重要:结论:包括印度尼西亚在内的发展中国家 IDA 患病率高与儿童发育迟缓有关,这表明两者之间存在协同作用。
期刊介绍:
Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries.
The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.