O056 - GESTATIONAL ANAEMIA AND ADVERSE PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

O056

GESTATIONAL ANAEMIA AND ADVERSE PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

I. Pinto Amorim Das Virgens^1,*, Z. A. Balogh^1,2, A. Kubik^1,3, B. Teutsch¹, A. Szabó¹, P. Fehévári¹, P. Hegyi¹, S. Valent², N. Ács^1,2

¹Centre for Translational Medicine, ²Department of Gynecology and Obstetrics, ³Department of Urology, Semmelweis University, Budapest, Hungary

Rationale: Anemia affects over 37% of women during pregnancy, posing a risk for several outcomes for both the child and mother. Our aim was to perform a systematic review and meta-analysis to investigate the association of gestational anemia (and its severity) and perinatal outcomes.

Methods: A systematic search was conducted on PubMed, EMBASE, and Cochrane Library on March 23, 2025, following the recommendations of the Cochrane Handbook. Studies evaluating pregnant patients with and without anemia and the outcomes of interest (preterm birth, small for gestational age, intrauterine growth restriction, miscarriages, stillbirth, neonatal mortality, or perinatal mortality) were eligible. Anemia and its degrees of severity were defined according to the cut-off values of the World Health Organization. Data from the eligible articles were extracted by two independent reviewers into an Excel sheet. The odds ratio (OR) and risk ratio (RR) were calculated with a 95% confidence interval (95% CI). Statistical heterogeneity across studies was assessed based on the I2 statistic.

Results: A total of 145 studies were included in the qualitative synthesis, of which 86 studies were included in the meta-analyses. Anemia was associated with preterm birth (RR = 1.42, 95% CI: 1.25, 1.61; 48 studies; I² = 94%) and neonatal mortality (RR = 1.22, 95% CI: 1.06, 1.41; 10 studies; I² = 29%). Severe anemia was associated with preterm birth (RR = 2.61, 95% CI:2.00, 3.41; 9 studies; I² = 85%; adjusted OR=1.39, 95% CI: 1.10, 1.76; 19 studies, I² = 89%), stillbirth (RR = 3.29, 95% CI: 2.35, 4.60; 8 studies; I² = 43%), neonatal mortality (RR = 4.46, 95% CI= 2.09, 9.52; 6 studies; I² = 64%), and perinatal mortality (RR = 5.68, 95% CI: 2.07, 15.61; 2 studies; I² = 0%).

Conclusion: Mothers with severe anemia have significantly higher risk of several adverse perinatal outcomes compared to those with mild and moderate anemia.

Disclosure of Interest: None declared