review · Nutrition Reviews
Anaemia during pregnancy remains a critical public health challenge in low- and middle-income countries. A comprehensive systematic review and meta-analysis of 53 studies covering 13,475 pregnant women evaluated the impact of nutrition education interventions. The findings demonstrate that women receiving nutrition education during pregnancy are 2.80 times more likely to adhere to iron-folic acid supplementation. Furthermore, the intervention resulted in an average increase in maternal haemoglobin levels of 0.88 grams per decilitre. Crucially, pregnant women participating in nutrition education programmes experienced a 34 percent lower risk of developing anaemia compared to control groups. Variation in the results across studies was substantially linked to baseline anaemia status, the duration of the intervention, and the geographic region. Overall, structured educational interventions provide measurable clinical improvements in maternal nutrition.
Anaemia during pregnancy poses substantial health risks to both mothers and infants, especially in resource-limited settings. By showing that structured educational programmes directly improve supplement adherence, raise haemoglobin levels, and cut anaemia risk by a third, this evidence helps healthcare providers and public health organisations design targeted, non-invasive strategies to improve maternal wellbeing.
The findings support the design and deployment of maternal health training packages, digital health interventions, and clinical education tools. Potential users include public health agencies, antenatal clinics, and non-governmental organisations seeking evidence-based behaviour change models. Because the evidence is derived from existing, tested programmes across low- and middle-income countries, the concepts are applied and tested, though specific educational products or software platforms would require adaptation to local clinical contexts.
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CONTEXT: Stakeholders implement nutrition education to prevent and control anemia during pregnancy. Nutrition education during pregnancy can increase the consumption of iron-folic acid (IFA) supplements and encourage behavioral changes. However, there is no comprehensive meta-analysis to determine the effectiveness of this intervention. OBJECTIVE: This review aimed to determine the effect of nutrition education on IFA supplementation (IFAS) compliance, hemoglobin level change, and prevalence of anemia in low- and middle-income countries. DATA SOURCES: The systematic searches on Ovid Medline, Scopus, Embase (Elsevier), Web of Science, Health and Medical Collection (ProQuest), and Google Scholar were conducted until September 11, 2023. The updated searches were performed on November 16, 2023. DATA EXTRACTION: In total, 12 436 records were imported to Covidence. Of these, 9109 records were screened by title and abstract. A total of 112 records were evaluated in full, and 53 articles were ultimately included based on eligibility. RESULTS: Fifty-three peer-reviewed research articles met the inclusion criteria, involving 13 475 pregnant women. Those who received nutrition education during pregnancy were 2.80 times more likely to comply with IFAS (odds ratio = 2.80; 95% CI: 2.04, 3.83; I2 = 66.20%). There was an average increase of 0.88 g/dL (Cohen's d = 0.88; 95% CI: 0.63, 1.13; I2 = 96.17%) in hemoglobin levels among women who received nutrition education. A meta-regression analysis revealed that 61.85% (adjusted R2 = 61.85%) of heterogeneity between standardized mean differences was explained by anemia status, intervention duration, and geographic region. Also, pregnant women in the nutrition education group had a 34% (relative risk = 0.66; 95% CI: 0.54, 0.80, I2 = 86.85%) lower risk of anemia compared with the control group. CONCLUSION: Nutrition education during pregnancy improves compliance with IFAS, increases hemoglobin levels, and reduces the risk of anemia. Therefore, it is crucial to enhance the existing nutrition education program to prevent and control anemia during pregnancy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023454241.
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DOI: 10.1093/nutrit/nuae170
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