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. 2015 Jul 22;2015(7):CD004736. doi: 10.1002/14651858.CD004736.pub5

Comparison 4. Supplementation with iron+folic acid versus no treatment/placebo.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Low birthweight (less than 2500 g) (ALL) 2 1311 Risk Ratio (M‐H, Random, 95% CI) 1.07 [0.31, 3.74]
2 Birthweight (ALL) 2 1365 Mean Difference (IV, Random, 95% CI) 57.73 [7.66, 107.79]
3 Preterm birth (less than 37 weeks of gestation) (ALL) 3 1497 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
4 Preterm birth (less than 37 weeks of gestation): SUBGROUP ANALYSIS by gestational age at the start of supplementation 3 1410 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
4.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation 2 1366 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
4.2 Late gestational age (20 weeks or more of gestation) at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.3 Unspecified or mixed gestational age at start of supplementation 1 44 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
5 Preterm birth (less than 37 weeks of gestation): SUBGROUP ANALYSIS by anaemia status at the start of supplementation 3 1497 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
5.1 Anaemic at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
5.2 Non‐anaemic at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
5.3 Unspecified or mixed anaemic status at start of supplementation 3 1497 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
6 Preterm birth (less than 37 weeks of gestation): SUBGROUP ANALYSIS by dose of iron 3 1497 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
6.1 Low daily dose (30 mg elemental iron or less) 1 131 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
6.2 Medium daily dose (31 to 59 mg elemental iron) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
6.3 Higher daily dose (60 mg elemental iron and above) 2 1366 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
7 Preterm birth (less than 37 weeks of gestation): SUBGROUP ANALYSIS by malarial status of setting 3 1497 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.40, 6.00]
7.1 Malarial setting 2 1449 Risk Ratio (M‐H, Random, 95% CI) 1.13 [0.92, 1.39]
7.2 Non‐malarial setting 1 48 Risk Ratio (M‐H, Random, 95% CI) 7.00 [0.38, 128.61]
8 Neonatal death (within 28 days after delivery) (ALL) 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
9 Neonatal death (within 28 days after delivery): SUBGROUP ANALYSIS by gestational age at start of supplementation 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
9.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
9.2 Late gestational age (20 weeks or more of gestation) at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
9.3 Unspecified or mixed gestational age at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
10 Neonatal death (within 28 days after delivery): SUBGROUP ANALYSIS by anaemia status at start of supplementation 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
10.1 Anaemic at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
10.2 Non‐anaemic at start of supplementation 1 97 Risk Ratio (M‐H, Random, 95% CI) 2.5 [0.10, 59.88]
10.3 Unspecified or mixed anaemic status at start of supplementation 2 1696 Risk Ratio (M‐H, Random, 95% CI) 0.79 [0.49, 1.27]
11 Neonatal death (within 28 days after delivery): SUBGROUP ANALYSIS by dose of iron 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
11.1 Low daily dose (30 mg elemental iron or less) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
11.2 Medium daily dose (31 to 59 mg elemental iron) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
11.3 Higher daily dose (60 mg elemental iron and above) 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
12 Neonatal death (within 28 days after delivery): SUBGROUP ANALYSIS by malarial status of setting 3 1793 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.51, 1.30]
12.1 Malarial setting 1 1648 Risk Ratio (M‐H, Random, 95% CI) 0.79 [0.49, 1.27]
12.2 Non‐malarial setting 2 145 Risk Ratio (M‐H, Random, 95% CI) 2.5 [0.10, 59.88]
13 Congenital anomalies (ALL) 1 1652 Risk Ratio (M‐H, Random, 95% CI) 0.70 [0.35, 1.40]
14 Maternal anaemia at term (Hb less than 110 g/L at 37 weeks' gestation or more) (ALL) 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
15 Maternal anaemia at term (Hb less than 110 g/L at 37 weeks' gestation or more): SUBGROUP ANALYSIS by gestational age at the start of supplementation 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
15.1 Early gestational age (less than 20 weeks of gestation or pre‐pregnancy) at start of supplementation 1 97 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
15.2 Late gestational age (20 weeks or more of gestation) at start of supplementation 2 249 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
15.3 Unspecified or mixed gestational age at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
16 Maternal anaemia at term (Hb less than 110 g/L at 37 weeks' gestation or more): SUBGROUP ANALYSIS by anaemia status at the start of supplementation 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
16.1 Anaemic at start of supplementation 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
16.2 Non‐anaemic at start of supplementation 2 280 Risk Ratio (M‐H, Random, 95% CI) 0.24 [0.09, 0.68]
16.3 Unspecified or mixed anaemic status at start of supplementation 1 66 Risk Ratio (M‐H, Random, 95% CI) 0.37 [0.22, 0.62]
17 Maternal anaemia at term (Hb less than 110 g/Lat 37 weeks' gestation or more): SUBGROUP ANALYSIS by dose of iron 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
17.1 Low daily dose (30 mg elemental iron or less) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
17.2 Medium daily dose (31 to 59 mg elemental iron) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
17.3 Higher daily dose (60 mg elemental iron and above) 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
18 Maternal anaemia at term (Hb less than 110 g/L at 37 weeks' gestation or more): SUBGROUP ANALYSIS by malarial status of setting 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
18.1 Malarial setting 1 66 Risk Ratio (M‐H, Random, 95% CI) 0.37 [0.22, 0.62]
18.2 Non‐malarial setting 2 280 Risk Ratio (M‐H, Random, 95% CI) 0.24 [0.09, 0.68]
19 Maternal iron deficiency at term (as defined by trialists, based on any indicator of iron status at 37 weeks' gestation or more) (ALL) 1 131 Risk Ratio (M‐H, Random, 95% CI) 0.24 [0.06, 0.99]
20 Maternal iron‐deficiency anaemia at term (Hb less than 110 g/L and at least one additional laboratory indicators at 37 weeks' gestation or more) (ALL) 1 131 Risk Ratio (M‐H, Random, 95% CI) 0.43 [0.17, 1.09]
21 Maternal death (death while pregnant or within 42 days of termination of pregnancy) (ALL) 1 131 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
22 Side effects (any reported throughout the intervention period) (ALL) 1 456 Risk Ratio (M‐H, Random, 95% CI) 44.32 [2.77, 709.09]
23 Maternal severe anaemia at any time during second and third trimester (Hb less than 70 g/L) (ALL) 4 506 Risk Ratio (M‐H, Random, 95% CI) 0.12 [0.02, 0.63]
24 Maternal clinical malaria 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
25 Infection during pregnancy (including urinary tract infections) (ALL) 1 48 Risk Ratio (M‐H, Random, 95% CI) 1.0 [0.15, 6.53]
26 Very low birthweight (less than 1500 g) (ALL) 1 48 Risk Ratio (M‐H, Random, 95% CI) 5.0 [0.25, 98.96]
27 Very premature birth (less than 34 weeks' gestation) (ALL) 2 92 Risk Ratio (M‐H, Random, 95% CI) 5.0 [0.25, 98.96]
28 Infant Hb concentration in the first 6 months (in g/L, counting the last reported measure after birth within this period) (ALL) 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
29 Infant serum ferritin concentration in the first 6 months (in μg/L, counting the last reported measure after birth within this period) (ALL) 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
30 Admission to special care unit (ALL) 1 48 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
31 Maternal anaemia at or near term (Hb less than 110 g/L at 34 weeks' gestation or more) (ALL) 3 346 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.21, 0.54]
32 Maternal iron deficiency at or near term (as defined by trialists, based on any indicator of iron status at 34 weeks' gestation or more) (ALL) 1 131 Risk Ratio (M‐H, Random, 95% CI) 0.24 [0.06, 0.99]
33 Maternal iron‐deficiency anaemia at or near term (Hb less than 110 g/L and at least one additional laboratory indicators at 34 weeks' gestation or more) (ALL) 1 131 Risk Ratio (M‐H, Random, 95% CI) 0.43 [0.17, 1.09]
34 Maternal Hb concentration at term or near term (in g/L, at 34 weeks' gestation or more) (ALL) 3 140 Mean Difference (IV, Random, 95% CI) 16.13 [12.74, 19.52]
35 Maternal Hb concentration within 6 wk postpartum (g/L) (ALL) 2 459 Mean Difference (IV, Random, 95% CI) 10.07 [7.33, 12.81]
36 Maternal high haemoglobin concentrations during second or third trimester (Hb more than 130 g/L) (ALL) 2 446 Risk Ratio (M‐H, Random, 95% CI) 1.78 [0.63, 5.04]
37 Maternal high haemoglobin concentrations at or near term (Hb more than 130 g/L at 34 weeks' gestation or more) (ALL) 2 314 Risk Ratio (M‐H, Random, 95% CI) 4.37 [0.58, 32.71]
38 Moderate anaemia at postpartum (Hb more than 80 g/L and less than 110 g/L) (ALL) 2 458 Risk Ratio (M‐H, Random, 95% CI) 0.34 [0.17, 0.69]
39 Maternal severe anaemia at term or near (Hb less than 70 g/L at 34 weeks' gestation or more) (ALL) 3 191 Risk Ratio (M‐H, Random, 95% CI) 0.14 [0.01, 2.63]
40 Severe anaemia at postpartum (Hb less than 80 g/L) (ALL) 3 491 Risk Ratio (M‐H, Random, 95% CI) 0.05 [0.00, 0.76]
41 Puerperal infection (ALL) 1 2863 Risk Ratio (M‐H, Random, 95% CI) 0.55 [0.13, 2.28]
42 Antepartum haemorrhage (ALL) 2 145 Risk Ratio (M‐H, Random, 95% CI) 1.25 [0.22, 7.12]
43 Postpartum haemorrhage (ALL) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
44 Placental abruption (ALL) 1 2863 Risk Ratio (M‐H, Random, 95% CI) 8.19 [0.49, 138.16]
45 Pre‐eclampsia (ALL) 1 48 Risk Ratio (M‐H, Random, 95% CI) 3.0 [0.13, 70.16]