The effect of maternal anemia during pregnancy on low birth weight in Ethiopia; a systematic review and meta-analysis.

BACKGROUND: Despite the fact that maternal anemia and low birth weight are significant public health issues that require investigation, developing countries like Ethiopia lack systematic reviews and meta-analyses on the subject. As a result, the objective of this review was to evaluate the total pooled effect of maternal anemia on low birth weight in Ethiopia. METHODS: The search was conducted across multiple electronic databases, including PubMed, EMBASE, CINAHL, Web of Science, AJOL, and Google Scholar. Grey literature was also explored through Google, and unpublished studies were sought from official repositories of Ethiopian universities. Data were extracted using Microsoft Excel and analyzed using STATA version 17 statistical software. Meta-analyses with random effects, subgroup analyses and meta-regressions were performed. Publication bias was measured using Egger regression and visual funnel plot inspection. RESULTS: This meta-analysis analysed data from 28 studies involving a total of 28,122 participants. The overall pooled analysis demonstrated a significantly increased risk of low birth weight among pregnant women with anaemia (AOR = 3.33, 95% CI: 2.84-3.81). Subgroup analyses revealed significant heterogeneity in effect sizes across various geographical regions, study durations, and study designs. The highest risk of low birth weight was observed in the Amhara region (AOR=3.99, 95%CI:3.31-4.67), in studies conducted after January 2021 (AOR=3.41, 95% CI: 2.71-4.10), and among studies utilized a cohort design (AOR = 3.93, 95% CI: 2.34-5.52). CONCLUSION AND RECOMMENDATION: The overall pooled estimate in this analysis reveals that women with anemia during pregnancy had a higher risk of low birth weight. These findings highlight the importance of prioritizing strategies that address maternal anemia as a means to reduce the burden of low birth weight. Strengthening antenatal care services to include routine anemia screening and management, alongside promoting nutritional interventions, could play a pivotal role in improving birth outcomes in this setting.