Comparative Impact of Maternal Anemia and Chronic Energy Deficiency on Low Birth Weight: Meta-Analysis: Analisis Komparasi Pengaruh Anemia dan Kekurangan Energi Kronis Selama Kehamilan terhadap Berat Badan Lahir Rendah: Meta-Analisis

Abstrak

Inggris

Background: Low birth weight (LBW) remains a major public health problem, particularly in low- and middle-income countries. It contributes substantially to neonatal morbidity and mortality. Some of the risk factors for LBW are maternal anemia and chronic energy deficiency (CED). These conditions are common during pregnancy and preventable. Objectives: This study aimed to analyze the comparation between maternal anemia and chronic energy deficiency during pregnancy and the risk of low birth weight. Methods: A systematic search of PubMed and Scopus was conducted for studies published between January 2020 and July 2025. Of 1,121 records identified, 22 observational studies (case–control and cohort) met the inclusion criteria. Studies evaluating the association of maternal anemia or CED with LBW were included. Data were extracted independently by two reviewers. Meanwhile, data analysis involved multiple methods. For example, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using meta-analytic models. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots. This study’s protocol was registered in PROSPERO (CRD420251138329). Discussions: From 22 studies, 19 studies assessed maternal anemia (n = 16,219), and 11 studies assessed CED (n = 4,440). Maternal CED was associated with a nearly threefold increased risk of LBW (OR = 2.98; 95% CI: 2.07–4.29; I² = 82%), while maternal anemia increased the risk by 2.4 times (OR = 2.44; 95% CI: 1.73–3.43; I² = 86%). Funnel plots showed no substantial publication bias. Conclusions: Both maternal anemia and chronic energy deficiency are significantly associated with an increased risk of low birth weight, with CED demonstrating a stronger association. Strengthening antenatal nutritional interventions is essential to prevent LBW incidences.

Bahasa Indonesia

Latar Belakang: Berat badan lahir rendah (BBLR) tetap menjadi tantangan kesehatan global, terutama di negara berpenghasilan rendah dan menengah, karena berhubungan erat dengan morbiditas dan mortalitas neonatal. Faktor gizi ibu, termasuk anemia dan kekurangan energi kronis (KEK), merupakan penyebab penting sekaligus dapat dicegah. Tujuan: Analisis komparasi pengaruh anemia dan kekurangan energi kronis (KEK) selama kehamilan terhadap risiko kejadian bayi berat lahir rendah. Metode: Pencarian dilakukan di PubMed dan Scopus (Januari 2020-Juli 2025). Dari 1121 artikel yang teridentifikasi, 22 studi memenuhi kriteria. Studi yang disertakan memiliki desain observasional (kasus-kontrol dan kohort) yang melaporkan hubungan antara anemia atau KEK pada ibu dengan BBLR. Ekstraksi data dilakukan secara independen oleh dua peneliti. Rasio odds (OR) gabungan dengan interval kepercayaan 95% (CI) dihitung menggunakan pendekatan statistik yang sesuai. Heterogenitas dinilai dengan statistik I², dan plot corong digunakan untuk menilai bias publikasi. Protokol tinjauan didaftarkan di PROSPERO CRD420251138329. Diskusi: Sebanyak 22 studi yang dianalisis, terdiri dari 19 studi tentang anemia ibu (n = 16.219) dan 11 studi tentang KEK (n = 4.440). Analisis gabungan menunjukkan KEK meningkatkan risiko BBLR hampir 3 kali lipat (OR = 2,98, 95% CI: 2,07–4,29, I² = 82%). Anemia juga meningkatkan risiko sebesar 2.4 kali (OR = 2,44, 95% CI: 1,73-3,43, I² = 86%). Funnel plot menunjukkan distribusi yang relatif simetris tanpa indikasi bias publikasi. Kesimpulan: Anemia dan KEK berhubungan signifikan dengan BBLR, dengan KEK menunjukkan asosiasi lebih kuat. Hasil ini menegaskan pentingnya intervensi antenatal, termasuk suplementasi zat besi dan peningkatan asupan energi-protein.

Kata kunci

• berat badan lahir rendah
• anemia
• kekurangan energi kronis
• status gizi kehamilan
• low birth weight
• chronic energy deficiency
• maternal nutrition