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Our study aimed to summarize the evidence for the association between maternal hemoglobin (Hb) concentrations and maternal or infant outcomes, evaluating it in a continuous manner. In this systematic review and meta\u2010analysis, we conducted an electronic search on PubMed, Embase, CINAHL, and Web of Science from inception to April 19, 2017, and further updated to November 21, 2018, applying subject heading terms related to pregnant women with anemia. We included 117 studies with 4,127,430 pregnancies. Maternal anemia increased the risk of low birth weight (odds ratio (OR), 1.65; 95% confidence interval (CI): 1.45\u22121.87), preterm birth (PTB) (OR, 2.11; 95% CI: 1.76\u20132.53), perinatal mortality (PNM) (OR, 3.01; 95% CI: 1.92\u22124.73), stillbirth (OR, 1.95; 95% CI: 1.15\u22123.31), and maternal mortality (OR, 3.20; 95% CI: 1.16\u22128.85). A nonlinear relationship was found between maternal Hb and adverse maternal and infant outcomes. The OR of outcomes such as PTB, small\u2010for\u2010gestational age, PNM, preeclampsia, gestational hypertension, and postpartum hemorrhage was increased by two to three times. Assessing Hb as a continuous variable is important to determine the associated risk of adverse outcomes with decreasing or increasing levels.<\/jats:p>","DOI":"10.1111\/nyas.14112","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T07:45:47Z","timestamp":1559288747000},"page":"69-82","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":177,"title":["Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"1450","author":[{"given":"Jenny","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Global Health Policy, School of International Health the University of Tokyo  Tokyo Japan"},{"name":"Global Public Health Research Foundation  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Mizanur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Global Health Policy, School of International Health the University of Tokyo  Tokyo Japan"},{"name":"Global Public Health Research Foundation  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Shafiur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Global Health Policy, School of International Health the University of Tokyo  Tokyo Japan"},{"name":"Global Public Health Research Foundation  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khin Thet","family":"Swe","sequence":"additional","affiliation":[{"name":"Department of Global Health Policy, School of International Health the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Rashedul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Global Health Policy, School of International Health the University of Tokyo  Tokyo Japan"},{"name":"Global Public Health Research Foundation  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Obaidur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Global Public Health Research Foundation  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamima","family":"Akter","sequence":"additional","affiliation":[{"name":"Global Public Health Research Foundation  Dhaka Bangladesh"},{"name":"Department of Epidemiology and Prevention, Center for Clinical Sciences National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,31]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Global Health Observatory Data Repository.Prevalence of anaemia in pregnant women. Estimates by WHO region [online]. 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