{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:41:36Z","timestamp":1777052496288,"version":"3.51.4"},"reference-count":77,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,7]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pregnancy-related anaemia significantly affects human development across life stages. In sub-Saharan Africa (SSA), country-specific epidemiological variations primarily driven by nutritional practices, socioeconomic factors and health-system disparities contribute to heterogeneity in prevalence, severity and adverse birth outcomes (ABOs). While anaemia and micronutrient deficiencies in pregnancy are well studied globally, comprehensive trimester-specific evidence and their associations with ABOs in SSA remain scarce. This review, therefore, examines the breadth and nature of existing evidence on these associations within SSA, thereby updating current knowledge and informing regionally tailored interventions and future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A scoping review methodology will be employed due to the limited volume of literature addressing the specific research questions and population. The review will follow the Joanna Briggs Institute (JBI) framework, applying the population-concept-context approach. Comprehensive searches will be conducted across CINAHL, MEDLINE, Cochrane Library, Scopus, Google Scholar, EBSCO Open Dissertations and relevant organisational websites. The planned search period will span from 1 January 2016 to 31 December 2025. Two reviewers will independently screen and extract data using JBI-adapted protocols within the Rayyan review platform. Any discrepancies will be resolved via discussion with the research team. Findings will be synthesised narratively through descriptive content analysis and visual mapping.<\/jats:p>\n                    <jats:p>\n                      This review will include peer-reviewed studies and grey literature that investigate the associations between anaemia or deficiencies in iron, folate and vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      during pregnancy trimesters and ABOs in SSA. All relevant sources of evidence will be considered, regardless of study design or methodology, provided they report on women of reproductive age who experienced anaemia in any trimester and were subsequently identified with ABOs. Birth outcomes of interest include low birth weight, macrosomia, small or large for gestational age, preterm birth, post-term birth and stillbirth. Only sources published in English from 2016 onward will be included. The studies\u2019 quality will be evaluated using Cochrane\u2019s risk of bias assessment and mixed methods appraisal tools and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This scoping review will not require ethical approval as it will synthesise published data and reports. It has been registered with the Open Science Framework. This review does not involve human participants. The final report will be submitted for publication in a peer-reviewed journal. The findings will be used to shape subsequent research, serving as a fundamental element of the evidence and knowledge mapping framework. As this study protocol was not reviewed by an ethics committee, the appropriate contact for research integrity matters is the Faculty of Health and Environmental Sciences, Auckland University of Technology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113826","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:05:38Z","timestamp":1777050338000},"page":"e113826","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping the evidence on anaemia across trimesters of pregnancy and risk of adverse birth outcomes in sub-Saharan Africa: a scoping review protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8496-4099","authenticated-orcid":false,"given":"Silas","family":"Adjei-Gyamfi","sequence":"first","affiliation":[{"name":"Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand"},{"name":"Savelugu Municipal Hospital, Ghana Health Service, Savelugu, Northern Region, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Zeng","sequence":"additional","affiliation":[{"name":"Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Armah","family":"Aryee","sequence":"additional","affiliation":[{"name":"University for Development Studies, Tamale, Northern, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2397-767X","authenticated-orcid":false,"given":"Gael Janine","family":"Mearns","sequence":"additional","affiliation":[{"name":"Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"2026042410051795000_16.4.e113826.1","unstructured":"WHO . The life-course approach: From theory to practice: Case stories from two small countries in Europe. World Health Organization - Regional Office for Europe 2018."},{"key":"2026042410051795000_16.4.e113826.2","doi-asserted-by":"crossref","first-page":"e702","DOI":"10.1016\/S2352-3026(23)00168-0","article-title":"The challenge of defining the global burden of iron deficiency anaemia","volume":"10","author":"Young","year":"2023","journal-title":"Lancet Haematol"},{"key":"2026042410051795000_16.4.e113826.3","unstructured":"WHO . Global nutrition targets 2025: Policy brief series (who\/nmh\/nhd\/14.2). Geneva: World Health Organization, 2014."},{"key":"2026042410051795000_16.4.e113826.4","unstructured":"WHO . Guideline: optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects. Geneva WHO; 2015."},{"key":"2026042410051795000_16.4.e113826.5","unstructured":"WHO . Nutritional anaemias: Tools for effective prevention and control. 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