{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:29:41Z","timestamp":1772166581377,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T00:00:00Z","timestamp":1599782400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T00:00:00Z","timestamp":1599782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["TTK200406511400"],"award-info":[{"award-number":["TTK200406511400"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Research Council","award":["UNS14197"],"award-info":[{"award-number":["UNS14197"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Syst Rev"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A significant cause of morbidity and mortality during pregnancy is maternal anaemia. The causes of anaemia and the sequelae are varied, and the prevention and management are public health challenges, especially in resource-limited settings and certain geographic locations. South Africa is plagued by a quadruple burden of disease, with high maternal mortality rates affected by hypertensive disorders of pregnancy, HIV, tuberculosis and neglected tropical diseases. This is most prevalent in people of lower socio-economic status. Poor nutrition, chronic infections, lack of access to health care facilities and poor compliance with micronutrient supplementation all contribute to maternal anaemia. The aim of this study is to systematically map the literature to ascertain the pooled prevalence and associated causes of anaemia in the South African pregnant population, which will enable health care workers and other key stakeholders to more pertinently address Sustainable Development Goal 3 focussing on good health and reducing maternal mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS will be searched using the keywords \u2018anaemia\u2019, \u2018haemoglobin\u2019, \u2018pregnancy\u2019, and \u2018South Africa\u2019 to conduct a systematic review and meta-analysis to explore, describe and map literature on the distribution and burden of anaemia in pregnant women in South Africa. The reference list of articles selected for review will be scanned for other articles of interest to our study question. Studies published in any language will be included in this review. As there may be differences in sampled populations in South Africa based on geography and sociodemographic factors, a weighted inverse-variance meta-analysis using a random-effects model will be carried out to generate a pooled prevalence estimate. A Funnel plot and Egger\u2019s regression test will be conducted to assess publication bias. Heterogeneity among studies will be checked using\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      to determine dispersion and meta-regression analysis will be performed to investigate the source of heterogeneity. The articles obtained by these searches will be analysed for causative factors, severity and outcomes by a parallel and independent review team, using suitable eligibility criteria. Screening, data extraction and quality appraisal will be conducted independently by two authors. Disagreement will be resolved by independent assessment by a third reviewer. Sub group analysis by region, stage of pregnancy, socio-economic status, severity and cause of anaemia will be conducted if sufficient data is available. Data will be analysed using statistical software and presented in evidence tables and in meta-analytic forest plots.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This protocol is developed to systematically review the literature on the prevalence and severity of anaemia, risk factors and outcomes in pregnant women in South Africa. Correlation of factors contributing to the development of anaemia and other disorders during pregnancy will facilitate exploration of appropriate medical and behavioural change interventions implemented within other countries or regions that mitigate risk. This study will assist local health systems to inform public health policies and practises for more favourable maternal and fetal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      This protocol is registered with PROSPERO (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42020157191\">CRD42020157191<\/jats:ext-link>\n                      )\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13643-020-01460-0","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T23:53:04Z","timestamp":1599781984000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The prevalence, risk factors and outcomes of anaemia in South African pregnant women: a protocol for a systematic review and meta-analysis"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0655-697X","authenticated-orcid":false,"given":"Vinogrin","family":"Dorsamy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chauntelle","family":"Bagwandeen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jagadesa","family":"Moodley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,9,11]]},"reference":[{"key":"#cr-split#-1460_CR1.1","unstructured":"Younger P. Stedman's Medical Dictionary, 28th ed.200734 Stedman's Medical Dictionary, 28th ed. . Philadelphia, PA: Lippincott Williams and Wilkins 2006. l+2170 pp.+appendices 176 pp. \u00a326.95"},{"key":"#cr-split#-1460_CR1.2","doi-asserted-by":"crossref","unstructured":"$49.95, ISBN: 0 7817 3390 1 Includes CD-ROM. Ref Rev. 2007;21(1):41-2.","DOI":"10.1108\/09504120710719671"},{"key":"1460_CR2","volume-title":"South Africa, Department of Health, Human Sciences Research Council, South African Medical Research Council. The South African National Health and Nutrition Examination Survey: SANHANES-1","author":"O Shisana","year":"2013","unstructured":"Shisana O. South Africa, Department of Health, Human Sciences Research Council, South African Medical Research Council. The South African National Health and Nutrition Examination Survey: SANHANES-1. Cape Town: HSRC Press; 2013."},{"issue":"1","key":"1460_CR3","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1016\/S2214-109X(13)70001-9","volume":"1","author":"FMM Stevens","year":"2013","unstructured":"Stevens FMM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995\u20132011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16\u201325.","journal-title":"Lancet Glob Health."},{"key":"1460_CR4","doi-asserted-by":"crossref","unstructured":"Hoque M. Risk factors for anaemia in pregnancy in rural KwaZulu-Natal, South Africa\u00a0: implication for health education and health promotion\u00a0: original research. 2009 [cited 2015 Nov 14]; Available from: http:\/\/reference.sabinet.co.za\/document\/EJC80328.","DOI":"10.1080\/20786204.2009.10873811"},{"key":"1460_CR5","volume":"2017","author":"BT Mkhize","year":"2017","unstructured":"Mkhize BT, Mabaso M, Mamba T, Napier CE, Mkhize-Kwitshana ZL. The Interaction between HIV and Intestinal Helminth Parasites Coinfection with Nutrition among Adults in KwaZulu-Natal. South Africa. BioMed Res Int. 2017 Mar 22;2017:e9059523.","journal-title":"South Africa. BioMed Res Int."},{"issue":"6","key":"1460_CR6","doi-asserted-by":"publisher","first-page":"459","DOI":"10.2471\/BLT.10.083568","volume":"89","author":"RJ Soares Magalh\u00e3es","year":"2011","unstructured":"Soares Magalh\u00e3es RJ, Clements AC. Spatial heterogeneity of haemoglobin concentration in preschool-age children in sub-Saharan Africa. Bull World Health Organ. 2011;89(6):459\u201368.","journal-title":"Bull World Health Organ."},{"issue":"8","key":"1460_CR7","doi-asserted-by":"publisher","first-page":"566","DOI":"10.7326\/M14-2932","volume":"162","author":"AG Cantor","year":"2015","unstructured":"Cantor AG, Bougatsos C, Dana T, Blazina I, McDonagh M. Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2015 Apr 21;162(8):566\u201376.","journal-title":"Ann Intern Med."},{"key":"1460_CR8","doi-asserted-by":"publisher","first-page":"f3443","DOI":"10.1136\/bmj.f3443","volume":"346","author":"BA Haider","year":"2013","unstructured":"Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW, et al. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. 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