Interventions to Promote Anemia Prevention Among Pregnant Women: A Systematic Review

Abstract

Physiological changes during the pregnancy period are factors that affect and cause pregnant women to experience iron deficiency anemia which eventually affects the women and infants. Therefore, the effective interventions to promote anemia prevention are significant. The purpose of this systematic review was to summarize and determine the interventions to promote anemia prevention among pregnant women. The results of interventions from the available evidence derived from primary research were conducted between the year 1997 and 2014.  The systematic review process followed the guidelines developed by the Joanna Briggs Institute (The Joanna Briggs Institute for Evidence Based Nursing & Midwifery [JBI], 2014) . A total of 10 quasi-experimental researches were included in the study which met the review inclusion criteria. The content analysis was used to summarize the data because the results cannot be used for meta-analysis due to the differences of the interventions and outcomes. 

There were a variety of methods found in this systematic review to promote anemia prevention. The 10 quasi-experimental studies include group education programs provided by the researcher and nutritionist using proper media. Furthermore, the studies also consisted of education with social support, education with motivation and education with mutual goal setting between researcher and control group. The 9 studies were conducted during the second and the third trimester and 1 study was conducted from the first through the third trimester. All the studies developed health education programs based on nursing theory such as: health belief model, protection motivations theory, self-care theory, health education theory and goal attainment theory. The interventions can increase the knowledge and behaviors to prevent anemia among pregnant women by taking iron supplements correctly and regularly having high-iron food or food supporting iron absorption, and avoiding food preventing iron absorption. Moreover, the experimental group had higher hematocrit, hemoglobin and serum ferritin levels than those in the control group.

According to this systematic review, it is suggested that when choosing appropriate intervention to promote anemia prevention among pregnant women, education provision should be provided via proper media so that the women had knowledge and modified their behaviors to prevent anemia or to increase the level of hematocrit.  Group education should provide with social support, motivation and mutual goal setting as well as selecting the suitable nursing theory framework. For further research, an experimental research design should be conducts, especially randomized controlled trials, to ensure the outcomes of the intervention for promoting anemia prevention among pregnant women.