Meta-analysisindependent cross-checkabstract checked★ key study I-LEG-127 standard review
Anaemia in pregnant women in Egypt
Anemia in pregnancy: a systematic review and meta-analysis of prevalence, determinants, and health impacts in Egypt.
Overview
Azzam A et al.. BMC Pregnancy Childbirth 2025 · PMID 39810098 · DOI 10.1186/s12884-024-07111-9
About half of pregnant women in Egyptian studies had anaemia measured by blood tests.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Estimate anaemia in pregnancy.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
18 studies, 14,548 women.
- What was actually found?
49% anaemic.
- How large was the observed effect?
49% (42-57).
- What do the results mean in everyday life?
Anaemia is common and must be diagnosed with a blood test.
- What are the study's limitations?
Heterogeneous studies.
- What does it say about Elawady's specific claim?
Contradicts dismissing anaemia as gas.
- Do the results apply to Germany and Europe?
Egypt-specific.
- What can explicitly not be concluded from this study?
It does not test the gas hypothesis directly.
Scientific in-depth review
1. Full reference
- Authors
- Azzam A et al.
- Journal
- BMC Pregnancy Childbirth
- Year
- 2025
- Identifier
- PMID 39810098 DOI 10.1186/s12884-024-07111-9 · PMC11731563
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref works API
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
No competing interests declared.
2. Research question
How prevalent is anaemia in pregnant women in Egypt and what are its determinants?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of prevalence studies
- Population
Pregnant women in Egypt
- Country
Egypt
- Period
Studies 2010-2024
- Sample size
18 studies, 14,548 women
- Inclusion and exclusion criteria
Egyptian studies reporting anaemia in pregnancy.
4. Methods and endpoints
- Exposure / intervention
Not applicable
- Comparator
Not applicable
- Endpoints
Anaemia prevalence; determinants; neonatal outcomes
- Statistical methods
Random-effects meta-analysis; Egger test
5. Actual results
- Results
Pooled prevalence 49% (95% CI 42-57); no difference Upper vs Lower Egypt; 65% in third trimester; determinants include lack of iron supplementation (OR 2.59), rural residence (1.76), intestinal parasites (1.38); low intake of meat, vegetables and fruits and high tea intake associated with anaemia; lower birth weight in infants of anaemic mothers.
- Absolute risks
49% prevalence
- Authors' conclusion
Anaemia in pregnant Egyptian women is a severe public health concern.
6. Strengths
- Egypt-specific pooled estimate
7. Weaknesses
- Heterogeneous primary studies
- Abstract only
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Prevalence studies of variable quality.
9. Assessment of the statistical interpretation
CI mildly asymmetric, consistent with transformed-scale pooling (stats/C-LEG-09_egypt_anaemia.py).
10. Relevance to the specific claim
Shows that laboratory-defined anaemia is very common in Egypt; dismissing dizziness or fatigue as 'gas' risks missing real anaemia (C-LEG-09 safety).
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
Egypt-specific.
13. Overall methodological judgement
Strong contextual evidence for the safety note.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Contribution of diet vs parasites vs supplementation.
15. Linked fact checks
- Gas from legumes and greens distends the colon, keeps blood from reaching the brain and causes dizziness that is wrongly diagnosed as anaemia; the human body is not equipped to digest the hulls of fava beans, lentils or beans. – Studies contradicting or limiting the claim
- There is no such thing as iron supplements: they are forbidden even for a pregnant woman with anaemia, because a diet that needs supplements is deficient. – Studies contradicting or limiting the claim
- No one needs vitamins or supplements: 'there is no such thing as dietary supplements', the body makes its own vitamins, and vitamins are on the forbidden list. – Studies contradicting or limiting the claim