Prevalence, types and determinants of anemia among pregnant women in Sudan: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Anemia during pregnancy is a public health problem especially in developing countries and it is associated with maternal and perinatal adverse outcomes. There is no meta-analysis on anemia during pregnancy in Sudan. The current systemic review and meta-analysis was conducted to assess the prevalence, types and determinant of anemia during pregnancy in Sudan. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases (PubMed, Cochrane Library, Google Scholar, CINAHL, and African Journals Online) were searched using; anemia, pregnancy related anemia and Sudan. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and Modified Newcastle - Ottawa quality assessment scale were used for critical appraisal of studies. The pooled Meta logistic regression was computed using OpenMeta Analyst software. RESULTS: = 0.465) between the anemic and no anemic women. Malaria was investigated in six studies. Pregnant women who had malaria infection during pregnancy were 1.94 times more likely to develop anemia than women who had no malaria infection (OR = 1.94, 95% CI =1.33-2.82). Six (37.5%) studies investigated type of anemia. The pooled prevalence of iron deficiency anemia (IDA) among pregnant women in Sudan was 13.6% (95% CI = 8.9-18.2). CONCLUSION: There is a high prevalence of anemia among pregnant in the different region of Sudan. While age and parity have no association with anemia, malaria infection was associated with anemia. Interventions to promote the strengthening of antenatal care, and access and adherence to nutrition, and malaria preventive measures are needed to reduce the high level of anemia among pregnant women in Sudan.
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Several systematic reviews have confirmed that P. falciparum is the highest inhabited organism in pregnancy to cause infection.
“Several systematic reviews have confirmed that P. falciparum is the highest inhabited organism in pregnancy to cause the infection [7, 22].”
From Malaria in pregnancy: Meta-analyses of prevalence and associated complications (2024) · cites this paper as [22]
The Results section reports an association between malaria infection and anemia in pregnant women in Sudan, but does not compare organisms or malaria species. A References entry names a study of P. falciparum infection during pregnancy; it does not establish the claim that P. falciparum is the most prevalent organism. Searches for that comparison and for the claim’s wording found no supporting passage in our copy. (LLM, conf=0.72)
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Elmugabil, A., Al-Nafeesah, A., AlEed, A., Alhabardi, N., & Adam, I. (2023) · SAGE Open Nursing · doi:10.1177/23779608231197590 · Cited by 7
Self-citationPrevalence and risk factors of iron deficiency anaemia with pregnancy at Minia University Hospital
Mostafa, E., Mohammed, H., Mohammed, E., & Ali, A. M. (2022) · Minia Journal of Medical Research · doi:10.21608/mjmr.2022.249060 · Cited by 7
“Along with our results Adam and Ali, (12) It is belived that women with high parity have low or no iron staorge as it hass been depleted by the repeated pregnaied hence parous women are more likely to be anemic.”
BackgroundUdho, S., Nankumbi, J., Namutebi, M., Mukunya, D., Ndeezi, G., & Tumwine, J. K. (2022) · South African Journal of Clinical Nutrition · doi:10.1080/16070658.2022.2148909 · Cited by 9 · see citing works
“30 However, our prevalence was lower than the 53% and 59% reported among pregnant women in Sudan 31 and India, 32 but higher than the 5% and 16% reported among pregnant Iranian women in the first and third trimesters respectively.”
ResultIlboudo, B., Traoré, I., Méda, C., Hien, A., Kinda, M., Dramaix-Wilmet, M., Savadogo, G. L., & Donnen, P. (2021) · The Pan African Medical Journal · doi:10.11604/pamj.2021.38.361.26612 · Cited by 6
“The factors most frequently associated with anaemia in pregnancy in Africa are multigestation, short interval between pregnancies, increased gestational age, rural residence, low education or income level, and insufficient preventive measures [4-8].”
BackgroundAntidepressant Prescription in Pregnancy
Andrade, C. (2020) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.20f13347 · Cited by 6 · see citing works
Anemia prevalence and severity among pregnant refugee women settled in the West Nile region, Uganda
Bongomin, F., Kibone, W., Nantale, R., Lebu, S., Awekonimungu, B., Musoke, P., Ebbs, D., Beardsley, R., Muoghalu, C., Ochaya, S., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0329970 · Cited by 4 · see citing works
“Nevertheless, our prevalence was comparable to the 53% and 59% reported among pregnant women in Sudan [23] and India [24] but lower than the 78% reported among pregnant women in Ghana [25] respectively.”
Aigbedion, G., Tseng, P., & Puthussery, S. (2025) · Nutrients · doi:10.3390/nu17142338 · Cited by 5 · see citing works
“For example, anaemia prevalence in Uganda is 30% [57] and Ethiopia is 26.4% [58]; however, it is comparable to Sudan at 53% [59] and Ghana at 51% [60].”
InfluentialAballo, J., Adokiya, M. N., & Boah, M. (2025) · Discover Public Health · doi:10.1186/s12982-025-00561-2 · Cited by 3 · see citing works
“Similarly, a pooled prevalence of 53% was reported among Sudanese pregnant women [5], while in South Africa, the pooled prevalence of anaemia in pregnant women was determined to be 31% [6].”
Idriss, M. I., Hussein, A., Mussa, A., Ali, E. W., Ibrahim, I., Modawe, G., Abdalhabib, E., Saboor, M., & Hajissa, K. (2024) · Journal of Medicine and Life · doi:10.25122/jml-2023-0441 · Cited by 5 · see citing works
“It is worth noting that a previous meta-analysis carried out in Sudan [31] also identified Eastern Sudan as having the highest rate of anemia.”
Alemayehu, B., Fenta, S. L., Gessesse, S. S., Gezahegn, T., Kassahun, E., & Balcha, W. F. (2022) · The Pan African Medical Journal · doi:10.11604/pamj.2022.42.76.34686 · Cited by 5
“%) of the mothers had a four and above history of ANC visits, and 292 (78.7”
BackgroundInfluentialAdokiya, M. N., Abodoon, G. N., & Boah, M. (2022) · Women & Health · doi:10.1080/03630242.2022.2030450 · Cited by 7 · see citing works
“Estimates of the prevalence of anemia among pregnant women range between 32% and 53% in parts of Africa (Adam, Ibrahim, and Elhardello 2018; Kassa et al. 2017).”
BackgroundMethodInfluentialCavalcanti, R. D. A. S., Diniz, A. D. S., & de Arruda, I. D. (2019) · Journal of the American College of Nutrition · doi:10.1080/07315724.2019.1592725 · Cited by 5
“It has been recorded for a long time that the populations most affected by anemia are women of childbearing age, pregnant women, and children (4, 5).”
BackgroundMoges, S., Kussa, S., Endale, A., Lajore, B. A., & Mekango, D. E. (2025) · Maternal-Fetal Medicine · doi:10.1097/fm9.0000000000000281 · Cited by 2 · see citing works
Anemia in pregnant women: findings from Kuwait birth cohort study
Al-Taiar, A., Ziyab, A., Hammoud, M., Al-Sabah, R., & Akhtar, S. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07439-w · Cited by 4 · see citing works
“…are challenging due to methodological differences, such as the timing of assessments across trimesters and the use of venous versus capillary blood samples [15, 22], anemia in pregnant women in Kuwait seems less significant as a public health concern compared to low-income settings [44, 45].”
Infectious and obstetric determinants of anemia among pregnant women in Southwest Ethiopia
Yosef, T., Gizachew, A., Fetene, G., Girma, D., Setegn, M., Tesfaw, A., Sisay, B., & Shifera, N. (2024) · Frontiers in Global Women's Health · doi:10.3389/fgwh.2024.1421884 · Cited by 4 · see citing works
“This fi nding aligns with studies conducted in Ethiopia and Sudan (3, 29, 30).”
ResultPrevalence and Determinants of Anemia during Pregnancy at Hodeida City, (Yemen) during the Year 2021
Gonaid, N. M. H., El-Sanousi, S., & Kadi, H. (2022) · International Journal of Health Sciences and Research · doi:10.52403/ijhsr.20220304 · Cited by 4
“No significant association reached in the present study between AIP and the age of pregnant woman, as not reached too in Sudanese study conducted during 2018 ((39)), and study conducted in Libya ((40)).”
BackgroundFite, M. B., Denio, A. D., Muyhe, A., Roro, E. M., Desalegn, M., & Gurmesa, T. T. (2020) · International Journal of Scientific Reports · doi:10.18203/issn.2454-2156.intjscirep20205031 · Cited by 5 · see citing works
“7% in Pakistan that is why anaemia has got consideration as public health concerns.(6-8) ABSTRACT”
BackgroundAl-Nimer, M., & HamaSalih, R. M. (2019) · Journal of Pharmaceutical Negative Results · doi:10.4103/jpnr.jpnr_7_19 · Cited by 4
“Nutritional deficiency of both Vitamin D3 and iron was observed in children under 5 years old.[16] Significant improvement of red cell indices is related to both iron therapy and Vitamin D3.”
BackgroundPrevalence of Anemia among Antenatal Women: A Cross Sectional Study from North Western India
Kumari, S., Rani, K., Baby, P., & Ravi, R. (2025) · Iranian Journal of Nursing and Midwifery Research · doi:10.4103/ijnmr.ijnmr_376_23 · Cited by 3
Maternal Anemia and Offspring Outcomes in India: A Scoping Review
Benavente, M., Geifman, N., Bath, S., & Ahankari, A. (2025) · Anemia · doi:10.1155/anem/2850956 · Cited by 3 · see citing works
“Systematic reviews in South Africa and Sudan reported maternal anemia prevalence ranging from 20% to 40% and 23%–76%, respectively [10, 41].”
Alie, M. S., Gichew, S., & Alemayehu, D. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-086539 · Cited by 1 · see citing works
Saeed, M., Adam, G. K., Hussein, S., AlHabardi, N., & Adam, I. (2024) · Patient Preference and Adherence · doi:10.2147/ppa.s476738 · Cited by 2 · see citing works
Self-citationPrevalence of Anemia during Pregnancy in Pakistan: Meta-analysis
Sehar, B., Moazzam, M., & Jawasreh, M. (2024) · Pioneer Journal of Biostatistics and Medical Research · doi:10.61171/v01.03.26 · Cited by 3
Osoro, C. B., Dellicour, S., Ochodo, E., Young, T., ter Kuile, F. O., Gutman, J., & Hill, J. (2023) · Malaria Journal · doi:10.1186/s12936-023-04698-w · Cited by 3 · see citing works
“Malaria in pregnancy is associated with severe maternal anaemia, maternal mortality, pregnancy loss, preterm delivery, and low birth weight [3–5].”
BackgroundAli, E. H., Alkindi, S., Mohamed, A. O., Awadalla, K., Abdlgadir, O., Adam, G., Magdi, M., Ibrahim, A., & Ghebremeskel, K. (2022) · Mediterranean Journal of Hematology and Infectious Diseases · doi:10.4084/mjhid.2023.002 · Cited by 3
Update of the nutritional situation in the Republic of Sudan
Abusalih, H., & Abusabeib, Z. A. (2020) · Special Issue July-December 2020 · doi:10.51745/najfnr.4.09.s17-s24 · Cited by 3
Prevalence and Risk Factors of Iron Deficiency Anemia among Postpartum Women
Darmawati, D., Syahbandi, S., Fitri, A., & Audina, M. (2020) · Journal of Nursing Care · doi:10.24198/jnc.v3i3.27463 · Cited by 3
Maternal <i>TMPRSS6</i> Gene Polymorphism rs855791SNP in Women with Preeclampsia
Ahmed, Y. I. B., Yagoub, H. S., & Hassan, M. A. (2023) · The Journal of Bioscience and Medicine · doi:10.4236/jbm.2023.111008 · Cited by 3
Prevalence of anemia and its associated factors among pregnant women in Yaqshiid district, Somalia
Ali Mude, A., & Agena, A. M. (2023) · Iraqi Journal of Hematology · doi:10.4103/ijh.ijh_13_23 · Cited by 2 · see citing works
Bereket, T., Tela, F. G., Gebretsadik, G. G., & Beyene, S. A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0318275 · Cited by 2 · see citing works
“Moreover, the result was lower than a study done in Adama [25], Southern Ethiopia [26], Zambia [27], and Sudan [28], it was also lower when compared with the national prevalence of anemia reported in EDHS 2016 [9].”
Prevalence of Anemia and Associated Factors among Pregnant Women in Kigeme Refugee Camp, Rwanda
Musirakumva, J. J. S., Renzaho, J., & Habineza, A. (2024) · Rwanda Journal of Medicine and Health Sciences · doi:10.4314/rjmhs.v7i2.12 · Cited by 2
“This prevalence was greater than the 7.9% anemia prevalence among pregnant women in Northern Ethiopia,[4] but somewhat comparable to those reported in Southern Ethiopia at 23.2%,[15] South America (24%),[16] and in Rwanda (23.5%).”
InfluentialR, E., Tombeg, Z., Hadi, A. J., Sudarman, S., Ishak, S., & Handayani, F. R. (2024) · Journal of Public Health and Pharmacy · doi:10.56338/jphp.v4i1.5041 · Cited by 2
“Examples of dietary restrictions such as a ban on eating red meat, eggs, or other types of food rich in iron can reduce the nutritional intake needed to prevent anemia in pregnant women (3,6,7).”
Backgroundde Andrade, A. M., Ramalho, A. A., Martins, F. A., Valentim-Silva, J. R., & Koifman, R. J. (2023) · Preventive medicine reports · doi:10.1016/j.pmedr.2023.102501 · Cited by 2
“The prevalence of pregnancy-related anemia ranges from 5.4 % in developed nations to over 80 % in developing ones, underlining its severe public health impact (Adam et al., 2018; Fowkes et al., 2018; Srour et al., 2018).”
InfluentialElmugabil, A., Alhabrdi, N. M., Rayis, D. A., Al‐Wutayd, O., & Adam, I. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.933557 · Cited by 3 · see citing works
Self-citationFaris, A., Abdullah, M., & Hadju, V. (2021) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2021.6924 · Cited by 2
“%) was reported among pregnant women in South America [2].”
BackgroundMensah, M. M., Opoku, S., Babah, R., & Nsiah, E. O. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70655 · Cited by 1 · see citing works
Al-Taher, R. H., Abuarab, M. E., Ahmed, A., Helalia, S. A., Hammad, E. A., & Mokhtar, A. (2025) · Applied Water Science · doi:10.1007/s13201-025-02656-2 · Cited by 1 · see citing works
“Sudan possesses 73.5 million hectares of potentially arable land; however, only 26 million hectares are presently cultivated (Adam et al. 2018).”
InfluentialDeterminants of Anemia Among Antenatal Care Attendees in Southwest Ethiopia: A Case‐Control Study
Yosef, T., Gizachew, A., & Shifera, N. (2025) · Health Science Reports · doi:10.1002/hsr2.71290 · Cited by 1
“The findings of this study align with previous research [26, 32 – 34], which consistently reported a strong link between malaria and anemia in pregnant women.”
Prevalence and risk factors for anemia during pregnancy in Sana'a city
Al-Jarrmozi, S. A. A., Almagrami, A. A., Al-Moyed, K. A., Al-Shamahy, H., Al-Haddad, A. M., Al-Arashi, I. A., Al-Dhuraibi, O. M., al-Ghulaibi, Y. M., Al-almohtadi, K. A., Khalil, E. H., et al. (2024) · مجلة جامعة صنعاء للطب والعلوم الصحية · doi:10.59628/jchm.v19i4.1380 · Cited by 1
“For instance, in Ethiopia, the pooled prevalence of anemia among ex-pectant mothers was 31.66% 11 , while in Sudan it was 53.0% [33].”
InfluentialCahyati, P., Pertiwi, S., Mardiah, S. S., Gantini, D., & Rismawan, W. (2024) · Journal of Drug Delivery and Therapeutics · doi:10.22270/jddt.v14i9.6723 · Cited by 1
“There needs to be coordination between agencies 10,17,19,24,28,38,39,42 .”
BackgroundMandar, O., Hassan, B., Abdelbagi, O., Eltayeb, R., Alhabardi, N., & Adam, I. (2022) · Journal of Blood Medicine · doi:10.2147/jbm.s355846 · Cited by 1
“A recent meta-analysis showed that the pooled prevalence of anaemia among pregnant women in Sudan was 53%.(33) In our study, antepartum haemorrhage was suggested as another factor for preoperative anaemia.”
MethodSelf-citationAssessment of Applying Clinical Audit for Pregnant Woman with Iron Deficiency Anemia.
Badry, Y., Mohammed, N. A., & Amein, N. (2020) · Minia Scientific Nursing Journal · doi:10.21608/msnj.2020.188031 · Cited by 1
Adam, A. M. S., Sharfeldeen, S. M. A., Yousif, N. E., Eltigani, S. A., Bakur, A., & Eltayeb, M. M. (2026) · Scientific African · doi:10.1016/j.sciaf.2026.e03709
Yeni Doğurmuş Kadınlarda Demir Desteği Kullanımı ve Anemi Durumu Arasındaki İlişkiyi Tanımlamak
Oruç, B., & Kahraman, S. (2026) · Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi · doi:10.46413/boneyusbad.1773074
Taye, E. A., Hailie, G. Y., & Kassaw, A. T. (2026) · Journal of Public Health Research · doi:10.1177/22799036261480284
“A total of 14,569 respondents were included in the analysis.”
Association between Helicobacter pylori Infection and Pregnancy-Related Complications
Zefenkey, Z. (2026) · Cihan University-Erbil Scientific Journal · doi:10.24086/cuesj.v10n1y2026.pp63-68
Adam, G. A., AlHabardi, N., & Adam, I. (2026) · International Journal of Women s Health · doi:10.2147/ijwh.s567668
Self-citationFetomaternal Outcome of Pregnant Women with Malaria
Mehwish, Memon, M., Solangi, B., Erum, Raishem, Farzana, Tosheeba, & Maheshwary, N. (2025) · Pakistan Journal of Health Sciences · doi:10.54393/pjhs.v6i7.3124
Maternal knowledge and adherence to iron-rich diet: A multicenter cross-sectional study
Yahaya, J., Bashir, Y. A., Magaji, A. A., Magaji, U., Turaki, A., Shemishere, U., Abdulrauf, M. S., Musa, F., & Anyebe, D. (2025) · Malahayati International Journal of Nursing and Health Science · doi:10.33024/minh.v8i2.637
“This is due to issues such as deficiency in iron and vitamins, poverty, lack of knowledge, and poor dietary habits among others (Adam, Ibrahim, & Elhardello, 2018).”
Ahmed, I., Elmugabil, A., Salih, M., Ali, L., Siniyeh, A., Khalifa, E. H., Hanafy, S., & Adam, I. (2025) · Nigerian Journal of Clinical Practice · doi:10.4103/njcp.njcp_648_24
Self-citationDeterminants of anaemia among pregnant women in Central Region, Ghana
Owusu-Sarpong, A., Anane, A., Sarpong, G., Kusi, R. A. A., Djan, R. O., Adu-Gyamfi, R., Adjin-Tettey, P., & Tetteh, A. K. (2024) · African Journal of Midwifery and Women s Health · doi:10.12968/ajmw.2024.0009
Pregnant Women’s Perception of Gestational Anemia and Iron Supplements in Oman
Al-Marzouqi, Z. K. D., Alsereahi, N. S., & Maqbali, S. K. A. (2024) · Journal of the Oman Medical Association · doi:10.3390/joma1010003
“Furthermore, 31% of gestational anemia cases are in the Middle East and Central Asia [7,8].”
Health-care professionals’ barriers to anemia prevention among pregnant women in Oman
Al-Marzouqi, Z. K. D., Al-Za’abi, R., & Al-Dhoani, A. (2024) · Advances in Biomedical and Health Sciences · doi:10.4103/abhs.abhs_98_23
Knowledge of Pregnant Women on Gestational Anemia Attending Primary Healthcare Institutions in Oman
Al-Marzouqi, Z. K. D., & Zakia, A.-M. (2024) · Global Journal of Health Sciences · doi:10.47604/gjhs.2398 · Cited by 4 · see citing works
“31% of gestational anemia among women above 18 years is identified in the Middle East of Central Asia [7, 8].”
Prevalence of Anaemia among Antenatal Clinic Attendees at A Tertiary Hospital in South West, Nigeria
Irinyenikan, T., Folarin, B. J., Alabi, B., Bade-Adefioye, A., & Sani, I. (2023) · European Journal of Clinical Medicine · doi:10.24018/clinicmed.2023.4.4.274
Severe Megaloblastic Anemia & Thrombocytopenia in Pregnancy: A Case Report
Nugraheni, A. I., Wijayanti, K. R. D., & Manuaba, I. A. R. W. (2023) · European Journal of Medical and Health Sciences · doi:10.24018/ejmed.2023.5.2.1667
Ilboudo, B., SAVADOGO, L. G. B., Traoré, I., Mèda, Z. C., Hien, A., Kinda, M., Hervé, H. I. E. N., Dramaix‐Wilmet, M., & Donnen, P. (2021) · Qeios · doi:10.21203/rs.3.rs-725745/v1 · Cited by 1 · see citing works
“Iron and vitamin deficiencies, hemorrhage, and infections including malaria are the major causes of this blood abnormality [4] .”
BackgroundGünaydın, B., Jovičić, S., & Milinković, N. (2026) · Journal of Medical Biochemistry · doi:10.5937/jomb0-69651
- Authors
- Adam, I., Ibrahim, Y., & Elhardello, O.
- Affiliations
- University of Khartoum (SD)
- University of Tabuk (SA)
- Scarborough General Hospital (GB)
- Corresponding author
- Adam, Ishag
- Venue
- BMC Hematology
- Published
- 2018-11-08
- Volume
- 18
- Issue
- 1
- Pages
- 31-31
- ISSN
- 2052-1839 (ISSN-L)
- PMC
- PMC6225563
- OpenAlex
- W2899558627
- Cited by
- 104
- References
- 45
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 16 · 2023: 19 · 2022: 21 · 2021: 13 · 2020: 8 · 2019: 6
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BMC Hematology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Keywords
- anemia in pregnancy, prevalence, iron deficiency anemia, malaria in pregnancy, risk factors, Sudan, maternal health, prenatal care, perinatal outcomes
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