Moringa oleifera supplementation for anemic pregnant women: A Systematic Review and Meta-analysis

Authors

  • Ermadina Mohamad Kalam Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
  • Norhayati Mohd Noor PhD, Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
  • Azlina Ishak M Med, Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
  • Siti Suhaila Mohd Yusoff MMed, Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia

DOI:

https://doi.org/10.3329/bjms.v23i3.75014

Keywords:

anemia; folic acid, iron; Moringa oleifera; pregnant PROSPERO registration number: CRD42022304292

Abstract

Objective: Iron  supplements  are  often  suggested  to  anemic  pregnant  women during  antenatal  care.  Moringa oleifera  (Moringa)  is  rich  in essential nutrients and commonly used as an alternative supplement to  overcome  anemia  in  pregnancy.  There  is  sparse  evidence  of  its efficacy  as  an  anemia  treatment.  Thus,  this  systematic  review  and meta-analysis  aimed  to  assess  the  effectiveness  of  Moringa’s supplementation for anemic pregnant women.

Materials and Methods: We  searched  the  Cochrane  Central  Register  of  Controlled  Trials, MEDLINE,  and  Epistemonikos  for  all  randomized  controlled  trials (RCTs)  reporting  anemic  pregnant  ladies  receiving  Moringa.  We independently  screened  the  titles  and  abstracts  of  identified  trials before  the  full  text  of  relevant  trials  were  evaluated  for  eligibility. We then independently extracted data on the methods, interventions, outcomes, and risk of bias from the included trials. Primary outcome measures were hemoglobin level and erythrocyte index levels while secondary outcomes were hematocrit level, ferritin level, and baby’s weight.

Results and Discussion: Fifteen  trials  with  a  total  of  808  anemic  pregnant  women  were analyzed using two comparisons. Moringa had increased hemoglobin level (MD 0.42, 95% CI 0.14 to 0.71; I  statistic = 78%) when used  2 as  an  adjunct  to  standard  treatment  as  well  as  when  it  was  used  alone  (MD  0.65,  95%CI  0.40  to  0.90;  I   statistic  =  0%;  p  <  0.05).  2 Furthermore,  Moringa has  increased  MCH  level  (MD  0.84,  95%CI  0.11  to  1.56;  I   statistic  =  0%;  p  =  0.02)  and  ferritin  level  (MD  2 18.80, 95%CI 7.53 to 30.07; p = 0.001) when used as an adjunct to standard treatment. However, it does not affect the MCV (p = 0.52), MCHC (p = 0.15), and hematocrit l (p = 0.88) for both comparisons. Conclusion. Moringa may increase hemoglobin levels when used in anemic  pregnant  women  either  as  an  adjunct  therapy  or  alternative therapy to iron supplements, with no severe adverse event that could disrupt  the  intervention.  Nevertheless,  further  research  is  needed  to determine  Moringa’s  precise  dose  and  ideal  preparation  that  will impact hemoglobin levels.

Bangladesh Journal of Medical Science Vol. 23 No. 03 July’24 Page : 597-609

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Published

2024-07-29

How to Cite

Kalam, E. M., Mohd Noor, N., Ishak, A., & Mohd Yusoff, S. S. (2024). Moringa oleifera supplementation for anemic pregnant women: A Systematic Review and Meta-analysis. Bangladesh Journal of Medical Science, 23(3), 597–609. https://doi.org/10.3329/bjms.v23i3.75014

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Section

Review Article