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

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; I2 statistic = 78%) when used as an adjunct to standard treatment as well as when it was used alone (MD 0.65, 95%CI 0.40 to 0.90; I2 statistic = 0%; p < 0.05). Furthermore, Moringa has increased MCH level (MD 0.84, 95%CI 0.11 to 1.56; I2 statistic = 0%; p = 0.02) and ferritin level (MD 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.