SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fped.2025.1674121
A systematic review and meta - analysis of the prevalence and associated factors of iron - deficiency anemia among Chinese children aged under 6 years of age
Provisionally accepted
- Pidu District People's Hospital, Chengdu, China
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Background: This meta-analysis aimed to determine the prevalence of iron-deficiency anemia (IDA) in Chinese children under 6 years of age and identify the associated risk factors. Methods: A comprehensive search was conducted for studies published up to 15 January 2025 in English and Chinese databases (PubMed, Embase, Web of Science, CNKI, and WanFang Data). A random-effects model was used to synthesize prevalence data and risk factors. Results: Twenty-three studies involving 93,570 children (19,994 with IDA) were included. The overall IDA prevalence was 20.61% (95% CI: 14.68%–26.54%), with higher rates in rural areas (29.96%) compared to urban areas (13.28%). Significant risk factors for IDA included male sex (OR = 1.35), age 6–12 months (OR = 4.10), age 13–24 months (OR = 2.66), low birth weight (<2500g) (OR = 1.46), maternal anemia during pregnancy (OR = 2.50), cesarean delivery (OR = 1.18), and premature birth (OR = 2.15). Protective factors included mixed feeding (OR = 0.59), artificial feeding (OR = 0.54), and early introduction of complementary feeding (<6 months) (OR = 0.57). Respiratory diseases, diarrhoea, and formula feeding were not significant risk factors. Meta-regression showed no impact of study design or sample size on these associations. Conclusion: Risk factors for IDA in Chinese children under 6 years of age include male sex, younger age (6–24 months), low birth weight, maternal anaemiaanemia, cesarean delivery, and premature birth. Mixed or artificial feeding and early complementary feeding may protect against IDA. Further large-scale worldwide studies are needed to confirm these findings and inform public health strategies.
Keywords: childhood, Risk factors, Prevalence, Meta-analysis, China, Iron-deficiency anemia
Received: 27 Jul 2025; Accepted: 25 Sep 2025.
Copyright: © 2025 Li, Gong, Lai, Mao, Wu, Feng, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yao Gong, gongyao2025@163.com
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