Prevalence of Short Stature, Underweight and Delayed Puberty in Iranian Patients with Thalassemia Major: A Systematic Review and Meta-Analysis

Growth disorders are considered as one of the common complications of thalassemia major patients. The present study was conducted to examine the prevalence of short stature, underweight, and delayed puberty in patients with thalassemia major in Iran. This review study was conducted based on systematic review and meta-analysis protocol (PRISMA) until 2017. To access relevant literature, two researchers independently searched Magiran, Medlib, Iranmedex, SID, PubMed, Scopus, ScienceDirect, Web of Science, as well as Google Scholar search engine. Pooled prevalence was calculated using a random effects model. Data were analyzed using Comprehensive Meta-Analysis Software (Version 2). In 18 studies, including 2,446 Iranian thalassemia major patients, the prevalence of short stature was estimated to be 52.3% (95%CI: 45.7-58.8). The lowest prevalence of short stature was in the North of Iran (42.4% [95%CI: 34.7-50.4]) and Mazandaran province (31.8% [95%CI: 27.5-36.5]), and the highest prevalence was in the South (64.6% [95%CI: 51.2-72.1]) and Fars province (71.4% [95%CI: 49.8-86.3]). The prevalence of short stature among males and females was estimated to be 48.7% (95%CI: 39.3-58.1) and 40.4% (95%CI: 30.4- 51.2), respectively, and male to female odds ratio was 1.21 (95%CI: 1.01-1.46, P=0.03). Prevalence of delayed puberty and underweight in Iranian thalassemia major patients were estimated to be 67.5% (95%CI: 46.8-83.1) and 47.6% (95%CI: 37.0-58.4), respectively. The results of this meta-analysis showed that the prevalence of short stature, delayed puberty, and underweight in Iranian thalassemia major patients is very high. Therefore, new planning and policies seem necessary to minimize the complications in patients with thalassemia major