Systematic review and meta-analysis of iodine deficiency and its associated factors among pregnant women in Ethiopia

Iodine deficiency (ID) is a global public health problem and its impact is more pronounced in low-income countries. During pregnancy, iodine requirement is known to elevate sharply, making pregnant women, especially those living in low-income countries highly vulnerable to iodine deficiency. This study aims to assess the prevalence of iodine deficiency and its associated factors among pregnant women in Ethiopia. A systematic literature search was performed by using PubMed, CINAHL, Web of science, global health, and Google scholar electronic databases. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I test. A random-effects model was used to estimate the pooled prevalence and pooled odds ratio. The presence of publication bias was checked using Funnel plot and Egger's test. One thousand one hundred and sixteen studies were reviewed and seven studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of seven studies that included 2190 pregnant women showed a pooled prevalence of iodine deficiency during pregnancy to be 68.76% (95% CI: 55.21-82.31). In a subgroup analysis, the prevalence in Oromia region is 71.93% (95% CI: 54.87-88.99) and in Amhara region is 60.93% (95% CI: 57.39-64.48). Iodized salt use (AOR = 0.18; 95% CI: 0.08-0.44) and 1st trimester pregnancy (AOR = 0.68; 95% CI: 0.47-0.99) were found to have a significant association with iodine deficiency. The prevalence of iodine deficiency during pregnancy using urine iodine is considerably high in Ethiopia. Using iodized salt is found to reduce the burden. Hence, there is a need to strengthen iodization programs to tackle the problem.