Review Article Iran J Ped Hematol Oncol. 2017, Vol 7.No 4, 245-259 Prevalence of Short Stature, Underweight and Delayed Puberty in Iranian Patients with Thalassemia Major: A Systematic Review and Meta-Analysis Gholamreza Badfar MD 1 , Marzieh Parizad Nasirkandy MD 2 , Masoumeh Shohani PhD 3 , Akram Mansouri MSc 4 , Ehsan Shabani MSc 5 , Shoboo Rahmati MSc 5 , Ali Soleymani Msc 6 , Milad Azami MD 7,* 1. Assistant Professor, Department of Pediatrics, Behbahan Faculty of Medical Sciences, Behbahan, Iran. 2. Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 3. Department of Nursing, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran 4. School of Nursing and Midwifery, Ahvaz jundishapour university of Medical science, Ahvaz, Iran 5. M.Sc. student of Epidemiology, Student Research Committee, School of Health, Ilam University of Medical Sciences, Ilam, Iran 6. Dezful University of Medical Sciences, Dezful, Iran 7. Medical Student, Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran. *Corresponding author: Milad Azami (MD), Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran. Email:MiladAzami@medilam.ac.ir. Received: 15 October 2016 Accepted: 2 February 2017 Abstract 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 Key words: Delayed Puberty, Growth Disorders, Thalassemia Introduction Thalassemia is the most common hereditary disease in Iran and the world (1). Approximately, 95% of thalassemia patients are born in Asia, the Middle East, and India (2-3). Iran is one of the countries where thalassemia occurs frequently and around 18616 people suffer from this disease (3). Due to abnormalities in the structure of hemoglobin chains in red blood cells (RBCs), the RBCs in the bloodstream do not have a normal life and they are quickly destroyed (4). Symptoms of the disease start with anemia, which is associated with change in appearance, bone problems, weakness, and delayed Downloaded from ijpho.ssu.ac.ir at 7:58 +0330 on Thursday December 9th 2021