The association between iron supplementation during pregnancy and the risk of childhood leukemia: a meta-analysis of case-control studies

Acute leukemia (AL) presents significant health challenges, particularly in children, and iron plays a critical role in cellular processes that could influence cancer development. The study was motivated by the need to clarify the potential role of iron supplementation during pregnancy in influencing the risk of developing childhood leukemia. This meta-analysis adhered to PRISMA guidelines and systematically searched PubMed, Scopus, and Web of Science databases up to April 2024 for relevant observational studies. Inclusion criteria focused on case-control studies assessing the relationship between iron supplementation during pregnancy and leukemia risk, reporting odds ratios (ORs) with 95% confidence intervals (CIs). Data extraction and quality assessment were performed independently by two researchers using the Newcastle-Ottawa Scale (NOS). Statistical analysis involved calculating overall relative risk (RR) using a random-effects model and assessing heterogeneity through Cochran’s Q test and the I² statistic. Publication bias was evaluated using Egger’s and Begg’s tests. The study analyzed data from 9 studies with 12 data sets involving a total of 4281 participants (2327 cases and 1954 controls). The findings indicated no significant association between iron supplementation during pregnancy and the overall risk of childhood leukemia (OR:1.01; 95% CI: 0.84–1.21, I2 = 63.2%). Also, no relationship was found between receiving iron supplements during pregnancy and the risk of AML (OR:1.01; 95% CI: 0.84–1.21, I2 = 56.6%) and ALL (OR:1.00; 95% CI: 0.81–1.24, I2 = 67.3%). This study found no significant association between iron supplementation during pregnancy and AL risk among case-control studies. Further research is needed to explore the potential influence of genetic and environmental factors on this relationship.