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All Journal Indonesian Journal of Biomedicine and Clinical Sciences
Budi Gunawan, Made Favian
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Clinical effects of Spirulina supplementation on hemoglobin levels in anemic pregnant women: a systematic review and meta-analysis Budi Gunawan, Made Favian; Soetomo, Cindy Thiovany; Darmayasa, Putu Bagus; Paramyta, I Gusti Ayu Cintya; Jayakusuma, I Putu Prabawa; Gunawan, I Made Indera
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 1 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i1.23573

Abstract

Anemia during pregnancy continues to pose a significant burden, particularly in low- and middle-income countries (LMICs). Anemia is a major contributor in increasing maternal illness and negative pregnancy outcomes. Spirulina, a nutrient-dense blue-green alga rich in bioavailable iron, has gained attention as a potential nutritional intervention to support hemoglobin improvement in pregnancy. This systematic review and meta-analysis, adhering to PRISMA standards, sought to assess the impact of Spirulina supplementation on improving hemoglobin levels among pregnant women. A single-arm meta-analysis was performed to assess the change in hemoglobin levels before and after Spirulina supplementation, while a comparative meta-analysis evaluated the mean difference in hemoglobin improvement between Spirulina and standard iron supplementation. Four eligible studies involving 1,070 pregnant women were included. The single-arm analysis demonstrated a significant increase in hemoglobin levels following Spirulina supplementation, with a pooled mean difference (MD) of 1.81 g/dL (95% CI: 0.24 - 3.39; p = 0.024). In the comparative analysis, Spirulina showed a non-significant trend toward higher hemoglobin than standard iron, with a pooled MD of 1.45 g/dL (95% CI: –0.22 - 3.13; p = 0.088). Risk of bias was low to moderate, and the overall certainty of evidence was classified as moderate. These findings suggest that Spirulina may be a promising adjunct for improving maternal hemoglobin, particularly in settings where local cultivation and food-based approaches are preferred. Further high-quality randomized trials are recommended to ascertain its clinical efficacy and inform policy on its integration into maternal nutrition programs.
Clinical effects of Spirulina supplementation on hemoglobin levels in anemic pregnant women: a systematic review and meta-analysis Budi Gunawan, Made Favian; Soetomo, Cindy Thiovany; Darmayasa, Putu Bagus; Paramyta, I Gusti Ayu Cintya; Jayakusuma, I Putu Prabawa; Gunawan, I Made Indera
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 1 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i1.23573

Abstract

Anemia during pregnancy continues to pose a significant burden, particularly in low- and middle-income countries (LMICs). Anemia is a major contributor in increasing maternal illness and negative pregnancy outcomes. Spirulina, a nutrient-dense blue-green alga rich in bioavailable iron, has gained attention as a potential nutritional intervention to support hemoglobin improvement in pregnancy. This systematic review and meta-analysis, adhering to PRISMA standards, sought to assess the impact of Spirulina supplementation on improving hemoglobin levels among pregnant women. A single-arm meta-analysis was performed to assess the change in hemoglobin levels before and after Spirulina supplementation, while a comparative meta-analysis evaluated the mean difference in hemoglobin improvement between Spirulina and standard iron supplementation. Four eligible studies involving 1,070 pregnant women were included. The single-arm analysis demonstrated a significant increase in hemoglobin levels following Spirulina supplementation, with a pooled mean difference (MD) of 1.81 g/dL (95% CI: 0.24 - 3.39; p = 0.024). In the comparative analysis, Spirulina showed a non-significant trend toward higher hemoglobin than standard iron, with a pooled MD of 1.45 g/dL (95% CI: –0.22 - 3.13; p = 0.088). Risk of bias was low to moderate, and the overall certainty of evidence was classified as moderate. These findings suggest that Spirulina may be a promising adjunct for improving maternal hemoglobin, particularly in settings where local cultivation and food-based approaches are preferred. Further high-quality randomized trials are recommended to ascertain its clinical efficacy and inform policy on its integration into maternal nutrition programs.
Co-Authors Darmayasa, Putu Bagus Gunawan, I Made Indera Jayakusuma, I Putu Prabawa Paramyta, I Gusti Ayu Cintya Soetomo, Cindy Thiovany