Adequate folate and iron intake during pregnancy is critical for maternal and fetal health. No previous studies to our knowledge have reported dietary supplement use and folate status among pregnant women sampled in NHANES, a nationally representative, cross-sectional survey. We analyzed data on 1296 pregnant women who participated in NHANES from 1999 to 2006 to characterize overall supplement use, iron and folic acid use, and RBC folate status. The majority of pregnant women (77%) reported use of a supplement in the previous 30 d, most frequently a multivitamin/-mineral containing folic acid (mean 817 μg/d) and iron (48 mg/d). Approximately 55–60% of women in their first trimester reported taking a folic acid- or iron-containing supplement compared with 76–78% in their second trimester and 89% in their third trimester. RBC folate was lowest in the first trimester and differed by supplement use across all trimesters. Median RBC folate was 1628 nmol/L among users and 1041 nmol/L among nonusers. Among all pregnant women, median RBC folate increased with trimester (1256 nmol/L in the first, 1527 nmol/L in the second, and 1773 nmol/L in the third). Given the role of folic acid in the prevention of neural tube defects, it is notable that supplement use and median RBC folate was lowest in the first trimester of pregnancy, with 55% of women taking a supplement containing folic acid. Future research is needed to determine the reasons for low compliance with supplement recommendations, particularly folic acid, in early pregnancy.
Findings provide insight into the strengths and challenges of transition for 1 program. The study has implications for change on a national level as programs around the country transition to provide families with comprehensive Healthy Homes services.
In the United States, women of child‐bearing age are advised to take a multivitamin dietary supplement before and during pregnancy to reduce the risks of some birth defects and enhance nutritional status. Despite these recommendations, dietary supplement use among pregnant women in the US has not been described using nationally representative data. Our objective was to examine the prevalence of and characteristics associated with dietary supplement use among pregnant women using NHANES 1999–2006 (n=1,350). Of pregnant women, 78% (Standard Error (SE): 2.1) reported supplement use in the month prior to the interview. Among pregnant women those reporting supplement use were more likely to be 30 years or older (41%, p<0.0001), have at least some college education (66%, p<0.0001)), be non‐ Hispanic White (63%, p<0.0001), married (67%, p<0.0001), and be in their second (41%, p<0.01) or third (40%, p<0.01) trimesters compared to those who reported no supplement use. After adjusting for all other characteristics, women with at least some college education remained more than 3 times more likely to use supplements during their pregnancy as compared to those with less than a high school education (Adjusted Odds Ratio (AOR) = 3.3, 95% CI 1.6, 6.8). ). Additionally, multiparous women were less likely to use supplements than primiparous women (AOR = 0.4, 95% CI 0.2, 0.9). These findings add to the relatively few studies describing supplement use by pregnant women in the US and identify characteristics that potentially could be useful for targeted prenatal nutritional intervention.
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