Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy

Abstract

This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9%), iron (55.4%), and multivitamins (76.2%) as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95%CI: 1.58-3.29; iron, RR = 1.99; 95%CI: 1.57-2.52, multivitamins, RR = 1.97; 95%CI: 1.54-2.51). Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95%CI: 1.18-1.70), but not multivitamins (RR = 0.87; 95%CI: 0.77-0.98). Use of folic acid was less prevalent in single women (RR = 0.67; 95%CI: 0.48-0.95) and during unplanned pregnancies (RR = 0.81; 95%CI: 0.71-0.92). Adequacy of prenatal care is a major determinant of vitamin/mineral intake during pregnancy.

Association Between Knowledge and Compliance of Taking Iron/Folic Acid Supplements During Pregnancy

“…This study shows that women who attended at least four antenatal care services were more likely to take a minimum of 90 IFA tablets during pregnancy, as shown other studies [21,12]. This indicates that effort to urge pregnant women to attend antenatal care regularly is important.…”

Prevalence of medication use among low risk pregnant women: A drug utilization study

“…Ferrous sulphate use, another antianemic, was reported by 70.39% of the patients. Similarly, Lunet et al (2008) and Domingues et al (2012) observed that 81.9 and 90% of pregnant women used iron during pregnancy in studies performed in Portugal and Brazil, respectively. Additionally, an intercontinental corporative study showed that 80% of Brazilian women included in the study used ferrous sulphate and folic acid (Collaborative Group on Drug use in Pregnancy -CGDUP, 1992).…”

Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro

“…10 Studies that have measured the use of iron supplement in a similar fashion have found similar prevalences (varying from 59% to 68%) among users of the SUS network prenatal service in the city of Jundiaí -SP -Brazil, 20 in a university hospital in Nigeria 21 and among childbearing women in the municipality of Rio Grande -RS -Brazil 22 and in Cambodia. 18 Lower figures were found in Tanzania (22%) 15 and higher ones in the United States (72%), 16 Denmark (77%), 14 Portugal (81.9%) 19 and Sweden (85%). 24 Authors who measured the use of iron supplement by other methods found a consumption of 74% of pills prescribed among low-income pregnant women in the United States 17 and 85% in the Philippines.…”

“…11 The low adherence of pregnant women to the use of iron supplements (IS) is one of the main obstacles to the effectiveness of such action. 12,13 Studies with pregnant women in developed and developing countries have identified the following factors associated with less frequent use of IS: younger age, 14,15 black race/skin color, 16,17 low level of education [17][18][19][20][21] and income, 16,21 unemployment, 14 being single without a partner at the start of gestation, 20 multiparity, 14,15,22 fewer prenatal consults, 13,15,18,22 inadequate prenatal care (in terms of start of prenatal care and number of consults), 19 presence of side-effects of supplementation, 13,21,[23][24][25] lack of guidance on use of supplements, 24,25 lack of knowledge of the importance of iron intake 13,24,25 and iron supplementation during pregnancy, 21 not having been diagnosed with anemia during pregnancy 15,24 and unavailability of free supplements in sufficient quantities. 18,21,23,25 Studies of this subject have already been conducted in two Brazilian cities: one in the State of São Paulo …”