Socioeconomic, Lifestyle and Dietary Factors Associated with Dietary Supplement Use during Pregnancy

Pouchieu, Camille; Lévy, Rachel; Faure, Céline; Andreeva, Valentina A.; Galán, Pilar; Herçberg, Serge; Touvier, Mathilde

doi:10.1371/journal.pone.0070733

Cited by 53 publications

(59 citation statements)

References 44 publications

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“…Confirming the results of previous studies, we found that while prevalence of supplement use during pregnancy was high, adherence to supplement recommendations was low; 8–12 women were more likely to meet the PFS and IS recommendations if they planned their pregnancy; 9,12 awareness of the importance of folic acid was greater than awareness of the recommended dose and timing of supplementation; 8 knowledge of the recommended duration, dose and importance of supplementation was greater for PFS than IS; 26,27 and knowledge regarding dietary sources of folate and iodine was poor 15,16,27 , with around half of pregnant women unable to name a single source and less than one‐in‐10 recognising bread as a good source of the nutrients. Notably, we did not find household income to be a predictor of supplement use, which suggests that the lack of subsidised or funded prescriptions for the recommended supplements in Australia is not a significant barrier to adherence.…”

Section: Discussionsupporting

confidence: 84%

“…Despite supplement use becoming common practice during pregnancy in Australia and worldwide, previous studies have consistently shown poor adherence to the recommendation for periconceptional folic acid supplementation (PFS) 8–12 . To the best of our knowledge, no published studies have assessed adherence to the PFS recommendation in a national sample of Australian women or the adherence to the more recent NHMRC recommendation regarding IS.…”

mentioning

confidence: 99%

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Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross‐sectional analysis

Malek

Umberger

Makrides

et al. 2016

Australian and New Zealand Journal of Public Health

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Objective: To determine pregnant women's knowledge of and adherence to the recommendations for periconceptional folic acid supplementation (PFS) and iodine supplementation (IS). Secondary objectives include determining predictors of adherence, and identifying influential nutrition information sources. Methods:A cross-sectional online survey was completed by 857 pregnant women, including a national cohort (n=455) recruited using an online panel provider and a South Australian cohort (n=402) recruited from a public maternity hospital.Results: Adherence to PFS and IS recommendations was 27% and 23%, respectively. Planning pregnancy and awareness of the correct timing of recommendations were predictors of adherence for both recommendations. Not consuming any alcohol during pregnancy and living in metropolitan areas also predicted adherence to the IS recommendation. Awareness of the recommendation was greater for folic acid (more than 90%) than iodine (56-69%). Knowledge of the importance of folic acid and iodine was greater than knowledge regarding the recommended dose and timing of supplementation. Main healthcare providers were considered the most influential nutrition information sources. Conclusions and implications:Knowledge of and adherence to supplement recommendations for preconception and pregnancy needs improvement. While main healthcare providers may play an important role, further research is needed to explore strategies for increasing adoption of recommendations.

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Section: Discussionsupporting

confidence: 84%

mentioning

confidence: 99%

Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross‐sectional analysis

Malek

Umberger

Makrides

et al. 2016

Australian and New Zealand Journal of Public Health

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“…Research from Romania revealed that above average nutritional knowledge was a strong determinant of folic acid, iron and multivitamins supplementation in pregnancy [6]. Similar to our results, other studies observed that women with higher incomes used supplementation more often [4,7,27,28]. This fact is not a surprise, as most of supplements are not subsidized, therefore they can be a substantial financial burden on a family's budget.…”

Section: Source Of Knowledge About Proper Nutrition During Pregnancysupporting

confidence: 88%

Dietary supplementation usage by pregnant women in Silesia — population based study

et al. 2018

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Objectives: Despite wide access to gynecological and obstetric advice, informational campaigns, and information online and in magazines aimed at pregnant women, there is a worryingly high percentage of women who still do not use recommended dietary supplementation. The aim of this study was to assess the frequency of micronutrient supplementation by pregnant women and to specify the determinants that impact decisions concerning supplementation. Material and methods:A cross-sectional survey was conducted between June 2016 and May 2017 among a group of pregnant women visiting gynecological and obstetric clinics in the Silesia region, who have completed an authorized questionnaire developed for the purpose of this study. The questionnaire addressed the women's dietary habits, micronutrient supplementation use, as well as their socio-economic status. Completed questionnaires were obtained from 505 pregnant women.Results: Microminerals and vitamins supplementation during pregnancy was declared by 410 (81.2%) women. The most often used supplement was folic acid (62%). More than one-third of pregnant women (38.4%) declared vitamin D intake. Among the recommended supplements, the least commonly used (30.3%) were polyunsaturated fatty acids (PUFA). Factors contributing to supplementation use during pregnancy are past history of miscarriage and socioeconomic factors, such as: place of residence, financial situation and level of education. Inhabitants of larger cities, women with better self-perceived financial situations, higher education levels and those presenting past history of miscarriage took the supplements significantly more often. Conclusions:Lower levels of education, low-income financial status and living in rural localities are among the factors correlating with worse adherence to supplementation guidelines.

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“…This confirms results of previous research that those who need supplements the most (i.e. those with the lowest dietary micronutrient intake) are the least likely to consume micronutrient supplements [40][41][42]. A recent study using data of 485 preconception women of the ALSWH study identified that 63% of the women used at least one supplement preconception and that 51% used a supplement containing folic acid [43].…”

Section: Discussionsupporting

confidence: 85%

Pre-pregnancy dietary micronutrient adequacy is associated with lower risk of developing gestational diabetes in Australian women

et al. 2019

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Pre-pregnancy dietary micronutrient adequacy is associated with lower risk of developing gestational diabetes in Australian women. Ntr (2018), https://doi. AbstractEvidence on pre-pregnancy dietary micronutrient intake in relation to gestational diabetes (GDM) development is limited. Therefore, we examined the prevalence of inadequate micronutrient intake before pregnancy and the association between pre-pregnancy dietary micronutrient adequacy, i.e. meeting micronutrient intake recommendations for a range of micronutrients, and risk of developing GDM in an Australian population. We hypothesized that women with an overall higher micronutrient adequacy would have a lower risk of developing GDM. We used data from the prospective Australian Longitudinal Study on Women's Health cohort, in which 3,607 women, aged 25-30 years at baseline in 2003 and without diabetes, were followed-up until 2015. Diet was assessed with a validated 101-item food frequency questionnaire. The Micronutrient Adequacy Ratio (MAR) was calculated as the micronutrient intake divided by its recommended dietary intake averaged over thirteen micronutrients. Multivariable regression models with generalized estimating equations were used to estimate relative risks (RR) and 95% confidence intervals (95% CI). In 6,263 pregnancies, 285 cases of GDM were documented (4.6%). High prevalences of inadequate dietary micronutrient intake were observed for calcium (47.9%), folate (80.8%), magnesium (52.5%), potassium (63.8%) and vitamin E (78.6%), indicating suboptimal pre-pregnancy micronutrient intakes. Inadequate intakes of individual micronutrients were not associated with risk of developing GDM. However, women in the highest quartile of the MAR had a 39% lower risk of developing GDM compared to women in the lowest quartile (RR 0.61, 95% CI 0.43-0.86, p for trend 0.01). These results highlight the importance of adequate prepregnancy micronutrient intake.

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Socioeconomic, Lifestyle and Dietary Factors Associated with Dietary Supplement Use during Pregnancy

Cited by 53 publications

References 44 publications

Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross‐sectional analysis

Poor adherence to folic acid and iodine supplement recommendations in preconception and pregnancy: a cross‐sectional analysis

Dietary supplementation usage by pregnant women in Silesia — population based study

Pre-pregnancy dietary micronutrient adequacy is associated with lower risk of developing gestational diabetes in Australian women

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