Determinants of Compliance With Iron and Folate Supplementation Among Pregnant Women in West Iran: A Population Based Cross-Sectional Study
-
Soraya Siabani
,
Sina Siabani
,
Hossien Siabani
,
Marjan Moeini Arya
,
Fateme Rezaei
,
Maryam Babakhani
Abstract
Objective: To assess the compliance with iron and folate supplementation, and the possibly causally associated factors, among pregnant women in western Iran.
Materials and methods: A cross-sectional study of 433 pregnant women, selected randomly amongst those (n = 8,500) attending 40 primary health care centers (PHCCs) in west Iran in 2017. A validated questionnaire was used to gather data, including demographic characteristics, the compliance with iron/folate supplementation and reasons for non-compliance.
Results: The participants’ mean age and the duration of their pregnancies when commencing supplementation were (27.86 ± 5.54y [µ ± SD]) and (23.29 ± 9.86w), respectively. The compliance was 71.6% / 28% for iron, and 81.5% / 40% for folate. The commonest causes of poor compliance were forgetfulness and side-effects. Educational status, age, and history of anemia were significantly positively associated with folate compliance. The compliance with iron was associated only with the level of education.
Conclusion: Although the compliance with iron and folate was relatively high, most women had not started taking the supplements regularly or at the correct time, usually due to forgetting and/or experiencing adverse side-effects.
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10. Di Renzo GC, Spano F, Giardina I, Brillo E, Clerici G, Roura LC. Iron deficiency anemia in pregnancy. Womens Health (Lond) 2015; 11: 891-900.
11. Auerbach M, Adamson JW. How we diagnose and treat iron deficiency anemia. Am J Hematol 2016; 91: 31-8.
12. Ladipo OA. Nutrition in pregnancy: mineral and vitamin supplements. Am J Clin Nutr 2000; 72: 280S-90S.
13. Rofail D, Colligs A, Abetz L, Lindemann M, Maguire L. Factors contributing to the success of folic acid public health campaigns. J Public Health (Oxf) 2012; 34: 90-9.
14. Department of Health Scottish Office Home and Health Department Welsh Office Department of Health and Social Services, Northern Ireland. Folic acid and the prevention of neural tube defects: report from an expert advisory group. Department of Health London 1992.
15. Saxena V, Naithani M, Kumari R, Singh R, Das P. Peri-conceptional supplementation of folic acid-knowledge and practices of pregnant women and health providers. J Family Med Prim Care 2016; 5: 387-92.
16. Organization WH. Standards for maternal and neonatal care, 2007.
17. Yerby MS. Management issues for women with epilepsy: neural tube defects and folic acid supplementation. Neurology 2003; 61: S23-6.
18. Blot I, Diallo D, Tchernia G. Iron deficiency in pregnancy: effects on the newborn. Curr Opin Hematol 1999; 6: 65-70.
19. Ugwu EO, Olibe AO, Obi SN, Ugwu AO. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. Niger J Clin Pract 2014; 17: 608-12.
20. Sing SR, Ratanasiri T, Thapa P, Koju R, Ratanasiri A, Arkaravichien T,Arkaravichien W. Effect of knowledge and perception on adherence to iron andfolate supplementation during pregnancy in Kathmandu, Nepal. J Med Assoc Thai 2014; 97: S67-74.
21. Seck BC, Jackson RT. Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr 2008 Jun; 11: 596-605.
22. Riazi H, Bashirian S. The pattern of folic acid intake in pregnant women referring to Fatemieh hospital in Hamadan (2005) . koomesh 2009; 10 :171-6.
23. Gebre A, Afework M, Belachew E. assessment of factors associated with adherence to Iron-Folic acid supplementation among urban and rural pregnant women in north western zone of tigray, Ethiopia: Comparative study. International Journal of Nutrition and Food Sciences 2015; 4: 161-8.
24. Habib F, Alabdin EH, Alenazy M, Nooh R. Compliance to iron supplementation during pregnancy. J Obstet Gynaecol 2009; 29: 487-92.
25. Passarelli V, de Figueiredo NSV, Angst DBM, Baldocchi MA, Rocha MSG. Folate use in women with epilepsy: Predictors of adherence in a specialized tertiary outclini. Epilepsy & Behavior 2015; 43: 74 – 6.
26. García-Fragoso L, García-García I, Rivera CE. The use of folic acid for the prevention of birth defects in Puerto Rico. Ethn Dis 2008; 18:S2-168-71.
27. Bastani F. The effect of education on nutrition behavioral intention and self-efficacy in women. Health Scope 2012; 1: 12-7.
28. Ogundipe O, Hoyo C, Østbye T, Oneko O, Manongi R, Lie RT, et al. Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study. BMC public health 2012; 12: 481.
29. Kulkarni B, Christian P, LeClerq SC, Khatry SK, Determinants of compliance to antenatal micronutrient supplementation and women’s perceptions of supplement use in rural Nepal. Public health nutrition 2010; 13: 82-90
30. Rezaei M, Mohammadinia N, Heidari N, Pejmankhah S. Awareness on taking folic acid among pregnant women who referred to heath centers in Iranshahr city (2010). Community Health Journal 2011: 53-61.
31. Karimi B, Karimi F, Ghorbani R .The intake of iron supplement and some related factors in pregnant women under supervision of health centers in Semnan, Iran. Payesh 2014; 13: 401-11.
2. King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr. 2000; 71: 1218S-25S.
3. WHO. Guideline: Daily iron and folic acid supplementation in pregnant women. Geneva, World Health Organization, 2012.
4. Beard JL. Effectiveness and strategies of iron supplementation during pregnancy. The American Journal of Clinical Nutrition 2000; 71: 1288S–94S.
5. Organization WH. The world health report 2002: reducing risks, promoting healthy life. World Health Organization.
6. Breymann C. Iron deficiency anemia in pregnancy. Semin Hematol 2015; 52: 339-47.
7. Rush D. Nutrition and maternal mortality in the developing world. Am J Clin Nutr 2000; 72: 212S-40S.
8. Peña-Rosas JP, Viteri FE. Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy. Cochrane Database Syst Rev 2009; (4): CD004736.
9. Rasmussen K. Is there a causal relationship between iron deficiency or Iron-deficiency anemia and weight at birth, length of gestation and perinatal Mortality? J Nutr 2001; 131: 590S-601S; discussion 601S-3S.
10. Di Renzo GC, Spano F, Giardina I, Brillo E, Clerici G, Roura LC. Iron deficiency anemia in pregnancy. Womens Health (Lond) 2015; 11: 891-900.
11. Auerbach M, Adamson JW. How we diagnose and treat iron deficiency anemia. Am J Hematol 2016; 91: 31-8.
12. Ladipo OA. Nutrition in pregnancy: mineral and vitamin supplements. Am J Clin Nutr 2000; 72: 280S-90S.
13. Rofail D, Colligs A, Abetz L, Lindemann M, Maguire L. Factors contributing to the success of folic acid public health campaigns. J Public Health (Oxf) 2012; 34: 90-9.
14. Department of Health Scottish Office Home and Health Department Welsh Office Department of Health and Social Services, Northern Ireland. Folic acid and the prevention of neural tube defects: report from an expert advisory group. Department of Health London 1992.
15. Saxena V, Naithani M, Kumari R, Singh R, Das P. Peri-conceptional supplementation of folic acid-knowledge and practices of pregnant women and health providers. J Family Med Prim Care 2016; 5: 387-92.
16. Organization WH. Standards for maternal and neonatal care, 2007.
17. Yerby MS. Management issues for women with epilepsy: neural tube defects and folic acid supplementation. Neurology 2003; 61: S23-6.
18. Blot I, Diallo D, Tchernia G. Iron deficiency in pregnancy: effects on the newborn. Curr Opin Hematol 1999; 6: 65-70.
19. Ugwu EO, Olibe AO, Obi SN, Ugwu AO. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. Niger J Clin Pract 2014; 17: 608-12.
20. Sing SR, Ratanasiri T, Thapa P, Koju R, Ratanasiri A, Arkaravichien T,Arkaravichien W. Effect of knowledge and perception on adherence to iron andfolate supplementation during pregnancy in Kathmandu, Nepal. J Med Assoc Thai 2014; 97: S67-74.
21. Seck BC, Jackson RT. Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr 2008 Jun; 11: 596-605.
22. Riazi H, Bashirian S. The pattern of folic acid intake in pregnant women referring to Fatemieh hospital in Hamadan (2005) . koomesh 2009; 10 :171-6.
23. Gebre A, Afework M, Belachew E. assessment of factors associated with adherence to Iron-Folic acid supplementation among urban and rural pregnant women in north western zone of tigray, Ethiopia: Comparative study. International Journal of Nutrition and Food Sciences 2015; 4: 161-8.
24. Habib F, Alabdin EH, Alenazy M, Nooh R. Compliance to iron supplementation during pregnancy. J Obstet Gynaecol 2009; 29: 487-92.
25. Passarelli V, de Figueiredo NSV, Angst DBM, Baldocchi MA, Rocha MSG. Folate use in women with epilepsy: Predictors of adherence in a specialized tertiary outclini. Epilepsy & Behavior 2015; 43: 74 – 6.
26. García-Fragoso L, García-García I, Rivera CE. The use of folic acid for the prevention of birth defects in Puerto Rico. Ethn Dis 2008; 18:S2-168-71.
27. Bastani F. The effect of education on nutrition behavioral intention and self-efficacy in women. Health Scope 2012; 1: 12-7.
28. Ogundipe O, Hoyo C, Østbye T, Oneko O, Manongi R, Lie RT, et al. Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study. BMC public health 2012; 12: 481.
29. Kulkarni B, Christian P, LeClerq SC, Khatry SK, Determinants of compliance to antenatal micronutrient supplementation and women’s perceptions of supplement use in rural Nepal. Public health nutrition 2010; 13: 82-90
30. Rezaei M, Mohammadinia N, Heidari N, Pejmankhah S. Awareness on taking folic acid among pregnant women who referred to heath centers in Iranshahr city (2010). Community Health Journal 2011: 53-61.
31. Karimi B, Karimi F, Ghorbani R .The intake of iron supplement and some related factors in pregnant women under supervision of health centers in Semnan, Iran. Payesh 2014; 13: 401-11.
| Files | ||
| Issue | Vol 12, No 4 (December 2018) | |
| Section | Original Articles | |
| Keywords | ||
| Compliance Folate Iron Pregnancy Antenatal Care | ||
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How to Cite
1.
Siabani S, Siabani S, Siabani H, Moeini Arya M, Rezaei F, Babakhani M. Determinants of Compliance With Iron and Folate Supplementation Among Pregnant Women in West Iran: A Population Based Cross-Sectional Study. J Family Reprod Health. 2018;12(4):197-203.
