Maternal adherence to micronutrient supplementation before and during pregnancy in Northwest China: a large-scale population-based cross-sectional survey.

Liu, Danmeng, Cheng, Yue, Dang, Shaonong, Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464, Zhao, Yaling, Li, Chao, Li, Shanshan, Lei, Fangliang, Qu, Pengfei, Mi, Baibing, Zhang, Ruo, Li, Jiamei, Zeng, Lingxia and Yan, Hong (2019) 'Maternal adherence to micronutrient supplementation before and during pregnancy in Northwest China: a large-scale population-based cross-sectional survey.'. BMJ Open, Vol 9, Issue 8, e028843.

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Abstract

OBJECTIVES
To report the situation of maternal micronutrient supplementation before and during pregnancy in Northwest China and to examine the rates of and factors related to the adherence to micronutrient supplementation among pregnant women in this region, where dietary micronutrient intake is commonly insufficient.
DESIGN
A large-scale population-based cross-sectional survey.
SETTING
Twenty counties and ten districts of Shaanxi Province.
PARTICIPANTS
A sample of 30 027 women were selected using a stratified multistage random sampling method. A total of 28 678 women were chosen for the final analysis after excluding those who did not provide clear information about nutritional supplementation before and during pregnancy.
MAIN OUTCOME MEASURES
Maternal adherence to micronutrient supplementation (high and low) were the outcomes. They were determined by the start time and duration of use according to Chinese guidelines (for folic acid (FA) supplements) and WHO recommendations (for iron, calcium and multiple-micronutrient (MMN) supplements).
RESULTS
In total, 83.9% of women took at least one kind of micronutrient supplement before or during pregnancy. FA (67.6%) and calcium (57.5%) were the primarily used micronutrient supplements; few participants used MMN (14.0%) or iron (5.4%). Adherence to supplementation of all micronutrients was low (7.4% for FA, 0.6% for iron, 11.7% for calcium and 2.7% for MMN). Higher educational levels, higher income levels, urban residence and better antenatal care (including pregnancy consultation and a higher frequency of antenatal visits) were associated with high adherence to micronutrient supplementation.
CONCLUSION
Maternal micronutrient supplementation before and during pregnancy in Northwest China was way below standards recommended by the Chinese guidelines or WHO. Targeted health education and future nutritional guidelines are suggested to improve this situation, especially in pregnant women with disadvantaged sociodemographic conditions.

Item Type:	Article
Subjects:	QU Biochemistry > Biochemistry of the Human Body > QU 130.5 Trace elements WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WQ Obstetrics > Pregnancy > WQ 200 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjopen-2018-028843
Depositing User:	Julie Franco
Date Deposited:	28 Aug 2019 11:06
Last Modified:	06 Sep 2019 15:27
URI:	https://archive.lstmed.ac.uk/id/eprint/11516

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