Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 8;9(8):e028843.
doi: 10.1136/bmjopen-2018-028843.

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

Danmeng Liu  1 , Yue Cheng  2 , Shaonong Dang  1 , Duolao Wang  3 , Yaling Zhao  1 , Chao Li  1 , Shanshan Li  1 , Fangliang Lei  1 , Pengfei Qu  4 , Baibing Mi  1 , Ruo Zhang  1 , Jiamei Li  5 , Lingxia Zeng #  6 , Hong Yan #  6   7   8
Affiliations

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

Danmeng Liu et al. BMJ Open. .

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.

Keywords: adherence; associated factors; micronutrient supplementation; pregnancy.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Imdad A, Yakoob MY, Bhutta ZA. The effect of folic acid, protein energy and multiple micronutrient supplements in pregnancy on stillbirths. BMC Public Health 2011;11(Suppl 3):S4 10.1186/1471-2458-11-S3-S4 - DOI - PMC - PubMed
    1. Branum AM, Bailey R, Singer BJ. Dietary supplement use and folate status during pregnancy in the United States. J Nutr 2013;143:486–92. 10.3945/jn.112.169987 - DOI - PMC - PubMed
    1. Gernand AD, Schulze KJ, Stewart CP, et al. . Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol 2016;12:274–89. 10.1038/nrendo.2016.37 - DOI - PMC - PubMed
    1. Tang L, Lee AH, Yau KKW, et al. . Consumption of dietary supplements by Chinese women during pregnancy and postpartum: a prospective cohort study. Matern Child Nutr 2017;13 10.1111/mcn.12435 - DOI - PMC - PubMed
    1. Hofmeyr GJ, Lawrie TA, Atallah Álvaro N, et al. . Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2014;3 Suppl 1 10.1002/14651858.CD001059.pub4 - DOI - PubMed

Publication types