Demographic variations and temporal trends in prenatal use of multiple micronutrient supplements in Beijing, 2013-2017

Abstract

Objective: To provide updated information about demographic variations and temporal trends in the prenatal use of multiple micronutrient (MMN) supplements in the metropolitan areas of China.

Design: Descriptive analysis of routine prenatal healthcare data between 2013 and 2017.

Setting: Chaoyang District, Beijing, China.

Participants: A total of 197 346 pregnant women who attended their first prenatal care visit and provided information about MMN supplementation during the periconceptional period.

Results: Of these pregnant women, 60·6 % reported consuming prenatal MMN supplements. In multivariate-adjusted models, there were significant gradients of age, education and parity in prenatal MMN supplementation, with the highest likelihood of MMN use among the oldest, the most highly educated and nulliparous women (Pfor trend < 0·001). Compared with that among unemployed women, prenatal MMN supplementation was more common among the employed, especially those engaged in business (adjusted relative risks (95 % CI): 1·08 (1·06, 1·10)) and management (1·10 (1·08, 1·12)). The proportion of prenatal MMN supplementation was 57·0 % in 2013, which increased to 63·5 % in 2017 (Pfor trend < 0·001). The trends varied by age, education and parity (Pfor heterogeneity < 0·001), whereas no significant difference was observed in trends across subgroups of ethnicity or occupation. The greatest magnitude increase in MMN supplement use occurred in women of age < 25 years (annual percent change: 5·7 %), less than high school education (9·6 %), parity ≥ 2 (6·8 %) or unemployment (6·1 %).

Conclusion: Approximately two-thirds of women consumed prenatal MMN supplements during the periconceptional period in the central area of Beijing and the proportion increased over time, indicating a need to evaluate the effectiveness and safety and to develop a guideline for relatively well-nourished women.

Keywords: Dietary supplements; Multivitamins; Pregnant women; Socio-economic status.

Fig. 1

Trends in prenatal use of multiple micronutrient (MMN) supplements by demographic characteristics, in Chaoyang District, Beijing, 2013–2017. (A) Maternal age, (B) educational level, (C) ethnicity, (D) occupation, (E) parity. As estimated by modified Poisson regression model, the annual percentage change in overall proportion of prenatal MMN use was 1·5 % (95 % CI: 1·2 %, 1·7 %) from 2013 to 2017. Interaction test indicated the differences in temporal trends between the subgroups of age, education level and parity (P < 0·001). ). (A) , <25; , 25–29; , 30–34; , 35–39; , ≥40; (B) , <high school; , high school; , bachelor degree; , postgraduate; (C) , Han; , Manchu; , other; (D) , management; , business; , sales and service; , professional; , unemployed ; , other; (E) , 0, , 1; , ≥2

Fig. 2

Trends in preconceptional and regular use of multiple micronutrient (MMN) supplements by demographic characteristics in Chaoyang District, Beijing, 2013–2017. (A) Maternal age, (B) educational level, (C) ethnicity, (D) occupation, (E) parity. As estimated by modified Poisson regression model, the annual percentage change in overall proportion of preconceptional and regular use was –0·1 % (95 % CI: –0·4 %, 0·3 %) from 2013 to 2017. Interaction test indicated the differences in temporal trends between the subgroups of age and education level (P < 0·001). A) , <25; , 25–29; , 30–34; , 35–39; , ≥40; (B) , <high school; , high school; , bachelor degree; , postgraduate; (C) , Han; , Manchu; , other; (D) , management; , business; , sales and service; , professional; , unemployed ; , other; (E) , 0, , 1; , ≥2