Iron supplementation among pregnant women: results from a population-based survey study

Abstract

Objectives: To measure the prevalence and risk factors associated with iron supplementation among pregnant women in the municipality of Rio Grande, Southern Brazil. Methods: All mothers living in this municipality who had children in 2007 were surveyed for demographic, socioeconomic and health care received during pregnancy and childbirth. The statistical analysis consisted of Poisson regression with robust adjustment of variance, and the measure of effect was prevalence ratio (PR). Results: Among the 2,557 mothers interviewed (99% of total), 59% were supplemented with iron during pregnancy period. After adjusting for various confounding factors, a higher PR to iron supplementation was observed among teenagers, women with black skin color, primigravidae, who had six or more antenatal visits, who performed prenatal care in public sector and received vitamin during pregnancy. Conclusion: There is a clear need to increase the iron supplementation coverage of all pregnant women, especially among those currently considered with low gestational risk. Keywords

Time And Number of Antenatal Visits in Low Socio-Economic Population: Outcomes And Related Factors

“…Recently published data have shown that increased use of iron and reduced anemia are directly proportional to good quality antenatal care, with 6 or more visits starting early in the pregnancy [12,20]. However, in the current study, no relationship was seen between anemia rates and the number of antenatal care visits or the time of presentation (p>0.05).…”

Factors associated with non-adherence to prescribed iron supplement use: a study with pregnant women in the city of Rio de Janeiro

“…13 In Senegal, it was found that 58% of pregnant women used 70% or more of iron supplements prescribed 25 and, in Vietnam, the mean duration of use of the supplement was 4.8 months. 23 The discrepancies observed between the prevalences of use of the iron supplement may be associated with various factors, such as greater use among populations with higher levels of schooling and income, [16][17][18][19][20][21] who have more extensive prenatal care coverage 13,15,18,19,22 and better access to the supplement. 18,21,23,25 However, the different ways of measuring the use of iron supplements in the studies may also contribute to the variations observed.…”

“…One plausible explanation of this is that the services investigated were giving more attention regarding the use of supplements to pregnant women who have historically been identified as more vulnerable. 22 The association between multiparity and lower use of iron supplements is widely documented in the literature. 14,15,22 Pregnant women who have already been through one or more pregnancies may be less concerned about health in gestation, especially if they have experienced a pregnancy without complications.…”

“…11 The low adherence of pregnant women to the use of iron supplements (IS) is one of the main obstacles to the effectiveness of such action. 12,13 Studies with pregnant women in developed and developing countries have identified the following factors associated with less frequent use of IS: younger age, 14,15 black race/skin color, 16,17 low level of education [17][18][19][20][21] and income, 16,21 unemployment, 14 being single without a partner at the start of gestation, 20 multiparity, 14,15,22 fewer prenatal consults, 13,15,18,22 inadequate prenatal care (in terms of start of prenatal care and number of consults), 19 presence of side-effects of supplementation, 13,21,[23][24][25] lack of guidance on use of supplements, 24,25 lack of knowledge of the importance of iron intake 13,24,25 and iron supplementation during pregnancy, 21 not having been diagnosed with anemia during pregnancy 15,24 and unavailability of free supplements in sufficient quantities. 18,21,23,25 Studies of this subject have already been conducted in two Brazilian cities: one in the State of São Paulo …”

“…18,21,23,25 Studies of this subject have already been conducted in two Brazilian cities: one in the State of São Paulo 20 and another in the State of Rio Grande do Sul. 22 However, pregnant women in other States also need to be the target of studies, with a view to comparing findings and identifying important factors for adherence to prescription of IS in diverse Brazilian settings.…”