Pill Count Adherence to Prenatal Multivitamin/Mineral Supplement Use among Low-Income Women

Abstract

In the United States, the prevalence of third trimester anemia among low-income pregnant women is 29% and has not improved since the 1980s. Although low adherence has been linked to the ineffectiveness of iron supplementation programs, data regarding adherence to supplementation in low-income women are currently lacking. Hence this study was conducted to better understand the factors associated with adherence to the use of iron-containing prenatal multivitamin/mineral supplements among low-income pregnant women. Adherence to supplement use was assessed by pill counts among 244 pregnant women of 867 women who were initially randomized to receive 1 of 3 prenatal supplements. All women received care at a public prenatal clinic. Maternal characteristics associated with adherence were identified using predictive modeling. Women took 74% of supplements as prescribed. Adherence was higher among non-Hispanic white women than among non-Hispanic black women (79% vs. 72%, P </= 0.01). Interactions of ethnicity with age group, smoking status, and prior supplement use were significant. Multivariate regression analysis stratified by ethnicity revealed that among the white women education beyond high school, unmarried status, nulligravidity, and smoking were positively associated with adherence. In contrast, among the black women, supplement use 3 mo prior to current pregnancy and no loss of appetite were positively associated with adherence. Further research investigating the influence of cultural factors is necessary to better understand adherence to supplement use and the differences in adherence among ethnic groups.

Compliance to Prenatal Iron and Folic Acid Supplement and Associated Factors among Women during Pregnancy in South East Ethiopia: A Cross-Sectional Study

“…The compliance rate of this study is lower than a study conducted in Kenya (24.5% [15], study conducted in Cambodia (47%) [16] and study conducted in India (35.5%) [17]. This could be due to differences in socioeconomic status of the study population.…”

Methylation variation atIGF2differentially methylated regions and maternal folic acid use before and during pregnancy

“…However, the prevalence of periconceptional (64%) and prenatal (53%) FA intake estimated from the present study is similar to that of the US 70,71 and other developed countries, 72 suggesting social desirability may not have unduly affected our findings. Moreover, in the event that FA intake was over-reported, such over-reporting would be expected to be similar by methylation status, with the net effect of attenuating the methylation differences observed.…”

Factors contributing to non-compliance to routine ante-natal haematinics among pregnant women attending ante-natal clinic in University of Maiduguri Teaching Hospital, Borno, Nigeria

“…Some haematinics are offensive to the nose for almost 73% of the respondents while 27% said it is not related to non-compliance, many reports are actually having a different opinion where only 2% think it does. 10 Twenty percent (20%) think the unavailability of the drugs in hospitals lead to most cases of non-compliance while the majority (80%) actually don't think it does, actually many developing countries have a properly managed program for pregnant women therefore many governmental based hospitals hardly run short of haematinics. The supplementation of Iron by vegetables in this study is a phenomenon that about 56% think causes non-compliance to haematinics by pregnant women while 44% are not of the opinion.…”

“…This high response in vegetable intake agrees with the moving from a monotonous diet to one containing a more diverse range of foods that has been shown to increase intake of energy as well as micronutrients in developing countries, the pregnant women's dietary diversity has been shown to be related to increased nutrient adequacy of the diet. 10,19 Some pregnant women taking haematinics (11%) never heard about the benefits of the drugs while a majority of others (89%) take the drugs because they have heard about its benefits. This varies with the reports in, where only 37.7% heard about its benefits before intake.…”

“…9 Anaemia in pregnancy continues to be a major health problem in most developing countries, with significant adverse effects for both mother and infant. 10 Iron deficiency is the main underlying cause for anaemia in pregnancy followed by folate deficiency. Anaemia has previously been shown to be associated with adverse pregnancy outcomes.…”