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尼泊尔产后母亲对铁叶酸补充剂的依从性较低:对2011年尼泊尔人口与健康调查的分析

Low compliance with iron-folate supplementation among postpartum mothers of Nepal: an analysis of Nepal Demographic and Health Survey 2011.

作者信息

Khanal Vishnu, Adhikari Mandira, Karkee Rajendra

机构信息

School of Public Health, Curtin University, Perth, Australia,

出版信息

J Community Health. 2014 Jun;39(3):606-13. doi: 10.1007/s10900-013-9806-6.

Abstract

One in five maternal deaths are directly attributable to anaemia in the world. The World Health Organization recommends iron supplementation from the second trimester of pregnancy to 45 days after delivery. The aim of this study was to determine the compliance rate of iron-folate consumption and the factors associated with iron-folate consumption among post-natal mothers in Nepal. This study utilised the data of Nepal Demographic and Health Survey (NDHS) 2011. The NDHS 2011 is a cross sectional and nationally representative survey. Of the 4,148 respondents, only 20.7% consumed iron throughout the post-natal period for 45 days. Mothers who had higher and secondary education [adjusted Odd ratio (aOR) 3.101; 95% CI (2.268-4.240)]; had attended four or more antenatal care visits [aOR 9.406; 95% CI (5.552-15.938)]; lived in Far-western development region [aOR 1.822; 95% CI (1.387-2.395)]; delivered in health facility [aOR 1.335; 95% CI (1.057-1.687)]; and attended postnatal care [aOR 2.348; 95% CI (1.859-2.965)] were more likely to take iron for 45 days of postpartum. Intervention to increase the compliance with the postpartum iron-folate supplementation are required to avoid adverse pregnancy outcomes associated with poor iron status with especial focus on the mothers who delivered at homes and did not attend post-natal check up.

摘要

全球五分之一的孕产妇死亡可直接归因于贫血。世界卫生组织建议从孕期第二个月开始至产后45天进行铁补充。本研究的目的是确定尼泊尔产后母亲铁叶酸摄入量的依从率以及与铁叶酸摄入相关的因素。本研究使用了2011年尼泊尔人口与健康调查(NDHS)的数据。2011年NDHS是一项具有全国代表性的横断面调查。在4148名受访者中,只有20.7%的人在产后45天内全程摄入了铁。接受过高等和中等教育的母亲[调整后比值比(aOR)3.101;95%置信区间(CI)(2.268 - 4.240)];进行过四次或更多次产前检查的母亲[aOR 9.406;95% CI(5.552 - 15.938)];居住在远西区发展区的母亲[aOR 1.822;95% CI(1.387 - 2.395)];在医疗机构分娩的母亲[aOR 1.335;95% CI(1.057 - 1.687)];以及接受过产后护理的母亲[aOR 2.348;95% CI(1.859 - 2.965)]在产后45天更有可能摄入铁。需要采取干预措施以提高产后铁叶酸补充的依从性,以避免与铁状态不佳相关的不良妊娠结局,尤其要关注在家分娩且未进行产后检查的母亲。

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