Gebreamlak Bisratemariam, Dadi Abel Fekadu, Atnafu Azeb
Teklaymanot General Hospital, Addis Ababa, Ethiopia.
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2017 Jan 27;12(1):e0169415. doi: 10.1371/journal.pone.0169415. eCollection 2017.
Iron deficiency during pregnancy is a risk factor for anemia, preterm delivery, and low birth weight. Iron/Folic Acid supplementation with optimal adherence can effectively prevent anemia in pregnancy. However, studies that address this area of adherence are very limited. Therefore, the current study was conducted to assess the adherence and to identify factors associated with a number of Iron/Folic Acid uptake during pregnancy time among mothers attending antenatal and postnatal care follow up in Akaki kality sub city.
Institutional based cross-sectional study was conducted on a sample of 557 pregnant women attending antenatal and postnatal care service. Systematic random sampling was used to select study subjects. The mothers were interviewed and the collected data was cleaned and entered into Epi Info 3.5.1 and analyzed by R version 3.2.0. Hierarchical Negative Binomial Poisson Regression Model was fitted to identify the factors associated with a number of Iron/Folic Acid uptake. Adjusted Incidence rate ratio (IRR) with 95% confidence interval (CI) was computed to assess the strength and significance of the association.
More than 90% of the mothers were supplemented with at least one Iron/Folic Acid supplement from pill per week during their pregnancy time. Sixty percent of the mothers adhered (took four or more tablets per week) (95%CI, 56%-64.1%). Higher IRR of Iron/Folic Acid supplementation was observed among women: who received health education; which were privately employed; who achieved secondary education; and who believed that Iron/Folic Acid supplements increase blood, whereas mothers who reported a side effect, who were from families with relatively better monthly income, and who took the supplement when sick were more likely to adhere.
Adherence to Iron/Folic Acid supplement during their pregnancy time among mothers attending antenatal and postnatal care was found to be high. Activities that would address the above mentioned factors were highly recommended to ensure the sustainability of mothers' adherence to the supplement.
孕期缺铁是贫血、早产和低出生体重的危险因素。最佳依从性的铁/叶酸补充剂可有效预防孕期贫血。然而，针对这一依从性领域的研究非常有限。因此，本研究旨在评估阿卡基卡利蒂次市参加产前和产后护理随访的母亲在孕期铁/叶酸摄入量的依从性，并确定与之相关的因素。
对557名参加产前和产后护理服务的孕妇进行了基于机构的横断面研究。采用系统随机抽样方法选择研究对象。对母亲进行访谈，收集的数据进行清理后录入Epi Info 3.5.1，并使用R 3.2.0版本进行分析。采用分层负二项泊松回归模型确定与铁/叶酸摄入量相关的因素。计算调整后的发病率比（IRR）及其95%置信区间（CI），以评估关联的强度和显著性。
超过90%的母亲在孕期每周至少服用一片铁/叶酸补充剂。60%的母亲依从（每周服用四片或更多片）（95%CI，56%-64.1%）。在接受健康教育、受雇于私人企业、完成中等教育以及认为铁/叶酸补充剂能补血的女性中，铁/叶酸补充剂的IRR较高，而报告有副作用、家庭月收入相对较高以及生病时服用补充剂的母亲更有可能依从。
发现参加产前和产后护理的母亲在孕期对铁/叶酸补充剂的依从性较高。强烈建议开展针对上述因素的活动，以确保母亲持续依从补充剂。
