Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, NY 13244, USA.
Nutrients. 2018 Sep 10;10(9):1275. doi: 10.3390/nu10091275.
Prenatal iron and folic acid (IFA) supplements are offered free to all pregnant women in Malawi to reduce maternal anemia and improve birth outcomes. We investigated the association between self-reported compliance to IFA intake and risk of low birth weight (LBW). Pregnant women who attended Bwaila Maternity Wing of Lilongwe District Hospital for delivery were recruited ( = 220). We used a questionnaire to collect self-reported information on IFA use and maternal sociodemographic data. Before delivery, blood samples for maternal hemoglobin (Hb) and folate status, and upon delivery, birth weight, and other newborn anthropometrics were measured. We used multivariable logistic regression to determine risk of LBW by prenatal IFA intake. The self-reported number of IFA pills taken during pregnancy was positively associated with Hb, but not serum and RBC folate concentration: <45, 45⁻89 and ≥90 pills taken corresponded with mean (SD) Hb 10.7 (1.6), 11.3 (1.8), and 11.7 (1.6) g/dL, respectively ( = 0.006). The prevalence of LBW was 20.1%, 13.5% and 5.6% for those who reported taking IFA pills <45, 45⁻89, and ≥90 pills, respectively ( = 0.027). Taking >60 IFA pills reduced risk of LBW delivery (OR (95% CI) = 0.15 (0.03⁻0.70), = 0.033) than taking ≤30 pills. Self-reported compliance to IFA use is valid for assessing prenatal supplement program in Malawi, especially Hb status, and can reduce the rate of LBW.
产前铁和叶酸（IFA）补充剂免费提供给马拉维的所有孕妇，以减少孕产妇贫血并改善生育结果。我们研究了自我报告的 IFA 摄入量依从性与低出生体重（LBW）风险之间的关联。在利隆圭区 Bwaila 妇产医院分娩的孕妇被招募（n=220）。我们使用问卷收集自我报告的 IFA 使用情况和孕产妇社会人口统计学数据。在分娩前，采集母体血红蛋白（Hb）和叶酸状况的血液样本，以及在分娩时，测量新生儿的体重和其他身体测量值。我们使用多变量逻辑回归来确定产前 IFA 摄入量与 LBW 的风险。怀孕期间自我报告的 IFA 片数与 Hb 呈正相关，但与血清和 RBC 叶酸浓度无关：<45、45-89 和≥90 片分别对应于平均（SD）Hb 10.7（1.6）、11.3（1.8）和 11.7（1.6）g/dL（=0.006）。报告服用 IFA 片数<45、45-89 和≥90 的 LBW 发生率分别为 20.1%、13.5%和 5.6%（=0.027）。服用>60 片 IFA 片可降低 LBW 分娩的风险（OR（95%CI）=0.15（0.03-0.70），=0.033），而服用≤30 片 IFA 片的风险更高。自我报告的 IFA 使用依从性可有效评估马拉维的产前补充计划，尤其是 Hb 状况，并可降低 LBW 发生率。
