中国西北地区孕妇妊娠前后微量营养素补充的依从性：一项基于大规模人群的横断面调查。
Maternal adherence to micronutrient supplementation before and during pregnancy in Northwest China: a large-scale population-based cross-sectional survey.
机构信息
Department of Epidemiology and Health Statistics, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Department of Nutrition, Xi'an Jiaotong University Health Science Center, Xi'an, China.
出版信息
BMJ Open. 2019 Aug 8;9(8):e028843. doi: 10.1136/bmjopen-2018-028843.
OBJECTIVES
To report the situation of maternal micronutrient supplementation before and during pregnancy in Northwest China and to examine the rates of and factors related to the adherence to micronutrient supplementation among pregnant women in this region, where dietary micronutrient intake is commonly insufficient.
DESIGN
A large-scale population-based cross-sectional survey.
SETTING
Twenty counties and ten districts of Shaanxi Province.
PARTICIPANTS
A sample of 30 027 women were selected using a stratified multistage random sampling method. A total of 28 678 women were chosen for the final analysis after excluding those who did not provide clear information about nutritional supplementation before and during pregnancy.
MAIN OUTCOME MEASURES
Maternal adherence to micronutrient supplementation (high and low) were the outcomes. They were determined by the start time and duration of use according to Chinese guidelines (for folic acid (FA) supplements) and WHO recommendations (for iron, calcium and multiple-micronutrient (MMN) supplements).
RESULTS
In total, 83.9% of women took at least one kind of micronutrient supplement before or during pregnancy. FA (67.6%) and calcium (57.5%) were the primarily used micronutrient supplements; few participants used MMN (14.0%) or iron (5.4%). Adherence to supplementation of all micronutrients was low (7.4% for FA, 0.6% for iron, 11.7% for calcium and 2.7% for MMN). Higher educational levels, higher income levels, urban residence and better antenatal care (including pregnancy consultation and a higher frequency of antenatal visits) were associated with high adherence to micronutrient supplementation.
CONCLUSION
Maternal micronutrient supplementation before and during pregnancy in Northwest China was way below standards recommended by the Chinese guidelines or WHO. Targeted health education and future nutritional guidelines are suggested to improve this situation, especially in pregnant women with disadvantaged sociodemographic conditions.
目的
报告中国西北地区孕妇妊娠前后微量营养素补充情况，并调查该地区孕妇（由于饮食中微量营养素摄入普遍不足）对微量营养素补充的依从率及其相关因素。
设计
大规模基于人群的横断面调查。
地点
陕西省 20 个县和 10 个区。
参与者
采用分层多阶段随机抽样方法抽取 30027 名妇女为样本。在排除了那些未提供妊娠前后营养补充明确信息的妇女后，共有 28678 名妇女进入最终分析。
主要观察指标
孕妇对微量营养素补充的依从率（高和低）。它们是根据中国指南（叶酸（FA）补充剂）和世卫组织建议（铁、钙和多种微量营养素（MMN）补充剂）确定的开始时间和使用持续时间来确定的。
结果
共有 83.9%的妇女在妊娠前后至少服用了一种微量营养素补充剂。FA（67.6%）和钙（57.5%）是主要使用的微量营养素补充剂；很少有参与者使用 MMN（14.0%）或铁（5.4%）。所有微量营养素补充的依从率均较低（FA 为 7.4%，铁为 0.6%，钙为 11.7%，MMN 为 2.7%）。较高的教育水平、较高的收入水平、城市居住和较好的产前保健（包括妊娠咨询和较高的产前检查频率）与对微量营养素补充的高度依从性相关。
结论
中国西北地区孕妇妊娠前后微量营养素补充远低于中国指南或世卫组织建议的标准。建议开展有针对性的健康教育和未来的营养指南，以改善这种情况，特别是在社会经济地位不利的孕妇中。
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