Oiye Shadrack, Juma Margaret, Konyole Silvenus, Adan Fatuma
Intergovernmental Authority on Development (IGAD), Djibouti.
University of Nairobi Institute of Tropical and Infectious Diseases (UNITID), Nairobi, Kenya.
J Pregnancy. 2020 May 11;2020:9621831. doi: 10.1155/2020/9621831. eCollection 2020.
Undesirable effects of a daily regimen of iron and folic acid ingested jointly (iron-folate) are potential disincentives to optimal antenatal supplementation. We intended to profile antenatal iron-folate side effects and elucidate their influence on supplementation duration in low-resource rural Kenya.
This was a cross-sectional descriptive study of randomly selected postnatal mothers of under-five-year-old children. Using a modified WHO Safe Motherhood Assessment standard questionnaire, they recalled the total number of days of antenatal iron-folate intake and the attendant supplement-attributed undesirable experiences. The analyses considered only participants who ingested the supplements in their immediate last pregnancies ( = 277).
About half of the study participants reported at least a side effect and a mean of 2.4 (SD 1.5) effects per person in the entire pregnancy period. Most common reported effects were chest pains (31.8%), constipation (28.5%), severe stomach pains (11.6%), and diarrhoea (11.6%). Mothers who reported at least a side effect ingested the supplements for ten days less compared to those who did not experience any effect ( = 0.03); and a greater proportion of the former were primigravida ( = 0.02) and used combined form of iron and folic acid ( = 0.003). In a multivariate analysis, significant correlations with supplementation compliance (ingestion for 90+ days) were found only for nausea and severe stomach pain experiences ( = -0.1, = 0.04; = 0.2, = 0.01, resp.).
The commonness of undesirable experiences attributed to daily ingestion of 60 mg iron and 0.4 mg folic acid and their deterrence to longer supplementation durations suggest the need for considering a weekly intermittent regimen for some antenatal women in such set-ups. Our study demonstrated that potentially, more counselling on nausea as a side effect might be critical in advancing iron-folate supplementation compliance.
每日联合摄入铁和叶酸（铁 - 叶酸）的不良影响可能会阻碍最佳产前补充。我们旨在剖析产前铁 - 叶酸的副作用，并阐明其对肯尼亚资源匮乏农村地区补充持续时间的影响。
这是一项对随机选取的五岁以下儿童产后母亲进行的横断面描述性研究。她们使用经过修改的世界卫生组织安全孕产评估标准问卷，回忆产前摄入铁 - 叶酸的总天数以及伴随补充剂出现的不良经历。分析仅纳入在最近一次怀孕时摄入过补充剂的参与者（= 277）。
约一半的研究参与者报告至少出现一种副作用，整个孕期每人平均出现2.4（标准差1.5）种副作用。报告的最常见副作用是胸痛（31.8%）、便秘（28.5%）、严重胃痛（11.6%）和腹泻（11.6%）。报告至少出现一种副作用的母亲与未出现任何副作用的母亲相比，补充剂摄入天数少十天（= 0.03）；前者中初产妇的比例更高（= 0.02），且使用铁和叶酸的联合剂型（= 0.003）。在多变量分析中，仅发现恶心和严重胃痛经历与补充依从性（摄入90天以上）存在显著相关性（分别为= -0.1，= 0.04；= 0.2，= 0.01）。
每日摄入60毫克铁和0.4毫克叶酸所导致的不良经历很常见，且会阻碍更长时间的补充，这表明在此类环境中，需要考虑为一些产前女性采用每周间歇性方案。我们的研究表明，对于恶心作为副作用进行更多的咨询可能对提高铁 - 叶酸补充依从性至关重要。
