Institute for Global Nutrition, University of California Davis, 3253 Meyer Hall, One Shields Avenue, Davis, CA 95616, USA.
Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic.
J Nutr Sci. 2022 Oct 28;11:e95. doi: 10.1017/jns.2022.94. eCollection 2022.
Access to and utilisation of antenatal care (ANC) is important for optimising health and nutrition during pregnancy. This study aimed to assess adherence to and factors associated with ANC and antenatal supplement use among Laotian women, and consider culturally appropriate strategies to increase micronutrient intakes. Mother-child (aged 21 d to <18 months) dyads ( 699) enrolled in a hospital-based prospective cohort study with the community comparison group in Luang Prabang province were interviewed about their antenatal history, supplement use, household sociodemographic and dietary practices, including postpartum food avoidances. Ninety percent of women (mean age 24⋅7 ± 6⋅3 years) reported receiving ANC during their pregnancy, with the majority reporting four to seven contacts, while 84⋅6 and 17⋅3 % reported supplement use during pregnancy and lactation, respectively. Adequate ANC contacts (≥8) and supplement use was more likely among women with complete primary education and from higher socioeconomic status households, and less likely among women belonging to ethnic minority populations and those who delivered their child at home. All women continued to consume salt while adhering to postpartum food avoidances; however, 58⋅5 and 38⋅7 % of habitual consumers restricted fish and soy sauces, respectively. Eighty-six percent of women reported they would be willing to take supplements when adhering to postpartum dietary restrictions. Overall, women's reported ANC attendance and antenatal supplement use was suboptimal. Understanding predictors of and barriers to ANC and supplement use may help implement effective public health strategies to improve adherence. Alongside targeted supplementation, salt fortification with micronutrients may be a viable population-wide intervention that needs further evaluation.
获得和利用产前护理(ANC)对于优化孕期健康和营养非常重要。本研究旨在评估老挝妇女对 ANC 和产前补充剂使用的依从性和相关因素,并考虑增加微量营养素摄入量的文化适宜策略。在老挝琅勃拉邦省,对 699 对母婴(年龄 21 天至<18 个月)进行了一项基于医院的前瞻性队列研究和社区对照组的访谈,内容包括其产前史、补充剂使用、家庭社会经济和饮食实践,包括产后食物禁忌。90%的女性(平均年龄 24.7±6.3 岁)报告在怀孕期间接受过 ANC,大多数报告接受了 4 至 7 次产前检查,而 84.6%和 17.3%的女性分别报告在怀孕期间和哺乳期使用了补充剂。完全接受过小学教育和来自较高社会经济地位家庭的女性更有可能接受足够的 ANC 检查和补充剂使用,而少数民族和在家分娩的女性则不太可能这样做。所有女性在遵守产后食物禁忌的同时仍继续食用盐;然而,58.5%和 38.7%的习惯性食用者分别限制食用鱼和酱油。86%的女性报告说,在遵守产后饮食限制的情况下,她们愿意服用补充剂。总体而言,女性报告的 ANC 出勤率和产前补充剂使用率并不理想。了解 ANC 和补充剂使用的预测因素和障碍可能有助于实施有效的公共卫生策略来提高依从性。除了有针对性的补充剂之外,用微量营养素强化盐可能是一种可行的人群干预措施,需要进一步评估。