Ajong Atem Bethel, Kenfack Bruno, Ali Innocent Mbulli, Yakum Martin Ndinakie, Ukaogo Prince Onydinma, Mangala Fulbert Nkwele, Aljerf Loai, Telefo Phelix Bruno
Department of Mother and Child care, Kekem District Hospital, Kekem, West Region, Cameroon.
Department of Biochemistry, University of Dschang, Dschang, West Region, Cameroon.
PLoS One. 2023 Oct 5;18(10):e0292303. doi: 10.1371/journal.pone.0292303. eCollection 2023.
Despite the evidence that calcium supplementation in pregnancy improves maternofoetal outcomes, many women still do not take calcium supplements during pregnancy in Cameroon. This study identifies factors that influence calcium supplementation during pregnancy in a low resource setting.
We conducted a cross-sectional hospital-based study (from November 2020 to September 2021) targeting 1074 healthy women in late pregnancy at the maternities of four major health facilities in the Nkongsamba Health District, Cameroon. Data were collected using an interview-administered semi-structured questionnaire and analysed using Epi Info version 7.2.4.0, and the statistical threshold for significance set at p-value = 0.05.
The mean age of the participants was 28.20±6.08 years, with a range of 15-47 years. The proportion of women who reported taking any calcium supplements in pregnancy was 72.62 [69.85-75.22]%. Only 12% of calcium-supplemented women took calcium supplements throughout pregnancy, while a majority (50%) took calcium supplements just for 4-5 months. Women believe that taking calcium supplements is more for foetal growth and development (37.12%) and prevention of cramps (38.86%), than for the prevention of hypertensive diseases in pregnancy (2.84%). About all pregnant women (97.65%) took iron and folic acid supplements during pregnancy, and 99.24% took these supplements at least once every two days. Upon control for multiple confounders, the onset of antenatal care before 4 months of pregnancy (AOR = 2.64 [1.84-3.78], p-value = 0.000), having had more than 3 antenatal care visits (AOR = 6.01 [3.84-9.34], p-value = 0.000) and support/reminder from a partner on the necessity to take supplements in pregnancy (AOR = 2.00 [1.34-2.99], p-value = 0.001) were significantly associated with higher odds of taking any calcium supplements in pregnancy.
Calcium supplementation practices in pregnancy remain poor in this population and far from WHO recommendations. Early initiation of antenatal care, a high number of antenatal visits and reminders or support from the partner on supplement intake significantly increase the odds of taking any calcium supplements in pregnancy. In line with WHO recommendations, women of childbearing age should be sensitised to initiate antenatal care earlier and attain as many visits as possible. Male involvement in prenatal care might also boost the likelihood of these women taking calcium supplements.
尽管有证据表明孕期补钙可改善母婴结局，但喀麦隆仍有许多女性在孕期不服用钙剂。本研究旨在确定在资源匮乏地区影响孕期补钙的因素。
我们开展了一项基于医院的横断面研究（2020年11月至2021年9月），目标人群为喀麦隆恩孔桑巴卫生区四个主要医疗机构产科的1074名妊娠晚期健康女性。通过访谈式半结构化问卷收集数据，并使用Epi Info 7.2.4.0进行分析，设定统计学显著性阈值为p值=0.05。
参与者的平均年龄为28.20±6.08岁，年龄范围为15 - 47岁。报告在孕期服用过任何钙剂的女性比例为72.62[69.85 - 75.22]%。在服用钙剂的女性中，只有12%在整个孕期都服用钙剂，而大多数（50%）仅服用4 - 5个月。女性认为服用钙剂更多是为了胎儿生长发育（37.12%）和预防抽筋（38.86%），而非预防孕期高血压疾病（2.84%）。几乎所有孕妇（97.65%）在孕期都服用铁剂和叶酸补充剂，99.24%至少每两天服用一次。在控制多个混杂因素后，妊娠4个月前开始产前检查（调整比值比[AOR]=2.64[1.84 - 3.78]，p值=0.000）、产前检查次数超过3次（AOR = 6.01[3.84 - 9.34]，p值=0.000）以及伴侣对孕期补充剂必要性的支持/提醒（AOR = 2.00[1.34 - 2.99]，p值=0.001）与孕期服用任何钙剂的较高几率显著相关。
该人群孕期补钙情况仍然较差，远未达到世界卫生组织的建议。早期开始产前检查、多次产前检查以及伴侣对补充剂摄入的提醒或支持可显著增加孕期服用任何钙剂的几率。根据世界卫生组织的建议，应提高育龄女性对早期开始产前检查并尽可能增加检查次数的认识。男性参与产前护理也可能提高这些女性服用钙剂的可能性。
