Islam Md Jahirul, Zobair Khondker Mohammad
Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia.
Ministry of Public Administration, Bangladesh Secretariat, Dhaka, Bangladesh.
PLOS Glob Public Health. 2024 Mar 4;4(3):e0002993. doi: 10.1371/journal.pgph.0002993. eCollection 2024.
Despite the established benefits of vitamins and minerals for maternal and neonatal health, global micronutrient deficiency remains a significant concern. As such, the World Health Organization advocates timely antenatal care (ANC) initiation and micronutrient supplementation for expectant mothers. This study investigates the association between ANC timing and frequency and maternal health behaviours, specifically iron-folic acid (IFA) intake, early breastfeeding initiation, and exclusive breastfeeding among married women in South Asia. By utilizing recent Demographic and Health Survey data, this study focuses on married women aged 15-49 in Bangladesh (N = 966), India (N = 89,472), and Pakistan (N = 1,005), specifically primiparous women with children aged 0-23 months living with the motherMultivariable analysis revealed that women receiving ≥4 ANC visits were more likely to consume IFA ≥90 days compared to those with fewer visits in Bangladesh (AOR: 1.85, 95% CI [1.30, 2.63]), India (AOR: 1.87, 95% CI [1.81, 1.94]), and Pakistan (AOR: 1.92, 95% CI [1.24, 2.97]). Women receiving first ANC in the second or third trimester were less likely to consume IFC for ≥90 days compared to those with first-trimester ANC. While the ANC timing did not significantly influence early breastfeeding initiation, ANC frequency was inversely associated with delayed initiation in all countries. Breastfeeding advice during ANC visits was significantly associated with reduced odds of delayed breastfeeding initiation. Neither ANC timing nor frequency significantly predicted exclusive breastfeeding, except for breastfeeding advice in India. This study highlights the importance of ANC in maternal and child health outcomes. ANC timing and frequency, along with breastfeeding advice during ANC, notably influence maternal IFA consumption and early breastfeeding initiation. These findings underscore the need for targeted interventions during ANC visits to enhance maternal and child health practices in low- and middle-income countries.
尽管维生素和矿物质对孕产妇和新生儿健康有既定的益处，但全球微量营养素缺乏仍然是一个重大问题。因此，世界卫生组织提倡为孕妇及时提供产前护理（ANC）并补充微量营养素。本研究调查了南亚已婚妇女的ANC时间和次数与孕产妇健康行为之间的关联，特别是铁叶酸（IFA）摄入量、早期开始母乳喂养以及纯母乳喂养情况。通过利用近期的人口与健康调查数据，本研究聚焦于孟加拉国（N = 966）、印度（N = 89,472）和巴基斯坦（N = 1,005）年龄在15 - 49岁的已婚妇女，特别是有0 - 23个月大孩子且与母亲同住的初产妇。多变量分析显示，与就诊次数较少的妇女相比，在孟加拉国（调整后比值比：1.85，95%置信区间[1.30, 2.63]）、印度（调整后比值比：1.87，95%置信区间[1.81, 1.94]）和巴基斯坦（调整后比值比：1.92，95%置信区间[1.24, 2.97]）接受≥4次ANC就诊的妇女更有可能摄入IFA≥90天。与在孕早期接受首次ANC的妇女相比，在孕中期或孕晚期接受首次ANC的妇女摄入IFC≥90天的可能性较小。虽然ANC时间对早期开始母乳喂养没有显著影响，但在所有国家，ANC次数与延迟开始母乳喂养呈负相关。ANC就诊期间的母乳喂养建议与延迟开始母乳喂养几率的降低显著相关。除了印度的母乳喂养建议外，ANC时间和次数均未显著预测纯母乳喂养情况。本研究强调ANC在孕产妇和儿童健康结局中的重要性。ANC时间和次数，以及ANC期间的母乳喂养建议，显著影响孕产妇的IFA摄入量和早期开始母乳喂养情况。这些发现强调了在ANC就诊期间进行有针对性干预以改善低收入和中等收入国家孕产妇和儿童健康实践的必要性。
