Analysis on the status of iron supplements during pregnancy and its influencing factors among pregnant women and puerperas in six provinces (autonomous regions) of China
LIU Lijun, YANG Qi, ZHANG Yingkui, LIU Zhiyu, WU Yuntao, ABuDouKeLiMu·YIBULAYIN, MENG Qingyou, WAN Ying, DI Jiangli
National Center for Women and Children′s Health ,China CDC. Beijing 100081,China
Abstract：Objective To understand and analyze the status of iron supplements during pregnancy and its influencing factors among pregnant women and puerperas in six provinces (autonomous regions) of China.Methods From October 2019 to February 2020, 1714 pregnant women and puerperas were recruited in 6 provinces(autonomous regions) of the surveillance areas by convenient sampling, the information about the demographic characteristics and iron supplements during pregnancy among the pregnant women and puerperas were collected with questionnaire. Logistic regression analysis was used to analyze the influencing factors of iron supplements.Results Among the pregnant women and puerperas, the proportion of never took iron supplements during pregnancy, occasionally, and continuously was 61.9%、23.6% and 14.4% respectively. The main reason for never taking iron supplements during pregnancy was that think unnecessary (53.4%), not be told by doctor (19.2%), always forget (9.6%). The results of multivariate logistic regression showed that the iron supplements rate of women in the eastern and western regions was significantly higher than that in the central regions, which was 1.50 times(OR=1.50,95%CI:1.06-2.11) and 1.52 times(OR=1.52,95%CI:1.07-2.16) higher than that in the central regions, respectively. The iron supplements rate of women in the north area was 1.54 times(OR=1.54,95%CI:1.18-2.03) higher than that in the south area. The iron supplements rate of women in second trimester, women in third trimester and women in puerpera was 1.58 times(OR=1.58,95%CI:1.02-2.44), 2.56 times (OR=2.56,95%CI:1.66-3.97)and 3.52 times(OR=3.52,95%CI:2.27-5.46) higher than that women in first trimester, respectively. The iron supplements rate of women who had ferritin examination during pregnancy was 1.36 times (OR=1.36,95%CI:1.02-1.83) higher than that without ferritin examination. The iron supplements rate of women with anemia and iron deficiency was 1.71 times (OR=1.71,95%CI:1.16-2.52) and 2.91 times(OR=2.91,95%CI:1.91-4.42) higher than that of women without anemia and iron deficiency, respectively.Conclusion The iron supplement rate during pregnancy among pregnant women and puerperas in the surveillance area is low. There are significant differences of iron supplements during pregnancy in different regions, areas and women. Health education should be carried out to promote reasonable supplement of iron during pregnancy
刘利君, 杨琦, 张英奎, 刘智昱, 吴云涛, 阿不都克里木·依不拉音, 孟庆有, 万英, 狄江丽. 中国六省(自治区)孕产妇孕期铁剂补充状况及其影响因素分析[J]. 中国生育健康杂志, 2021, 32(5): 401-406.
LIU Lijun, YANG Qi, ZHANG Yingkui, LIU Zhiyu, WU Yuntao, ABuDouKeLiMu·YIBULAYIN, MENG Qingyou, WAN Ying, DI Jiangli. Analysis on the status of iron supplements during pregnancy and its influencing factors among pregnant women and puerperas in six provinces (autonomous regions) of China. Chinese Journal of Reproductive Health, 2021, 32(5): 401-406.
1 Stevens GA,Finucane MM,De-Regil LM,et al.Global,regional,and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011:a systematic analysis of population-representative data.Lancet Glob Health,2013a,1:e16-25. 2 Daru J,Zamora J,Fernández-Félix BM,et al.Risk of maternal mortality in women with severe anaemia during pregnancy and post partum:a multilevel analysis.Lancet Glob Health,2018,6:e548-e554. 3 WHO.Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity.Vitamin and Mineral Nutrition Information System.Geneva,World Health Organization,2011 (WHO/NMH/NHD/MNM/11.1) (http://www.who.int/vmnis/indicators/haemoglobin.pdf,accessed 27 Jan.2021). 4 Sanchez-Gonzalez LR,Castro-Melendez SE,Angeles-Torres AC et al.Efficacy and safety of adjuvant recombinant human erythropoietin and ferrous sulfate as treatment for iron deficiency anemia during the third trimester of pregnancy .Eur J Obstet Gynecol Reprod Biol,2016,205:32-6. 5 Pavord S,Daru J,Prasannan N,et al.UK guidelines on the management of iron deficiency in pregnancy.Br J Haematol,2020,188:819-830. 6 WHO recommendations on antenatal care for a positive pregnancy experience.Geneva:World Health Organization; 2016 (http://apps.who.int/iris/bitstream/10665/250796/1/9789241549912-eng.pdf,accessed 27 Jan.2021). 7 Hu HQ,Huang AQ,Yang Q,et al.Prevalence and Risk Factors of Anemia of Pregnant Women- 6 Provinces in China,2014-2018,China CDC Weekly,2020.4.3 No.14. 8 健康中国行动推进委员会,健康中国行动(2019—2030年),http:// www.gov.cn/xinwen/2019-07/15/content_5409694.htm.2019. 9 赵思宇,景文展,刘珏等.中国妇女2012-2016年妊娠期贫血患病状况的Meta分析.中华预防医学杂志,2018;52:951-957. 10 赖建强,荫士安,马冠生,等.孕期妇女营养与健康状况调查.营养学报,2007,29:4-8. 11 王杰,赵丽云,朴建华,等.2009年中国8省 (市) 孕妇营养与健康状况结果分析.卫生研究,2011,40:201-203. 12 胡漫丽,秦蕊,林小芳,等.中国4 城市部分妇女孕期与哺乳期营养补充剂使用状况分析.中国妇幼保健,2019,34:3769-3772. 13 石英杰,陈云利,湛永乐,等.中国不同孕期妇女营养素补充剂的使用情况和地区差异性分析.中国慢性病预防与控制,2020,28:586-595. 14 中华医学会妇产科学分会产科学组,孕前和孕期保健指南(2018),中华围产医学杂志,2018 ,21:145-152. 15 Gebreamlak B,Dadi AF,Atnafu A.High adherence to Iron/folic acid supplementation during pregnancy time among antenatal and postnatal care attendant mothers in governmental health centers in Akaki Kality Sub City,Addis Ababa,Ethiopia:hierarchical negative binomial Poisson regression.PLoS One,2017,12:e0169415. 16 Kamau MW,Mirie W,Kimani S.Compliance with Iron and folic acid supplementation (IFAS) and associated factors among pregnant women:results from a cross-sectional study in Kiambu County,Kenya.BMC Public Health,2018,18:580. 17 胡漫丽,秦蕊,林小芳,等.中国4城市部分妇女孕期与哺乳期营养补充剂使用状况分析.中国妇幼保健,2019,16:3769-3772.
