Dietary supplementation usage by pregnant women in Silesia — population based study
Abstract
Objectives: Despite wide access to gynecological and obstetric advice, informational campaigns, and information online and in magazines aimed at pregnant women, there is a worryingly high percentage of women who still do not use recommended dietary supplementation. The aim of this study was to assess the frequency of micronutrient supplementation by pregnant women and to specify the determinants that impact decisions concerning supplementation.
Material and methods: A cross-sectional survey was conducted between June 2016 and May 2017 among a group of pregnant women visiting gynecological and obstetric clinics in the Silesia region, who have completed an authorized questionnaire developed for the purpose of this study. The questionnaire addressed the women’s dietary habits, micronutrient supplementation use, as well as their socio-economic status. Completed questionnaires were obtained from 505 pregnant women.
Results: Microminerals and vitamins supplementation during pregnancy was declared by 410 (81.2%) women. The most often used supplement was folic acid (62%). More than one-third of pregnant women (38.4%) declared vitamin D intake. Among the recommended supplements, the least commonly used (30.3%) were polyunsaturated fatty acids (PUFA). Factors contributing to supplementation use during pregnancy are past history of miscarriage and socioeconomic factors, such as: place of residence, financial situation and level of education. Inhabitants of larger cities, women with better self-perceived financial situations, higher education levels and those presenting past history of miscarriage took the supplements significantly more often.
Conclusions: Lower levels of education, low-income financial status and living in rural localities are among the factors correlating with worse adherence to supplementation guidelines.
Keywords: dietary supplementssupplementationpregnancynourishment
References
- Zespół Ekspertów Polskiego Towarzystwa Ginekologicznego. Rekomendacje Polskiego Towarzystwa Ginekologicznego w zakresie stosowania witamin i mikroelementów u kobiet planujących ciążę, ciężarnych i karmiących. Ginekol. Pol. 2014; 85: 395-399, indexed in Pubmed. ; 24834713.
- Godala M, Pietrzak K, Łaszek M, et al. Health behaviours of pregnant residents of Łódź. Part I. Diet and vitamin-mineral supplementation. ProblHigEpidemiol. 2012; 93 (1): 38-42.
- Suliga E. Nutritional behaviours of pregnant women in rural and urban environments. Ann Agric Environ Med. 2015; 22(3): 513–517.
- Nisar YB, Dibley MJ, Mir AM. Factors associated with non-use of antenatal iron and folic acid supplements among Pakistani women: a cross sectional household survey. BMC Pregnancy Childbirth. 2014; 14: 305.
- Friberg AK, Jørgensen FS. Few Danish pregnant women follow guidelines on periconceptional use of folic acid. Dan Med J. 2015; 62(3).
- Popa AD, Niţă O, Graur Arhire LI, et al. Nutritional knowledge as a determinant of vitamin and mineral supplementation during pregnancy. BMC Public Health. 2013; 13: 1105.
- Köken GN, Derbent AU, Erol O, et al. Awareness and use of folic acid among reproductive age and pregnant women. J Turk Ger Gynecol Assoc. 2013; 14(2): 87–91.
- Baron R, Manniën J, te Velde SJ, et al. Socio-demographic inequalities across a range of health status indicators and health behaviours among pregnant women in prenatal primary care: a cross-sectional study. BMC Pregnancy Childbirth. 2015; 15: 261.
- Nelson CRM, Leon JA, Evans J. The relationship between awareness and supplementation: which Canadian women know about folic acid and how does that translate into use? Can J Public Health. 2014; 105(1): e40–e46.
- Kim MW, Ahn KiH, Ryu KJ, et al. Preventive effects of folic acid supplementation on adverse maternal and fetal outcomes. PLoS One. 2014; 9(5): e97273.
- Hodgetts VA, Morris RK, Francis A, et al. Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small-for-gestational age neonates: a population study, systematic review and meta-analysis. BJOG. 2015; 122(4): 478–490.
- Bibbins-Domingo K, Grossman DC, Curry SJ, et al. US Preventive Services Task Force. Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement. JAMA. 2017; 317(2): 183–189.
- De-Regil LM, Palacios C, Lombardo LK, et al. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2016(1): CD008873.
- Wolsk HM, Harshfield BJ, Laranjo N, et al. Vitamin D supplementation in pregnancy, prenatal 25(OH)D levels, race, and subsequent asthma or recurrent wheeze in offspring: Secondary analyses from the Vitamin D Antenatal Asthma Reduction Trial. J Allergy Clin Immunol. 2017; 140(5): 1423–1429.e5.
- Zimmermann MB. The effects of iodine deficiency in pregnancy and infancy. Paediatr Perinat Epidemiol. 2012; 26 Suppl 1: 108–117.
- Milman N, Paszkowski T, Cetin I, et al. Supplementation during pregnancy: beliefs and science. Gynecol Endocrinol. 2016; 32(7): 509–516.
- Breymann C. Iron Deficiency Anemia in Pregnancy. Semin Hematol. 2015; 52(4): 339–347.
- De Giuseppe R, Roggi C, Cena H. n-3 LC-PUFA supplementation: effects on infant and maternal outcomes. Eur J Nutr. 2014; 53(5): 1147–1154.
- Miles EA, Calder PC. Maternal diet and its influence on the development of allergic disease. Clin Exp Allergy. 2015; 45(1): 63–74.
- Skowrońska-Jóźwiak E, Adamczewski Z, Tyszkiewicz A, et al. Assessment of adequacy of vitamin D supplementation during pregnancy. Ann Agric Environ Med. 2014; 21(1): 198–200.
- Oliver EM, Grimshaw KEC, Schoemaker AA, et al. Dietary habits and supplement use in relation to national pregnancy recommendations: data from the EuroPrevall birth cohort. Matern Child Health J. 2014; 18(10): 2408–2425.
- Zygmunt A, Adamczewski Z, Zygmunt A, et al. An assessment of the effectiveness of iodine prophylaxis in pregnant women--analysis in one of reference gynaecological-obstetric centres in Poland. Endokrynol Pol. 2015; 66(5): 404–411.
- Milewicz T, Czyżewicz M, Stochmal E, et al. Intake of iodine-containing multivitamin preparations by pregnant women from the Krakow region of Poland. Endokrynol Pol. 2011; 62(4): 309–315.
- Wierzejska R, Jarosz M, Siuba M. Diets supplementation of pregnant women - recomendation and practice. Ginekol. Położ. 2012; 7: 70-78.
- Sobek G, Socha P, Pawelec S, et al. Assessment of knowledge of women about the need for the use of supplements during pregnancy. Stand Med Pediatr 2017; 14: 126-135 http://www standardy pl/artykuly/id. ; 1229.
- Libuda L, Stimming M, Mesch C, et al. Frequencies and demographic determinants of breastfeeding and DHA supplementation in a nationwide sample of mothers in Germany. Eur J Nutr. 2014; 53(6): 1335–1344.
- Branum AM, Bailey R, Singer BJ. Dietary supplement use and folate status during pregnancy in the United States. J Nutr. 2013; 143(4): 486–492.
- Pouchieu C, Lévy R, Faure C, et al. Socioeconomic, lifestyle and dietary factors associated with dietary supplement use during pregnancy. PLoS One. 2013; 8(8): e70733.
- Xing XY, Tao FB, Hao JH, et al. Periconceptional folic acid supplementation among women attending antenatal clinic in Anhui, China: data from a population-based cohort study. Midwifery. 2012; 28(3): 291–297.
- Fulford B, Macklon N, Boivin J. Mental models of pregnancy may explain low adherence to folic acid supplementation guidelines: a cross-sectional international survey. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014; 176: 99–103.
- Bojar I, Owoc A, Humeniuk E, et al. Inappropriate consumption of vitamins and minerals by pregnant women in Poland. Ann Agric Environ Med. 2012; 19(2): 263–266.