Inlfuencing Factors Of Maternal Micronutrient Supplementation And The Effects On The Pregnant Outcomes: The C-ABC Study

Objective This study aims to describe the present situation of maternal micronutrientsupplementation, analyze the influence factors, and examine the association betweenmaternal micronutrient supplementation and intrauterine growth of fetus, premature,small for gestational age, low birth weight.Methods Maternal and Child Health Centers in Hefei, Maanshan, Wuhu were chosenand pregnant women who firstly received prenatal care at these centers were selected asthe study participants from Oct2008to Oct2010. All participants were asked tocomplete the self-administered questionnaires to collect such data as demographiccharacteristics, history of prior pregnancy and disease, intention of this pregnancy,mental health status of in the first trimester and frequency of supplying multivitamins,mul-microelement, calcium, iron, folic acid. Follow up delivery records which includefetal gender and gestational weeks, weight, height, circumference of head,circumference of chest of neonates. The Chi-square tests were used to compared thedistribution difference of micronutrients supplement among different groups ofdemography variable. Linear regression analysis was used to examine the associationbetween maternal micronutrients supplement and indicator of intrauterine growth. Thelogistic regression analysis was adopted to explore the possible influence factors ofmaternal micronutrients supplement and the effect of maternal micronutrients supplement on premature, small for gestational age and low birth weight.Results A total of13121pregnant women participated in the study, and10269pregnant women delivered single live birth. The number of pregnant women nevertaking multivitamin, mul-microelement, calcium, iron, folic acid in first trimester was8973(87.4%)、9334(90.9%)、9079(88.4%),9805(95.5%)、3012(29.3%), the number ofnever supplying folic acid before pregnancy was6716(65.4%). The number of pregnantwomen supplying multivitamin, mul-microelement, calcium, iron, folic acid in firsttrimester for more than a month was660(6.4%),520(5.1%),384(3.7%),208(2.0%),5358(52.2%). The number of supplying folic acid half a year prior to conception formore than a month was2021(19.7%). The logistic regression showed that the older age,higher education degree of pregnant women or their husbands and higher familyincomes were promotive factors of maternal micronutrient supplementation. Aftercontrolling the confounding factors including maternal age, education, BMI, experienceof miscarriage and induced abortion, family income and gender of fetal, linearregression analysis showed that taking multivitamin(B:60.86,95CI%:28.39-93.33),multi-microelement(B:61.98,95CI%:25.52-98.44) and folic acid(B:23.39,95CI%:4.04-42.74) in first trimester can increase the birth weight, and taking multivitamin(B:0.19,95CI%:0.04-0.34), multi-microelement(B:0.24,95CI%:0.08-0.41) in the firsttrimester can increase the circumference of chest significantly. After controlling theconfounding factors multifactor, logistic regression analysis showed that takingmulti-microelement(OR:0.26,95CI%:0.10-0.70) and folic acid(OR:0.75,95CI%:0.56-1.00) continually in first trimester can reduce the risks of small for gestational age.Conclusion Age, education degree, family income and pregnancy intention areinfluence factors of maternal micronutrient supplementation. Micronutrientsupplementation of pregnant women may promote intrauterine growth of fetus.