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Nutrients 2018, 10(9), 1275;

Compliance to Prenatal Iron and Folic Acid Supplement Use in Relation to Low Birth Weight in Lilongwe, Malawi

Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, NY 13244, USA
Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea
Current address: Department of Human Nutrition and Health, Lilongwe University of Agriculture & Natural Resources (LUANAR), P.O. Box 219 Lilongwe, Malawi.
S.S. was a post-doctoral fellow in the research team at the time when the research was carried out.
Author to whom correspondence should be addressed.
Received: 5 July 2018 / Revised: 23 August 2018 / Accepted: 6 September 2018 / Published: 10 September 2018
(This article belongs to the Special Issue Micronutrients Intake and Status during Pregnancy and Lactation)
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Prenatal iron and folic acid (IFA) supplements are offered free to all pregnant women in Malawi to reduce maternal anemia and improve birth outcomes. We investigated the association between self-reported compliance to IFA intake and risk of low birth weight (LBW). Pregnant women who attended Bwaila Maternity Wing of Lilongwe District Hospital for delivery were recruited (n = 220). We used a questionnaire to collect self-reported information on IFA use and maternal sociodemographic data. Before delivery, blood samples for maternal hemoglobin (Hb) and folate status, and upon delivery, birth weight, and other newborn anthropometrics were measured. We used multivariable logistic regression to determine risk of LBW by prenatal IFA intake. The self-reported number of IFA pills taken during pregnancy was positively associated with Hb, but not serum and RBC folate concentration: <45, 45–89 and ≥90 pills taken corresponded with mean (SD) Hb 10.7 (1.6), 11.3 (1.8), and 11.7 (1.6) g/dL, respectively (p = 0.006). The prevalence of LBW was 20.1%, 13.5% and 5.6% for those who reported taking IFA pills <45, 45–89, and ≥90 pills, respectively (p = 0.027). Taking >60 IFA pills reduced risk of LBW delivery (OR (95% CI) = 0.15 (0.03–0.70), p = 0.033) than taking ≤30 pills. Self-reported compliance to IFA use is valid for assessing prenatal supplement program in Malawi, especially Hb status, and can reduce the rate of LBW. View Full-Text
Keywords: prenatal iron and folic acid (IFA) supplements; low birth weight; maternal anemia; Malawi prenatal iron and folic acid (IFA) supplements; low birth weight; maternal anemia; Malawi

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Chikakuda, A.T.; Shin, D.; Comstock, S.S.; Song, S.; Song, W.O. Compliance to Prenatal Iron and Folic Acid Supplement Use in Relation to Low Birth Weight in Lilongwe, Malawi. Nutrients 2018, 10, 1275.

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