A Postpartum Survey of Vitamin Supplementation during Pregnancy in Ireland
M. O’Duill1, C. McArdle1, E.G. O’Malley1, C.M.E. Reynolds1, R.A.K. Kennedy1, M.J. Turner1
1. UCD Centre for Human Reproduction, Coombe Women and Infants, University Hospital, Cork St, Dublin 8, Ireland
The World Health Organization (WHO) strongly recommends that as part of standard antenatal care worldwide, women should take iron and Folic Acid (FA) supplementation throughout pregnancy to decrease low birth weight, maternal anaemia and iron deficiency.1 In a setting where the prevalence of anaemia amongst pregnant women is <20% or if iron is not tolerated well, this can be taken intermittently with a once week supplementation of 2.8mg FA (or as 400 micrograms per day) and 120mg of elemental iron.2 Previous studies of maternal supplementation, particularly FA consumption, usually focused on early pregnancy. Information is limited on intake as pregnancy advances. We present results of a postpartum survey conducted in the Coombe Women and Infants University Hospital in 2018 to examine vitamin supplementation after the first trimester.
A detailed questionnaire was completed by women recruited at their convenience in the postnatal wards after delivering a live healthy baby. This questionnaire focused on their use of FA, iron and other vitamin supplements in pregnancy. It included questions regarding timing of initiation, supplement brand and duration of use, and also knowledge regarding the function of these supplements. Of the 106 respondents, 50.9%(n=54) were first-time mothers, the mean age was 30.4 years (SD 5.8) and 78.3%(n=83) were Irish-born.
Preconceptual use of FA was reported by 44.3% (n=47) of women and the mean duration of FA use before becoming pregnant was 32.7 weeks (SD 45.7) in this group. Of the 54.7% (n=58) of women who did not take FA preconceptionally, the mean point of commencement of FA was 6.4 weeks (SD 4.0) after the last menstrual period. The most commonly selected reason for not taking FA preconceptionally was ‘I did not expect to get pregnant’ (68.6% (n=35)). The mean gestation for stopping FA was 29.2 weeks (SD 12.0) gestation. Regarding the source of advice on FA, 62.6% (n=66) were advised by their family doctor and 34.8% (n=33) selected ‘to prevent/reduce spina bifida’ as their reason for taking FA.
A total of 68 women were taking the multivitamin Pregnacare as their source of FA and they continued to a mean gestation of 32.8 weeks (SD 10.6). A further 3.7% (n=3) reported taking a different pregnancy branded multivitamin, 8.5% (n=7) were taking a vitamin D supplement and 4.9% (n=4) reported taking an omega-3 supplement. Of the 101 respondents, 59 (58.4%) women reported taking iron at some point during pregnancy. The mean gestation of starting iron tablets was 16.5 (SD 10.8) weeks and the mean number of weeks iron was taken for was 18.3 (SD 11.7) weeks. The most commonly used iron supplement was Galfer (61.0% (n=36)) and the main reason cited for taking iron was ‘anaemia/low iron’ (49%).
We found maternal consumption of iron and FA supplementation in this high-resource setting varied widely across all three trimesters. The use of vitamin supplementation in the second and third trimester was common but did not comply with WHO recommendations. The variations amongst individual women was wide. This highlights the need for standardisation of the advice that healthcare professionals give to women before and during pregnancy.
UCD Centre for Human Reproduction,
Coombe Women and Infants,
1. World Health Organization. Daily iron supplementation in adult women and adolescent girls [Internet]. World Health Organization; 2016. Available from:
http://www.who.int/elena/titles/guidance_summaries/daily_iron_pregnancy/en/Accessed 5th March 2019
2. World Health Organization. Intermittent iron and folic acid supplementation in non-anaemic pregnant women [Internet]. World Health Organization, 2012. Available from: http://apps.who.int/iris/bitstream/10665/75335/1/9789241502016_eng.pdf?ua=1&ua=1&ua=1 Accessed 5th March 2019