Adherence to Iron and Folic Acid Supplementation (IFAS) intake among pregnant women: A systematic review meta-analysis. (January 2022)

• Record Type: Journal Article
• Authors: Saragih, Ita Daryanti; Dimog, Eva Felipe; Saragih, Ice Septriani; Lin, Chia-Ju
• Is Part Of: Midwifery. Volume 104(2022)
• Publication Date: 2022-01
• Subjects: Adherence -- Anaemia -- Iron and folic acid supplementation -- IFAS -- Pregnant women; Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2021.103185
• Languages: English
• ISSNs: 0266-6138

Abstract

Highlights: Pregnant women are at a high risk of anaemia. First pregnancy, anaemia, and adequate iron and folic acid supplementation (IFAS) knowledge contributed to IFAS adherence. Iron and folic acid deficiency anaemia can be prevented by delivering and implementing strategies to improve the adherence of IFAS Enhanced health education is necessary to promote the IFAS uptake. Abstract: Objective: Adherence to iron and folic acid supplementation represents a significant factor contributing to the prevention and treatment of anaemia in pregnancy. However, limited studies have systematically investigated iron and folic acid supplementation adherence among pregnant mothers using a global perspective. We aimed to systematically identify iron and folic acid supplementation adherence and associated factors among pregnant women. Design: For this systematic review and meta-analysis, we did a systematic search of Academic Search Complete, CINAHL, MEDLINE, PubMed, and Web of Science from inception to October 20, 2020. We included all cohort, case–control, and cross-sectional studies and used the Joanna Briggs Institute tool to assess study quality. A meta-analysis was performed to synthesise the pooled odds ratio for iron and folic acid supplementation adherence using a random-effects model. Heterogeneity was measured using the I 2 statistic, and Egger's test was used to assess publication bias. Measurements and findings: Eighteen studies were included in systematic review and meta-analysis, including a total of 5, 537 pregnant women. The pooled odds ratio for iron and folic acid supplementation adherence in primipara vs multipara, anaemia vs non-anaemia, knowledgeable vs limited knowledge of anaemia, and knowledgeable vs limited knowledge of iron and folic acid supplementation were 3.91 (95% confidence interval: 1.75–8.75), 1.09 (95% confidence interval: 0.67–1.77), 0.32 (95% confidence interval: 0.15–0.69), and 2.48 (95% confidence interval: 1.13–5.47), respectively. Key conclusions: This review yielded evidence that having one pregnancy, having anaemia, and having satisfactory knowledge of both anaemia and iron and folic acid supplementation were positively associated with iron and folic acid supplementation adherence.