Association between periconceptional supplementation of folic acid or multiple-micronutrients containing folic acid and preterm delivery in women / 北京大学学报(医学版)

OBJECTIVE@#To explore the association between periconceptional supplementation of folic acid or multiple-micronutrients containing folic acid(MMFA) and risk of preterm delivery in women with natural conception, singleton pregnancy and vaginal delivery.@*METHODS@#A retrospective cohort study was performed based on the prenatal health care system and hospital information system of Tongzhou Maternal and Child Health Hospital of Beijing and the women who had their prenatal care in the hospital from January 2015 to December 2018 were included. The information of 16 332 women who conceived naturally, had a singleton pregnancy, and delivered vaginally was collected. Compliance scores were constructed based on the time of initiation and the frequency of taking nutritional supplements. The association between maternal periconceptional micronutrient supplementation, including pure folic acid (FA) pills or MMFA and the rate of preterm delivery was evaluated using Logistic regression models.@*RESULTS@#The preterm delivery rate (gestational week < 37 weeks) of the study population was 3.8%, and the mean (standard deviation) of gestational age was (38.98±1.37) weeks. A total of 6 174 (37.8%) women took FA during the periconceptional period, 8 646 (52.9%) women took MMFA, and 1 512 (9.3%) women did not take any nutritional supplements. The association between periconceptional supplementation of FA or MMFA and risk of preterm delivery in women was not statistically significant [adjusted odds ratio (aOR)=1.01, 95%CI: 0.74-1.37]. The associations with preterm birth were not statistically significant in further analysis by the type of nutritional supplements, time of initiation, and the frequency of supplementation. In addition, the association between the compliance score of taking supplements and the rate of preterm delivery was not statistically significant, either.@*CONCLUSION@#This study did not find an association between the risk of preterm delivery and the use of FA or MMFA during the periconcep-tional period in women with natural conception, singleton pregnancy, and vaginal delivery. In the future, multicenter studies with large-scale prospective cohort or population-based randomized controlled trials are warranted to confirm the association between taking FA or MMFA during the periconceptional period and preterm delivery among women.

Knowledge and Use of Complementary Food Fortification with Multiple Micronutrient Powders in Selected Communities in the Philippines

Introduction: Micronutrient malnutrition among young Filipino children is attributed to inadequate food intake and improper feeding practices. To improve nutrient intake, home fortification using multiple micronutrient powders (MNPs) targeting 6 -23 monthold children became an intervention program referred to as Point of Use Complementary Food Fortification with Multiple Micronutrient Powders in Zamboanga City and the Municipality of Aurora in Region IX, Philippines. This study aimed to determine the extent of knowledge and use of complementary food with MNPs in the context of the said intervention program and implementation areas. Methods: A cross-sectional survey was conducted among 120 randomly selected primary caregivers with 6 -23-month-old children in the covered program areas. A questionnaire designed to elicit knowledge and use of MNPs was developed and pre-tested before data collection. Results: Results showed that all respondents were aware of MNPs, with local health workers as the information source. Percentage of respondents with knowledge of the purpose of MNPs varied widely. Among those who did, the most well-known function was improving children’s health status. The most common practice of fortifying food with MNP involved adding it to boiled rice and vegetable dishes. Home fortification is popularly practised after cooking the food. Of the 20% respondents who claimed to observe changes in their children due to MNP, the top two positive results were children’s increased appetite and increased growth. Conclusion: Awareness of the MNP does not necessarily translate into knowledge of what the MNP is made up of or its purpose. Although home food fortification using MNP was practised by most households, this study revealed deviations from recommendations on how to properly fortify their foods using the MNPs. Based on the findings in this study, there is a need to complement awareness of the primary caregivers with knowledge on MNPs through counselling and initiating support groups among caregivers to serve as credible and first hand examples of the proper use of MNPs.