Assessment of nutritional status, use of nutritional supplements and their adherence during pregnancy

Abstract

Objective: The objective of the present study was to assess the nutritional status during pregnancy, survey the prescribed nutritional supplements, and monitor the adherence to prescribed nutritional supplements & to assess the attitude/experience of subjects towards supplement use. Methods: This was a prospective study. A data collection form was used to collect demographic data, Biochemical, clinical, obstetrics, nutritional supplements and dietary data. The adherence to the supplements by using 24-h recall method was noted, and the attitude towards supplement use was assessed. Results: The study was conducted over a period of six months in a tertiary care hospital in Pimpri- Chinchwad which comprised of 193 subjects. There was not much difference in the mean age of the pregnant women attending antenatal care at the hospital, which figured up to 29.93 years. The nutritional status of the study population was assessed and was classified on the basis of BMI and MUAC. BMI measurements revealed that out of 193 subjects studied, 5(2.5%) were underweight, 78(40%) had normal nutritional status, 75(38.8%) were overweight, and 35(18%) were obese. MUAC measurements show 19(9.8%) had moderate malnutrition (MUAC190-230mm), and 174(90.1%) had normal nutritional status (MUAC>230mm). FIGO analysis showed that an average of 47.33 out of 193 required assessment of nutritional status in detail. Out of the 193 subjects studied, combination therapy with Calcium & Vitamin D3 193(100%) was the most commonly prescribed nutritional supplement, followed by combination of Folic acid & iron 151(78.23%), and monotherapy with iron & folic acid respectively 42(21.7%) Adherence to the oral nutritional supplements was measured by a 24-h recall method, 11(6%) of the population reported skipping the prescribed supplements on the previous day. Out of 193 participants surveyed, 67(34.7%) reported they tend to skip the nutritional supplements sometimes. Reported barriers to adherence were forgetfulness (55%), followed by metallic taste (26%), fear of ADRs (9%), gastric ADRs (5%), and inconvenience in taking them along with other medications (5%). Conclusion: The findings of our study reveal that many pregnant women continue to have compromised nutritional status, despite the fact that there exist recommendations and ways for treating under nutrition, lack of sufficient dietary intake of the nutrients, weight management during pregnancy for avoiding post-pregnancy complications.