Abstract
BackgroundPregnancy is a high-risk period for vitamin D (Vit D) deficiency, and there is a direct relationship between Vit D deficiency during this period and maternal and fetal complications. Therefore, this study aimed to assess the knowledge, attitude, and practice of pregnant women concerning the adoption of behaviors to prevent Vit D deficiency and identify the determinant factors of such behaviors.MethodsIn this cross-sectional study, 185 pregnant women with a mean age of 27.52 ± 5.9 years were selected from the Health Centers in Tabriz, Iran, using the stratified random sampling between 2018 September 23 and 2019 June 21. Data were collected using a researcher-made questionnaires comprising demographic information, knowledge, attitude, and practice of pregnant women towards Vit D deficiency. The chi-square test and Fisher’s exact test were used to determine the relationship between the demographics of pregnant women and their knowledge and attitude. Moreover, the general linear model test was used to determine the predictors of performance. The p-value< 0.05 was considered to be significant in this study.ResultsThe findings showed that 85.6% of pregnant women were well aware of the importance and role of Vit D in pregnancy. In addition, 76.7 and 75% of the participants had good knowledge of getting enough Vit D from sunlight and preventing Vit D deficiency in pregnancy, respectively. Moreover, 91.7% of the pregnant women believed that Vit D has a vital role in maternal and fetal health, and 61.1% showed a high level of perceived self-efficiency in preventing Vit D deficiency. In addition, 67.2% of women regarded the unpleasant taste and price of Vit D rich foods, such as seafood, as barriers to get Vit D, and 91.7% mentioned the lack of public places specific to women and living in apartments as barriers to getting enough Vit D from sunlight. According to the results, 57.8 and 79.4% of pregnant women performed at a moderate level in getting Vit D from food and sunlight, respectively. In general, educational attainment (Pvalue = 0.02, B = 0.56), pregnancy age (Pvalue = 0.04, B = -0.26), parity (Pvalue = 0.03, B = -0.45), and perceived self-efficacy of mothers (Pvalue < 0.001, B = 0.340) were the determinant factors of getting Vit D from food and sunlight as behaviours to prevent Vit D deficiency in pregnancy.ConclusionThe findings of the current study revealed that despite the good knowledge of women about the Vit D deficiency during pregnancy, their performance was moderate. The unpleasant taste and high price of seafood were barriers to using them, and the lack of public places specific to women and living in apartments, were barriers to using sunlight. The most important determinant of preventive behaviours was perceived self-efficacy. Developing an awareness program to promote best practices in pregnant women is essential to prevent vitamin D deficiency.
Highlights
Pregnancy is a high-risk period for vitamin D (Vit D) deficiency, and there is a direct relationship between Vit D deficiency during this period and maternal and fetal complications
Knowledge of pregnant women about Vit D The results showed that 85.6% of participants were well aware of the importance and role of Vit D in pregnancy, 76.7% of them were well aware of getting Vit D from sunlight exposure, and 75% were aware of how to prevent Vit D deficiency
Knowledge of pregnant women This study showed that the majority of the participants had good knowledge of the importance and role of Vit D in pregnancy, and how to get Vit D from sunlight and prevent Vit D deficiency in pregnancy
Summary
Pregnancy is a high-risk period for vitamin D (Vit D) deficiency, and there is a direct relationship between Vit D deficiency during this period and maternal and fetal complications. Pregnancy Vit D deficiency is very prevalent in many parts of the world and can be regarded as a health issue in both developed [3, 4] and developing countries [5,6,7,8]. Studies around the world indicate a high prevalence of Vit D deficiency in pregnant women [12,13,14,15,16,17]. Reported prevalence rates of maternal Vit D deficiency in a systematic review conducted in 2018 were between 70 and 80% across Asia, the Middle East and Africa [18]. By a systematic review conducted in 2017 the prevalence of Vit D deficiency in Iranian pregnant women was 56% and mean Vit D concentration have been reported 15.69 ng/ml [19]. A recent study showed that 76.8% of the studied Iranian pregnant women were deficient in Vit D [20]
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