بررسی آگاهی، میزان و نحوه مصرف اسیدفولیک در بارداری و پیش بارداری: یک مرور نظام‌مند و متآنالیز

نوع مقاله : مروری

نویسندگان

1 مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران. دانشجوی دکترای تخصصی بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران

2 استاد گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

3 دانشجوی دکترای تخصصی بهداشت باروری، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: اسیدفولیک، یک ماده مغذی مهم برای حفظ و ارتقاء سلامت محسوب می‌شود و کمبود اسیدفولیک در دوران بارداری احتمال سقط خودبه‌خودی جنین، نقص لوله عصبی، پره‌اکلامپسی، دکولمان جفت، زایمان زودرس، وزن کم هنگام تولد و کم‌خونی را افزایش می‌دهد و بسیاری از موارد ذکر شده، از طریق افزایش دریافت اسیدفولیک در بارداری و پیش بارداری قابل پیشگیری است. مطالعه حاضر با هدف تعیین سطح آگاهی و میزان مصرف اسیدفولیک در بارداری و پیش بارداری به‌روش متاآنالیز انجام شد.
روش‌کار: در این مطالعه مرور سیستماتیک و فراتحلیل (متاآنالیز) به منظور یافتن مقالات مرتبط، مجلات فارسی و انگلیسی زبان نمایه شده در SID، Iranmedx، Irandoc، Magiran، Scopus و Pubmed با استفاده از کلید واژه‌های Mesh تا اول مرداد سال 1397 مورد جستجو قرار گرفتند. جهت بررسی ناهمگنی در مطالعات از شاخص I2 استفاده شد. داده‌ها با روش متاآنالیز و با استفاده از مدل اثرات تصادفی مورد تجزیه و تحلیل قرار گرفتند.
یافته­ها: از بین 2366 مقاله یافت شده در جستجوی اولیه، تعداد 16 مطالعه برای مرور سیستماتیک و متاآنالیز انتخاب گردید. در متاآنالیز انجام شده با توجه به مدل اثرات تصادفی به‌دلیل میزان ناهمگنی 97%، حیطه شنیدن نام اسیدفولیک توسط زنان 8/84% (1/90-5/77)، آگاهی زنان از نقش اسیدفولیک 2/37% (1/48-5/27)، آگاهی از زمان مصرف اسیدفولیک 3/27% (3/39-9/17)، آگاهی از دوز صحیح مصرف اسیدفولیک 2/75% (2/84-3/63)، مصرف اسیدفولیک در بارداری 74% (6/81-2/65)، مصرف اسیدفولیک در قبل از بارداری 3/18% (9/25-6/12)، مصرف منظم 47% (3/90-8/7) و مصرف نامنظم اسیدفولیک در مجموع 9/40% (7/82-1/9) برآورد شد.
نتیجه­گیری: سطح آگاهی زنان سنین باروری نسبت به مکمل اسیدفولیک و نقش ارزنده آن در بارداری مطلوب نمی‌باشد. از آنجا که پرسنل بهداشتی به‌عنوان مهم‌ترین منبع کسب اطلاعات در زمینه مصرف اسیدفولیک شناخته شده‌اند، لذا اهتمام بیشتر آنان در این رابطه کمک شایانی به افزایش سطح آگاهی زنان می‌نماید.

کلیدواژه‌ها

عنوان مقاله [English]

The level of Knowledge and consumption of Folic Acid in pregnancy and pre-conception: A Systematic Review and Meta-analysis

نویسندگان [English]

  • Fatemeh Ghaffari Sardasht 1
  • Afsaneh Keramat 2
  • Morvarid Irani 3
1 Nursing and Midwifery Care Research Center, Mashhad university of medical sciences, Mashhad, Iran. PhD student in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
2 Professor, Department of Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
3 PhD student in Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad university of medical sciences, Mashhad, Iran.
چکیده [English]

ntroduction: Folic acid is an important nutrient for maintaining and improving health and its deficiency during pregnancy increase the risk of spontaneous abortion, neural tube defects, preeclampsia, placental abruption, preterm labor, low birth weight and anemia. These risks can be prevented by increasing folic acid intake during pregnancy and pre-conception. Therefore, this study was performed with aim to determine the level of knowledge and consumption of Folic acid in pregnancy and pre-conception through meta-analysis.
Methods: In this systematic review and meta-analysis study, for finding the related articles, the Persian and English journals which were indexed in databases of SID, Iranmedx, Irandoc, Magiran, Scopus, and PubMed were searched with Mesh keywords up to August, 2018. I2 index was used to assess the heterogeneity in the studies. Data were analyzed by meta-analysis method using random effects model.
Results: Of the 2366 articles found in the primary search, 16 articles were selected for systematic review and meta-analysis. In the meta-analysis, according to the random effects model due to heterogeneity 97% , these results were estimated: hearing the name of folic acid by women in 84.8% (77.5-90.1), knowledge of women from the role of folic acid in 37.2% (27.5-48.1), knowledge of the time of taking folic acid in 27.3% (17.9-39.3), knowledge of the correct dose of folic acid in 75.2% (63.3-84.2), use of Folic acid during pregnancy in 74% (65.2-81.6), use of folic acid in pre-pregnancy in 18.3 % (12.6-25.9), regular consumption in 47% (7.8-90.3), and irregular consumption of folic acid in 40.9% (9.1-82.7).
Conclusion: The level of knowledge of women at reproductive age about folic acid complementary and its valuable role in pregnancy is not desirable. Since health personnel are the most important source of information on the use of folic acid, so they have to work more efforts in this regard to increase the level of women's knowledge.

کلیدواژه‌ها [English]

  • Folic acid
  • Function
  • Iran
  • Knowledge
  • Meta-analysis
  • Reproductive age
  • Systematic review

مراجع

  1. Toriello HV. Policy statement on folic acid and neural tube defects. Genet Med 2011; 13(6):593-6.
  2. Obeid R, Kasoha M, Kirsch SH, Munz W, Herrmann W. Concentrations of unmetabolized folic acid and primary folate forms in pregnant women at delivery and in umbilical cord blood. Am J Clin Nutr 2010; 92(6):1416-22.
  3. Irani M, Amirian M, Sadeghi R, Lez JL, Latifnejad Roudsari R. The effect of folate and folate plus zinc supplementation on endocrine parameters and sperm characteristics in sub-fertile men: a systematic review and meta-analysis. Urol J 2017; 14(5):4069-78.
  4. Brustolin S, Giugliani R, Félix TM. Genetics of homocysteine metabolism and associated disorders. Braz J Med Biol Res 2010; 43(1):1-7.
  5. Centers for Disease Control and Prevention. Pregnancy risk assessment monitoring system (PRAMS). Atlanta: Centers for Disease Control and Prevention; 2010.
  6. Gaskins AJ, Rich-Edwards JW, Hauser R, Williams PL, Gillman MW, Ginsburg ES, et al. Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth. Obstet Gynecol 2014; 124(1):23-31.
  7. Viswanathan M, Treiman KA, Kish-Doto J, Middleton JC, Coker-Schwimmer EJ, Nicholson WK. Folic acid supplementation for the prevention of neural tube defects: an updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2017; 317(2):190-203.
  8. Wen SW, Chen XK, Rodger M, White RR, Yang Q, Smith GN, et al. Folic acid supplementation in early second trimester and the risk of preeclampsia. Am J Obstet Gynecol 2008; 198(1):45.e1-7.
  9. Nilsen RM, Vollset SE, Rasmussen SA, Ueland PM, Daltveit AK. Folic acid and multivitamin supplement use and risk of placental abruption: a population-based registry study. Am J Epidemiol 2008; 167(7):867-74.
  10. Timmermans S, Jaddoe VW, Hofman A, Steegers-Theunissen RP, Steegers EA. Periconception folic acid supplementation, fetal growth and the risks of low birth weight and preterm birth: the Generation R Study. Br J Nutr 2009; 102(5):777-85.
  11. Irani M, Khadivzadeh T, Nekah A, Mohsen S, Ebrahimipour H, Tara F. The prevalence of congenital anomalies in Iran: a systematic review and meta-analysis. Iran J Obstet Gynecol Infertil 2018; 21(Supple):29-41. (Persian).
  12. Relton CL, Pearce MS, Burn J, Parker L. An investigation of folate‐related genetic factors in the determination of birthweight. Pediatr Perinat Epidemiol 2005; 19(5):360-7.
  13. Karen N, Oakley GP Jr. Tracking the prevention of folic acid- preventable spina bifida and anencephaly. Birth Defects Res A Clin Mol Teratol 2006; 76(9):654-7.
  14. Hodgetts VA, Morris RK, Francis A, Gardosi J, Ismail KM. Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small‐for‐gestational age neonates: a population study, systematic review and meta‐analysis. BJOG 2015; 122(4):478-90.
  15. Wang M, Li K, Zhao D, Li L. The association between maternal use of folic acid supplements during pregnancy and risk of autism spectrum disorders in children: a meta-analysis. Mol Autism 2017; 8(1):51.
  16. Blencowe H, Cousens S, Modell B, Lawn J. Folic acid to reduce neonatal mortality from neural tube disorders. Int J Epidemiol 2010; 39(Suppl 1):i110-21.
  17. Wright AJ, Dainty JR, Finglas PM. Folic acid metabolism in human subjects revisited: potential implications for proposed mandatory folic acid fortification in the UK. Br J Nutr 2007; 98(4):667-75.
  18. Blom HJ, Smulders Y. Overview of homocysteine and folate metabolism. With special references to cardiovascular disease and neural tube defects. J Inherit Metab Dis 2011; 34(1):75-81.
  19. Baio J. National center on birth defects and developmental disabilities. Atlanta, GA: CDC; 2012.
  20. Nosrat SB, Sedehi M, Golalipour MJ. Knowledge and practice of urban Iranian pregnant women towards folic acid intake for neural tube defect prevention. J Pak Med Assoc 2012; 62(8):785-9.
  21. Mobasheri E, Sedehi M, Golalipour MJ. Awareness regarding consumption of folic acid in rural pregnant women in northern Iran. Iran J Obstet Gynecol Infertil 2012; 15(30(:29. (Persian).
  22. Riazi H, Bashirian S, Cheraghi F. Folic acid intake during preconceptional period. Sci J Hamadan Nurs Midwifery Facul 2010; 18(2):38-48. (Persian).
  23. Temel S, Erdem Ö, Voorham TA, Bonsel GJ, Steegers EA, Denktaş S. Knowledge on preconceptional folic acid supplementation and intention to seek for preconception care among men and women in an urban city: a population-based cross-sectional study. BMC Pregnancy Childbirth 2015; 15(1):340.
  24. Schmidt FL, Hunter JE. Methods of meta-analysis: correcting error and bias in research findings. London: Sage Publications; 2014.
  25. Hematyar M, Fazel SZ, Nazari L. Awareness on taking folic acid supplement among women in the obstetric clinics in Tehran. J Qazvin Univ Med Sci 2009; 13(1):94-8. (Persian).
  26. Anjamshoa H, Dehghan A. Knowledge, attitude and performance of pregnant women in Kerman towards supplement consumption in 2014. Nurs Iran Vulnerable 2014; 2(5):52-62.
  27. Malekia A, Ahmadnia E. Assessment of knowledge and practice among pregnant women on folic acid intake and its related factors. Prev Care Nurs Midwifery J 2011; 1(1):31-6.
  28. Rezaei M, Mohammadinia N, Heidari N, Pejmankhah S. Awareness on taking folic acid among pregnant women who referred to health centers in Iranshahr city. Comm Health J 2010; 5(1):53-61.
  29. Safdarian L, Adineh M. Knowledge, attitude and practice of pregnant women about benefits and doses of folic acid consumption during pregnancy. Tehran Univ Med J 2004; 62(4):321-5. (Persian).
  30. Rezaei Z, Ahmadi FS, Niroomanesh S, Ejtemaee Mehr S, Davari Tanha F, Aminian A, et al. Performance of pregnant women on folic acid intake. Acta Med Iran 2013; 51(10):697-700.
  31. Kadivar MR, Moradi F, Massumi SJ, Shenavar R. Folic acid consumption in Fars province, southern Iran. J Res Health Sci 2005; 5(2):11-4.
  32. Jabbari H, Bakhshian F, Alikhah H, Piri R, Naghavi-Behzad M, Karkon Shayan F. Provision of iron and folic acid supplementations for pregnant women in public and private sectors of Tabriz, Iran. Iran J Neonatol 2015; 6(3):32-8.
  33. Noroozi A, Tahmasebi R. Application of health belief model's constructs for predicting regular consumption of folic acid supplements in pregnant women referred to Borazjan’s health centers in 2014-15. Iran Sci Med J 2016; 19(1):77-90.
  34. Masoumi SZ, Parsa P, Kazemi F, Soltanian AR, Dadvand G, Habib S. Investigation of nutritional behaviors in the first and second trimesters in pregnant women referring to clinics in Hamadan, Iran, in 2013. Glob J Health Sci 2016; 8(9):261.
  35. Mashayekhi SO, Dilmaghanizadeh M, Sattari MR. A survey on the consumption, knowledge and attitude of pregnant women toward the effects of folic acid on pregnancy outcome in Tabriz. Iran J Child Neurol 2011; 5(1):35-42.
  36. Riazi H, Bashirian S, Amini L. Awareness of pregnant women about folic acid supplementation in Iran. J Family Rep Health 2012; 6(4):159-63.
  37. Brachlo K, Ghorbani S, Karbord AA. Knowledge, attitude and performance in primiparous women using folic acid before and during pregnancy and its risk factors in Qazvin in 2011. Iran J Edrak 2011; 8(30):35-40. (Persian).
  38. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Ann Intern Med 2007; 147(8):163-94.
  39. Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive meta-analysis version 2 Biostat, Englewood, NJ: Comprehensive Meta Analyses Software; 2005.
  40. Kim J, Yon M, Kim CI, Lee Y, Moon GI, Hong J, Hyun T. Preconceptional use of folic acid and knowledge about folic acid among low-income pregnant women in Korea. Nutr Res Pract 2017; 11(3):240-6.
  41. Jou H, Hsu IP, Liu CY, Chung SH, Chen SM, Gau ML. Awareness and use of folic acid among pregnant women in Taipei. Taiwan J Obstet Gynecol 2010; 49(3):306-10.
  42. Lawal T, Adeleye A. Determinants of folic acid intake during preconception and in early pregnancy by mothers in Ibadan, Nigeria. Pan Afr Med J 2014; 19:113.
  43. McWalter P, Al Shmassi A, Eldali A. Awareness and use of folic acid in a clinic-based Saudi pregnant population. Saudi J Med Med Sci 2015; 3(2):141-5.
  44. Lauria L, Adinolfi G, Bartolomeo F, Petruccelli E, Grandolfo M. Women’s knowledge and periconceptional use of folic acid: data from three birth centers in Italy. Rare Dis Orphan Drugs 2014; 1:99-107.
  45. Peake JN, Copp AJ, Shawe J. Knowledge and periconceptional use of folic acid for the prevention of neural tube defects in ethnic communities in the United Kingdom: systematic review and meta‐analysis. Birth Defects Res A Clin Mol Teratol 2013; 97(7):444-51.
  46. Al-Holy M, Eideh A, Epuru S, Abu-Jamous D, Ashankyty I. Awareness of folic acid intake among women in the childbearing age in hail region—Saudi Arabia. Food Nutr Sci 2013; 4(1):49-55.
  47. Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr 2000; 71(5):1295S-303S.
مجله زنان، مامایی و نازایی ایران
دوره 22، شماره 2
اردیبهشت 1398
صفحه 84-95

فایل ها

هم رسانی

ارجاع به این مقاله

آمار