Adherence to iron prophylactic therapy during pregnancy in an urban regional hospital in South Africa

Abstract

Background: Iron and folic acid supplementation plays a major role in the prevention and control of iron-deficiency anaemia in pregnancy. Therefore, this study assesses adherence to prophylactic iron supplementation during the antenatal period in South Africa.

Methods: An observational study was conducted in a regional hospital from January to December 2016. HIV-uninfected (n = 100) and HIV-infected (n = 100)] women were enrolled and subdivided into three groups: (a) ≤ 34 weeks (n = 33), (b) 34–36 weeks (n = 34) and (c) ≥ 37 weeks (n = 33) gestational age respectively. A structured questionnaire was used for data collection. Data were coded and statistically analysed using SPSS software. Pill count and self-reported data from women (n = 24) at ≤ 34 weeks and 34–36 weeks reflected < 50% adherence and 46% non-adherence, being higher in the HIV-infected women (75%). Nausea was the commonest side effect across all trimesters (79. 2%). Adherence (27.8%) and non-adherence (72.1%) to iron, folic acid and calcium supplementation were found in 88% of women.

Conclusion: This study found that adherence to micronutrient supplementation is low in pregnancy, albeit higher in HIV-infected women receiving antenatal care at a regional hospital in Durban, South Africa.

Abbreviations: Haemoglobin (Hb), Human Immune Deficiency Virus (HIV), antiretroviral therapy (ARV), zidovudine (ZDV), tuberculosis (TB), low to middle- income countries (LMICs), World Health Organization (WHO), antenatal clinic (ANC).