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目的 分析陕西省妇女孕前和孕期不同类型铁补充剂及补血中成药的使用情况及其影响因素.方法 采用分层多阶段随机整群抽样方法,以问卷调查方式收集2010-2013年怀孕且结局明确的育龄妇女相关信息,提取孕前孕期微营养素服用数据资料,对孕前孕期铁补充剂及补血中成药使用情况进行描述性分析,运用logistic回归分析其影响因素.结果 共调查28367人,孕前孕期铁剂、含铁复合营养素及补血中成药总服用率为28.99%,铁剂服用率相对较低(5.33%);3类补充剂均为孕前、早期服用率较低,孕中、晚期服用率较高,连续≥2个时期服用率很低.3种补充剂在服用时间、地区、人群分布的差异均有统计学意义.logistic回归分析显示:铁剂服用的积极因素为文化程度大专或以上(OR=1.920,95%CI:1.617~2.279)、产检次数≥6次(OR=1.832,95%CI:1.604~2.091)等;服用含铁复合营养素的积极因素与铁剂基本相同,消极因素为农村居民(与城市居民相比,OR=0.872,95%CI:0.788~0.966);补血中成药服用的积极因素为农村居民(与城市居民相比,OR=1.285,95%CI:1.141~1.447);消极因素为文化程度大专或以上(OR=0.855,95%CI:0.746~0.979)等.结论 2010-2013年陕西省妇女孕前和孕期3类补充剂总体服用率较低,铁剂各阶段服用率均较低,孕前、孕早期预防性补铁率尤其低.应采取措施全面提高陕西地区妇女孕前孕期铁剂补充率,同时加强补血中成药临床使用的规范化.

Objective To understand the prevalence of prenatal supplementations of iron, iron-containing multi-micronutrients (IMMN) and antianemic Chinese patent medicines (ACPM) and associated factors in women in Shaanxi province. Methods A sample of 28367 childbearing-age women who gave birth during 2010-2013 and had specific information of the prenatal nutrients supplementation were recruited using stratified multistage cluster random sampling in Shaanxi province. The information about their basic characteristics and prenatal supplementation of nutrients were collected by a questionnaire survey. Descriptive analysis method was used to analyze the intake rate of iron, IMMN and ACPM during each period of pregnancy, and logistic regression model was used to identify associated factors. Results The overall prevalence of prenatal iron, IMMN and ACPM supplementation was low (28.99%), and the intake rate of iron was the lowest (5.33%). The prevalence of prenatal supplementation of iron, IMMN and ACPM were lower before pregnancy and in the first trimester than in the second and third trimester. The intake rates for consecutive 2 periods were very low (all were lower than 2.00%). The intake rates of iron, IMMN and ACPM significantly increased year by year. Women living in central Shaanxi had relatively high intake rates of iron (7.22%) and IMMN (16.55%), and women in southern Shaanxi had relatively high intake rate of ACPM (18.50%). The results of logistic regression analysis showed that higher educational level(OR=1.920, 95%CI: 1.617-2.279), antenatal care times≥6 (OR=1.832, 95%CI: 1.604-2.091), etc. were the positive factors for iron intake, and these positive factors were similar to those for IMMN intake. Additionally, rural residence was the negative factor for IMMN intake (compared with urban residence, OR=0.872, 95%CI:0.788-0.966). Conversely, higher educational level (OR=0.855, 95%CI:0.746-0.979), higher household income (OR=0.864, 95%CI: 0.796-0.938) were negative factors for ACPM intake, and rural residence was its positive factor (OR=1.285, 95% CI: 1.141-1.447). Conclusions The prevalence of prenatal supplementation of iron, IMMN and ACPM were low in women in Shaanxi, especially the intake rate of iron was the lowest. The prophylactic iron supplementation before pregnancy or in the first trimester was rare. Measures should be taken to improve the prenatal supplementation of iron in Shaanxi and to standardize the clinical use of ACPM.