{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:21:36Z","timestamp":1783344096058,"version":"3.54.6"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2012,6,26]],"date-time":"2012-06-26T00:00:00Z","timestamp":1340668800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Folate and iron deficiency during pregnancy are risk factors for anaemia, preterm delivery, and low birth weight, and may contribute to poor neonatal health and increased maternal mortality. The World Health Organization recommends supplementation of folic acid (FA) and iron for all pregnant women at risk of malnutrition to prevent anaemia. We assessed the use of prenatal folic acid and iron supplementation among women in a geographical area with a high prevalence of anaemia, in relation to socio-demographic, morbidity and health services utilization factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We analysed a cohort of 21,889 women who delivered at Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania, between 1999 and 2008. Logistic regression models were used to describe patterns of reported intake of prenatal FA and iron supplements.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Prenatal intake of FA and iron supplements was reported by 17.2% and 22.3% of pregnant women, respectively. Sixteen percent of women reported intake of both FA and iron. Factors positively associated with FA supplementation were advanced maternal age (OR\u2009=\u20091.17, 1.02-1.34), unknown HIV status (OR\u2009=\u20091.54, 1.42-1.67), a diagnosis of anaemia during pregnancy (OR\u2009=\u200912.03, 9.66-14.98) and indicators of lower socioeconomic status. Women were less likely to take these supplements if they reported having had a malaria episode before (OR\u2009=\u20090.57, 0.53-0.62) or during pregnancy (OR\u2009=\u20090.45, 0.41-0.51), reported having contracted other infectious diseases (OR\u2009=\u20090.45, 0.42-0.49), were multiparous (OR\u2009=\u20090.73, 0.66-0.80), had preeclampsia\/eclampsia (OR\u2009=\u20090.48, 0.38-0.61), or other diseases (OR\u2009=\u20090.55, 0.44-0.69) during pregnancy. Similar patterns of association emerged when iron supplementation alone and supplementation with both iron and FA were evaluated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>FA and iron supplementation are low among pregnant women in Northern Tanzania, in particular among women with co-morbidities before or during pregnancy<jats:italic>.<\/jats:italic> Attempts should be made to increase supplementation both in general and among women with pregnancy complications.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2458-12-481","type":"journal-article","created":{"date-parts":[[2012,6,27]],"date-time":"2012-06-27T12:34:14Z","timestamp":1340800454000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: A cross-sectional hospital-based study"],"prefix":"10.1186","volume":"12","author":[{"given":"Olukemi","family":"Ogundipe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrine","family":"Hoyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Truls","family":"\u00d8stbye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olola","family":"Oneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Manongi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolv Terje","family":"Lie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Kjersti","family":"Daltveit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2012,6,26]]},"reference":[{"key":"4215_CR1","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1056\/NEJM199911113412001","volume":"341","author":"RJ Berry","year":"1999","unstructured":"Berry RJ, Li Z, Erickson JD, Li S, et al: Prevention of neural-tube defects with folic acid in China. China-U.S. collaborative project for neural tube defect prevention. N Engl J Med. 1999, 341: 1485-1490. 10.1056\/NEJM199911113412001.","journal-title":"N Engl J Med"},{"key":"4215_CR2","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1056\/NEJM199212243272602","volume":"327","author":"AE Czeizel","year":"1992","unstructured":"Czeizel AE, Dud\u00e1s I: Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992, 327: 1832-1835. 10.1056\/NEJM199212243272602.","journal-title":"N Engl J Med"},{"key":"4215_CR3","volume-title":"Dietary reference intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic acid, Biotin, and Choline","author":"Institute of Medicine","year":"1998","unstructured":"Institute of Medicine: Dietary reference intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic acid, Biotin, and Choline. 1998, Washington, DC: National Academy Press, (prepublication edition)"},{"key":"4215_CR4","volume-title":"Standards for Maternal and Neonatal Care","author":"World Health Organization Department of Making Pregnancy Safer","year":"2007","unstructured":"World Health Organization Department of Making Pregnancy Safer: Standards for Maternal and Neonatal Care. 2007, [1 screen]. Available from: http:\/\/whqlibdoc.who.int\/hq\/2007\/a91272.pdf,"},{"key":"4215_CR5","doi-asserted-by":"publisher","first-page":"756","DOI":"10.3945\/jn.110.128793","volume":"141","author":"RJ Stoltzfus","year":"2011","unstructured":"Stoltzfus RJ: Iron interventions for women and children in low-income countries. J Nutr. 2011, 141: 756-762. 10.3945\/jn.110.128793.","journal-title":"J Nutr"},{"issue":"2 Suppl","key":"4215_CR6","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1542\/peds.2004-1441","volume":"115","author":"ZA Bhutta","year":"2005","unstructured":"Bhutta ZA, Darmstadt GL, Hasan BS, et al: Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics. 2005, 115 (2 Suppl): 519-617.","journal-title":"Pediatrics"},{"key":"4215_CR7","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.ajog.2005.06.018","volume":"194","author":"SL Carmichael","year":"2006","unstructured":"Carmichael SL, Shaw GM, Yang W, et al: National birth defects prevention study. Correlates of intake of folic acid-containing supplements among pregnant women. Am J Obstet Gynecol. 2006, 194: 203-210. 10.1016\/j.ajog.2005.06.018.","journal-title":"Am J Obstet Gynecol"},{"issue":"5 Suppl","key":"4215_CR8","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1093\/ajcn\/71.5.1280s","volume":"71","author":"LH Allen","year":"2000","unstructured":"Allen LH: Anaemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr. 2000, 71 (5 Suppl): 1280-1284.","journal-title":"Am J Clin Nutr"},{"key":"4215_CR9","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1093\/ajcn\/78.4.773","volume":"78","author":"ME Cogswell","year":"2003","unstructured":"Cogswell ME, Parvanta I, Ickes L, et al: Iron supplementation during pregnancy, anaemia, and birth weight: a randomized controlled trial. Am J Clin Nutr. 2003, 78: 773-781.","journal-title":"Am J Clin Nutr"},{"key":"4215_CR10","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1093\/jn\/135.7.1776","volume":"135","author":"AT Merchant","year":"2005","unstructured":"Merchant AT, Msamanga G, Villamor E, et al: Multivitamin supplementation of HIV-positive women during pregnancy reduces hypertension. J Nutr. 2005, 135: 1776-1781.","journal-title":"J Nutr"},{"key":"4215_CR11","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.4269\/ajtmh.2007.76.1066","volume":"76","author":"E Villamor","year":"2007","unstructured":"Villamor E, Msamanga G, Saathoff E, et al: Effects of maternal vitamin supplements on malaria in children born to HIV-infected women. Am J Trop Med Hyg. 2007, 76: 1066-1071.","journal-title":"Am J Trop Med Hyg"},{"key":"4215_CR12","volume-title":"Tanzania Demographic and Health Survey 2004\u201305","author":"National Bureau of Statistics (NBS) [Tanzania] and ORC Macro","year":"2005","unstructured":"National Bureau of Statistics (NBS) [Tanzania] and ORC Macro: Tanzania Demographic and Health Survey 2004\u201305. 2005, Dar Es Salaam, Tanzania: National Bureau of Statistics and ORC Macro"},{"key":"4215_CR13","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1080\/j.1600-0412.1999.780703.x","volume":"78","author":"SN Massawe","year":"1999","unstructured":"Massawe SN, Urassa EN, Nystr\u00f6m L, Lindmark G: Effectiveness of primary level antenatal care in decreasing anemia at term in Tanzania. Acta Obstet Gynecol Scand. 1999, 78: 573-579. 10.1080\/j.1600-0412.1999.780703.x.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"4215_CR14","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1038\/sj.ejcn.1601300","volume":"56","author":"SG Hinderaker","year":"2002","unstructured":"Hinderaker SG, Olsen BE, Lie RT, Bergsj\u00f8 PB, Gasheka P, Bondevik GT, Ulvik R, Kv\u00e5le G: Anemia in pregnancy in rural Tanzania: associations with micronutrients status and infections. Eur J Clin Nutr. 2002, 56: 192-199. 10.1038\/sj.ejcn.1601300.","journal-title":"Eur J Clin Nutr"},{"key":"4215_CR15","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1111\/j.1365-3016.2005.00633.x","volume":"19","author":"DH Charles","year":"2005","unstructured":"Charles DH, Ness AR, Campbell D, et al: Folic acid supplements in pregnancy and birth outcome: re-analysis of a large randomised controlled trial and update of Cochrane review. Paediatr Perinat Epidemiol. 2005, 19: 112-124. 10.1111\/j.1365-3016.2005.00633.x.","journal-title":"Paediatr Perinat Epidemiol"},{"key":"4215_CR16","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1093\/ajcn\/84.5.1134","volume":"84","author":"RM Nilsen","year":"2006","unstructured":"Nilsen RM, Vollset SE, Gjessing HK, et al: Patterns and predictors of folic acid supplement use among pregnant women: the Norwegian Mother and Child Cohort Study. Am J Clin Nutr. 2006, 84: 1134-1141.","journal-title":"Am J Clin Nutr"},{"key":"4215_CR17","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.ypmed.2008.06.014","volume":"47","author":"S Timmermans","year":"2008","unstructured":"Timmermans S, Jaddoe VW, Mackenbach JP, Hofman A, Steegers-Theunissen RP, Steegers EA: Determinants of folic acid use in early pregnancy in a multi-ethnic urban population in The Netherlands: The Generation R study. Prev Med. 2008, 47: 427-432. 10.1016\/j.ypmed.2008.06.014.","journal-title":"Prev Med"},{"key":"4215_CR18","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1093\/jn\/133.6.1974S","volume":"33","author":"ME Cogswell","year":"2003","unstructured":"Cogswell ME, Kettel-Khan L, Ramakrishnan U: Iron supplement use among women in the United States: science, policy and practice. J Nutr. 2003, 33: 1974-1977.","journal-title":"J Nutr"},{"key":"4215_CR19","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1017\/S136898000769956X","volume":"10","author":"VK Knudsen","year":"2007","unstructured":"Knudsen VK, Hansen HS, Ovesen L, et al: Iron supplement use among Danish pregnant women. Public Health Nutr. 2007, 10: 1104-1110.","journal-title":"Public Health Nutr"},{"key":"4215_CR20","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1017\/S1368980007000237","volume":"11","author":"PL Lutsey","year":"2008","unstructured":"Lutsey PL, Dawe D, Villate E, et al: Iron supplementation compliance among pregnant women in Bicol, Philippines. Public Health Nutr. 2008, 11: 76-82.","journal-title":"Public Health Nutr"},{"key":"4215_CR21","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1017\/S1368980007000924","volume":"11","author":"BC Seck","year":"2008","unstructured":"Seck BC, Jackson RT: Determinants of compliance with iron supplementation among pregnant women in Senegal. Public Health Nutr. 2008, 11: 596-605.","journal-title":"Public Health Nutr"},{"key":"4215_CR22","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1111\/j.1471-0528.2008.01672.x","volume":"115","author":"NA Habib","year":"2008","unstructured":"Habib NA, Daltveit AK, Bergsjo P, et al: Maternal HIV Status and pregnancy outcomes in North Eastern Tanzania: A registry based study. BJOG. 2008, 115: 616-624. 10.1111\/j.1471-0528.2008.01672.x.","journal-title":"BJOG"},{"key":"4215_CR23","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1016\/S1473-3099(09)70227-0","volume":"9","author":"JA Bartlett","year":"2009","unstructured":"Bartlett JA, Shao JF: Successes, challenges, and limitations of current antiretroviral therapy in low-income and middle-income countries. Lancet Infect Dis. 2009, 9: 637-649. 10.1016\/S1473-3099(09)70227-0.","journal-title":"Lancet Infect Dis"},{"key":"4215_CR24","volume-title":"Global health risks: mortality and burden of disease attributable to selected major risks","author":"World Health Organization","year":"2009","unstructured":"World Health Organization: Global health risks: mortality and burden of disease attributable to selected major risks. 2009, Geneva: World Health Organization, Retrieved from http:\/\/www.who.int\/healthinfo\/global_burden_disease\/global_health_risks\/en\/index.html,"},{"key":"4215_CR25","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3109\/00016349609047094","volume":"75","author":"P Bergsjo","year":"1996","unstructured":"Bergsjo P, Seha AM, Ole-King'ori N: Hemoglobin concentration in pregnant women. Experience from Moshi, Tanzania. Acta Obstet Gynecol Scand. 1996, 75: 241-244. 10.3109\/00016349609047094.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"4215_CR26","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1016\/S0140-6736(98)04197-X","volume":"351","author":"WW Fawzi","year":"1998","unstructured":"Fawzi WW, Msamanga GI, Spiegelman D, et al: Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania. Lancet. 1998, 351: 1477-1482. 10.1016\/S0140-6736(98)04197-X.","journal-title":"Lancet"},{"key":"4215_CR27","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1086\/592715","volume":"198","author":"AM van Eijk","year":"2008","unstructured":"van Eijk AM, Ouma PO, Williamson J, et al: Plasma folate level and high-dose folate supplementation predict sulfadoxine-pyrimethamine treatment failure in pregnant women in Western Kenya who have uncomplicated malaria. J Infect Dis. 2008, 198: 1550-1553. 10.1086\/592715.","journal-title":"J Infect Dis"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-12-481.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2458-12-481\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-12-481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-12-481.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T19:42:05Z","timestamp":1630525325000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/1471-2458-12-481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,26]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["4215"],"URL":"https:\/\/doi.org\/10.1186\/1471-2458-12-481","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,26]]},"assertion":[{"value":"18 January 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2012","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2012","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"481"}}