Consumption of Iron/Folic Acid Tablets during Pregnancy and Its Tendency to Pregnancy Outcomes: A Cross-sectional Study in Indonesia

Dear Editor, Iron is very important for pregnant women for fetal and placental growth and preventing bleeding during childbirth.[1] The prevalence of anemia in pregnant women in Indonesia is still quite high, namely 48.9%.[2] For this reason, iron/folic acid (IFA) tablets are given during pregnancy, and it is recommended that a minimum of 90 tablets be consumed.[3] This analysis aimed to describe the consumption of IFA tablets during pregnancy and its trends in pregnancy outcomes. This analysis uses report data from the 2018 Indonesian Basic Health Survey, which is a cross-sectional study. The object of analysis is women aged 10–54 years and who have ever been pregnant. The variables analyzed were the history of consuming IFA tablets during the last pregnancy and pregnancy outcomes, namely: (1) gestational age at delivery <37 weeks (premature), (2) history of child’s birth weight <2500 g (low birth weight), and (3) nutritional status bad for children aged 0–23 months (weight for age). Data were analyzed descriptively to describe a comparison of the history of IFA tablet consumption and pregnancy outcomes according to coverage in each province and a bivariate correlation test was carried out to assess the relationship. The proportion of women aged 10–54 years who received IFA tablets during their last pregnancy was 87.6%, but only 37.7% took ≥90 tablets. From the results of sorting provinces according to the proportion of consumption of 90 IFA tablets from the highest to the lowest, it appears that as the proportion decreases, the proportion of premature births increases. The same pattern was obtained when compared with the proportion of poor nutritional status in children aged 0–23 months. Meanwhile, there is relatively no difference in the proportion of giving birth to children with low birth weight. The bivariate correlation test strengthens these findings. The proportion of history of consuming IFA tablets during pregnancy was significantly related to premature birth and the prevalence of poor nutritional status in children aged 0–23 months but was not significant with a history of birth weight in children aged 0–59 months <2500 g [Table 1].Table 1: Correlation test between the history of taking iron/folic acid tablets during pregnancy and pregnancy outcomeIn lower-middle-income countries, the consumption of nutritious food for some people is often limited. Hence, pregnant women are given nutritional supplements, including IFA tablets. However, it turns out that only a third of pregnant women consume according to government recommendations. This condition is a problem considering that the prevalence of anemia in Indonesia is still relatively high.[2] Several factors influence the low consumption of IFA tablets during pregnancy, such as age over 45 years, low education level, low-income families, and not using prenatal care services.[4] Other factors are side effects, forgetfulness, a history of safe pregnancy without IFA tablets, and the inability to pay transportation costs to get IFA tablets.[5] Therefore, health service providers must look for breakthroughs either through the role of family (husband), health cadres, or others to ensure that pregnant women receive and consume a minimum of 90 IFA tablets during pregnancy. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.