Pharmaceutical Sciences ETDs

Author

Sizhu Liu

Publication Date

8-30-2011

Abstract

Background: Prenatal vitamin use is recommended as a necessary supplement prior to conception and throughout pregnancy. Multivitamin use in early pregnancy can significantly reduce risks for birth defects: cardiovascular defects, limb defect, urinary tract abnormalities, orofacial clefts and neural tube defects (NTDs). Sixty-nine to seventy-eight percent of women take vitamins after pregnancy recognition, while only 23-35% of women in the U.S. start to use vitamins before pregnancy recognition. Rates of NTDs by ethnicity demonstrate that Hispanics have the highest prevalence (4.2 per 10,000 births) than Non-Hispanics. (Non-Hispanic Black or African American: 3.2 per 10,000 births; Non-Hispanic Whites: 2.6 per 10,000 births). Objectives: To explore the prevalence rates of multivitamin use during pregnancy and to find out the predictors of vitamin use using an established cohort in New Mexico. Methods: This is a cross-sectional analysis which used data from the Safety of Medication and Perception of Teratogenicity (SMART)' study. Patients in the SMART study were recruited from 5 University of New Mexico affiliated prenatal clinics. Patients were considered vitamin users if they took vitamins at least 4 times a week. Based on the different time exposure to vitamins, vitamin use was further categorized into three groups: pre-conceptional vitamin users, vitamin users after pregnancy recognition, and vitamin non-users. Chi square and ANOVA were used to identify potential predictors including sociodemographic characteristics, lifestyle characteristics, medical and reproductive health, and medication use. For multivariate analysis, ordinal logistic regression and polychotomous logistic regression model were used. Results: Most pregnant women (71.9%) in the sample began to take vitamins regularly after pregnancy recognition. Earlier vitamin use in pregnancy was significantly associated with pregnancy planning independent of other maternal characteristics. Education level and health insurance status revealed a significant interaction with respect to vitamin use. Lastly, almost one third (32.1%) of women in this study had a history of adverse pregnancy outcomes and 45.0% of women had at least one medical condition. Vitamin non-users were more likely to have experience of adverse pregnancy outcomes in prior pregnancies compared to women who used vitamin after pregnancy recognition. Implication: This study highlights the importance of promoting vitamin use in New Mexico in women of childbearing years prior to conception and in early pregnancy, given the finding that less than one third of women used vitamins during the pre-conceptional period. Public health strategies should also include the promotion of pregnancy planning.

First Advisor

Bakhireva, Ludmila

First Committee Member (Chair)

Bakhireva, Ludmila

Degree Name

Pharmaceutical Sciences

Second Committee Member

Dodd, Melanie

Level of Degree

Masters

Third Committee Member

Georgopoulos, Larry

Department Name

College of Pharmacy

Language

English

Document Type

Thesis

Keywords

Pregnancy--Nutritional aspects, Vitamins in human nutrition, Vitamin therapy--New Mexico.

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