References
Compliance to mineral supplementation among pregnant women at a public health clinic in Malaysia

Abstract
Background
Prenatal supplementation has been introduced to pregnant women during early pregnancy to prevent complication to both mother and fetus. The complications include anaemia, postpartum haemorrhage, low birth weight and fetal defects.
Aim
To assess compliance with vitamin and mineral supplementation in pregnant women.
Methods
A cross-sectional design with simple random sampling was used in this study with 100 respondents who attended the maternal and child clinic in Selangor, Malaysia.
Findings
The findings showed that 86 respondents (86%) were compliance towards vitamin and mineral supplementation, whereas 35 respondents (35%) were non-compliance mainly due to forgetfulness. The result indicated a significant association between compliance with race (p=0.02), occupation (p<0.01), household income (p=0.02), education (p<0.01), parity (p<0.01) and trimester (p=0.02).
Conclusion
Majority of the respondents acknowledge that side effects and forgetfulness were the main influencing factors towards non-compliance.
Prenatal vitamin and minerals supplementation, or hematinics, are essential dur ing pregnancy to promote maternal and child health. The supplements consist of iron (Fe), folic acid, vitamin B12, zinc (Zn), and cobalt (Co). The main function of hematinics is to increase serum erythropoietin level in the blood since the concentration of this serum drops during pregnancy (Hambali et al, 2016).
The common physiological changes that occur during pregnancy include cardiovascular, respiratory, haematological, renal, gastrointestinal and endocrine systems (Tan and Tan, 2013). During pregnancy, the plasma volume increases to approximately around 30–50% (1 200–1 300 ml). The blood volume begins to increase as early as seven weeks of gestation by 10%–15% and the spike occurs at 30–34 weeks of gestation. The red blood cells also increase and this is triggered by an increase in erythropoietin secretion from the kidney. It has been reported that the 18%–25% increment in the red blood cell caused an imbalance towards the 30%–50% increment in the plasma volume, which resulted in anaemia (Tan and Tan, 2013).
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