Department of Statistics Malaysia. Department of Statistics Malaysia Press Release Report of household income and basic amenities survey 2016. 2017. (accessed 15 August 2018)

Demailly R, Escolano S, Quantin C, Tubert-Bitter P, Ahmed I Prescription drug use during pregnancy in France: a study from the national health insurance permanent sample. Pharmacoepidemiology and Drug Safety. 2017; 26:(9)1126-1134

Compliance and its determinants regarding iron and folic acid supplementation during pregnancy in Kathmandu, Nepal. 2016.

Sadore AA, Gebretsadik LA, Hussen MA Compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha District, South Ethiopia: community based cross-sectional study. Journal of Environmental and Public Health. 2015; 1-8

Sajith M, Nimbargi V, Agiwale J, Shah S, Tekawade S, Pawa A Correlations of adherence to iron supplements and prevalence of anemia in antenatal women. International Journal Reproductive Contraceptive Obstetric and Gynecology. 2016; 5:(10)3448-3452

Meningkatkan Pengurusan yang Efektif bagi Ibu Hamil dengan Anemia di Klinik Kesihatan. 2011.

Tan EK, Tan EL Alterations in physiology and anatomy during pregnancy. Best Practice and Research Clinical Obstetrics and Gynaecology. 2013; 27:(6)791-802

Taye B, Abeje G, Mekonen A Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: a cross-sectional study. Pan African Medical Journal. 2015; 20

Compliance to vitamin and mineral supplementation among pregnant women in urban and rural areas in Malaysia. 2010.

UNESCO Institute of Statistics. Participation in education. 2018. (accessed 21 August 2018)

How to use pharmacy claims data to measure patient nonadherence? The example of oral diabetics in therapy of type 2 diabetes mellitus. European Journal Health Econyclopedia. 2012; 14:551-568

Adequacy of antenatal care: associated factors and pregnancy outcomes among women attending public health clinics in Selangor, Malaysia. 2016. (accessed 21 August 2018)

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

02 June 2021
Volume 29 · Issue 6



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.


To assess compliance with vitamin and mineral supplementation in pregnant women.


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.


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).


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).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month