Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months.
OBJECTIVE
To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies.


METHODS
This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression.


RESULTS
Thirty-eight (65.5%) preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times.


CONCLUSIONS
Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.
Universidade Federal de Viçosa (UFV), Departamento de Medicina e Enfermagem, Viçosa/MG, Brazil.
Brunnella Alcantara Chagas de
BA
Freitas
Universidade Federal de Viçosa (UFV), Departamento de Medicina e Enfermagem, Viçosa/MG, Brazil.
Luciana Moreira
LM
Lima
Fundação Oswaldo Cruz, Instituto Fernandes Figueira, Rio de Janeiro/RJ, Brazil.
Maria Elisabeth Lopes
ME
Moreira
Universidade Federal de Viçosa (UFV), Departamento de Nutrição e Saúde, Viçosa/MG, Brazil.
Silvia Eloiza
SE
Priore
Universidade Federal de Viçosa (UFV), Departamento de Medicina e Enfermagem, Viçosa/MG, Brazil.
Bruno David
BD
Henriques
Centro Viva Vida de Referência Viçosa e Região de Saúde, Viçosa/MG, Brazil.
Carla Fernanda Lisboa Valente
CF
Carlos
Centro Viva Vida de Referência Viçosa e Região de Saúde, Viçosa/MG, Brazil.
Jusceli Souza Nogueira
JS
Sabino
Universidade Federal de Viçosa (UFV), Departamento de Nutrição e Saúde, Viçosa/MG, Brazil.
Sylvia do Carmo Castro
Sdo C
Franceschini
D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D000751:Anemia, Neonatal / Q000188:drug therapy* / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D019587:Dietary Supplements / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D015995:Prevalence; D011446:Prospective Studies; D012016:Reference Values; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology*; D015032:Zinc / Q000097:blood / Q000172:deficiency*; D016903:Drug Monitoring
D018977:Micronutrients; D007501:Iron; D015032:Zinc