Abstract

Objective: This study aimed to assess the adherence to folic acid and iron (FAI) supplements among pregnant females and analyze the reasons for poor compliance.
Methods: A cross-sectional survey involved 206 pregnant women at Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia. Demographic data were collected, and the associations between these characteristics and the barrier to compliance were examined.
Results: The mean age of all participants was 30 ± 1.1 years, most of whom were aged between 21 and 36 years. The majority had at least a secondary education (41.7%), and many held university or postgraduate degrees (30.1%). About two-thirds were employed, and just over half reported a moderate monthly income. A small number had medical conditions such as hypertension, diabetes, or hypothyroidism. Most participants were multigravida and interviewed during the second trimester. Almost all women reported taking FAI supplements, mainly prescribed by physicians. Many started supplementations in the first trimester (59.2%), although a considerable number began later (41.8%). While overall uptake was high, more than a quarter (n = 56) reported challenges with consistent use. Common barriers included side effects (especially from iron), advice from others to stop, forgetfulness, and pill fatigue (p < 0.05). Some women were unsure about the benefits or worried about possible harm to the fetus.
Conclusion: Older women who had a higher level of education, were not employed, or had existing medical conditions, showed significantly better adherence to supplementation. On the other hand, monthly income and number of previous pregnancies and deliveries did not show a significant relationship with compliance.

Key words: Folic acid, iron supplements, adherence, pregnancy, Saudi Arabia