Prenatal micronutrient supplements are cost-effective in reducing nutritional deficiencies and adverse pregnancy and birth outcomes. However, poor adherence remains a potential barrier to the successful implementation of these supplementation programs. This systematic review assessed the effectiveness of interventions designed to increase adherence to prenatal micronutrient supplementation. Following the Cochrane Collaboration Methodology, literature searches were conducted in six electronic databases and gray literature (on July 24, 2020), and abstract screening, data extraction, and risk of bias assessment were conducted independently by two reviewers. We included 22 studies. Interventions that resulted in increased adherence were most of the education-based strategies, consumption monitoring by volunteer health workers or family members, SMS reminders, free provision of supplements, a multicomponent intervention with community mobilization, and a participatory action research intervention. In several studies, increased adherence was accompanied by beneficial effects on pregnancy and birth outcomes. Given the heterogeneity of study designs and methods used to define and measure adherence, a meta-analysis was not appropriate. We identified several potentially effective strategies to improve supplementation adherence, which may need to be adapted to specific contexts when considered for program implementation. However, additional high-quality studies are critically needed to effectively guide policies and programs.

中文翻译：

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增加孕期微量营养素补充依从性的干预措施：系统评价

产前微量营养素补充剂在减少营养缺乏和不良妊娠和分娩结果方面具有成本效益。然而，依从性差仍然是成功实施这些补充计划的潜在障碍。该系统评价评估了旨在提高对产前微量营养素补充依从性的干预措施的有效性。遵循 Cochrane 协作方法，在 6 个电子数据库和灰色文献中进行文献检索（2020 年 7 月 24 日），由两名审稿人独立进行摘要筛选、数据提取和偏倚风险评估。我们纳入了 22 项研究。导致依从性增加的干预措施大多是基于教育的策略、志愿卫生工作者或家庭成员的消费监测、短信提醒、免费提供补充剂、社区动员的多组分干预以及参与式行动研究干预。在几项研究中，增加的依从性伴随着对妊娠和分娩结果的有益影响。鉴于用于定义和衡量依从性的研究设计和方法的异质性，荟萃分析是不合适的。我们确定了几种潜在有效的策略来提高补充剂的依从性，在考虑计划实施时可能需要适应特定的环境。然而，迫切需要额外的高质量研究来有效地指导政策和计划。增加的依从性伴随着对妊娠和分娩结果的有益影响。鉴于用于定义和衡量依从性的研究设计和方法的异质性，荟萃分析是不合适的。我们确定了几种潜在有效的策略来提高补充剂的依从性，在考虑计划实施时可能需要适应特定的环境。然而，迫切需要额外的高质量研究来有效地指导政策和计划。增加的依从性伴随着对妊娠和分娩结果的有益影响。鉴于用于定义和衡量依从性的研究设计和方法的异质性，荟萃分析是不合适的。我们确定了几种潜在有效的策略来提高补充剂的依从性，在考虑计划实施时可能需要适应特定的环境。然而，迫切需要额外的高质量研究来有效地指导政策和计划。在考虑计划实施时，可能需要根据具体情况进行调整。然而，迫切需要额外的高质量研究来有效地指导政策和计划。在考虑计划实施时，可能需要根据具体情况进行调整。然而，迫切需要额外的高质量研究来有效地指导政策和计划。