Association Between Preconception Counseling and Folic Acid Supplementation Before Pregnancy and Reasons for Non-Use

Abstract

Objective To examine the relationship between preconception counseling (PCC) on folic acid and folic acid use and reasons for non-use. Methods We analyzed Maryland Pregnancy Risk Assessment Monitoring System (PRAMS) survey responses from women with live births from 2009-2011. Multivariable weighted logistic regression models (n=4426) adjusting for maternal sociodemographics were used to explore the associations between PCC receipt and folic acid use and reasons for non-use. Results Less than 30% of women received folic acid PCC and only 32% of women took folic acid daily prepregnancy. The most common reasons for non-use were “not planning pregnancy” (61%) and “didn't think needed to take” (41%). PCC receipt was associated with three times the odds of folic acid use (adjusted odds ratio [aOR] 3.17, 95% CI 2.48-4.06) and half the odds of reporting “didn't think needed to take” (aOR 0.47, 95% CI 0.28-0.78) as a reason for non-use. Conclusions Folic acid use remains low. Folic acid PCC was associated with increased folic acid use but few women received it. Our data support initiatives to promote provision of folic acid PCC to all women of childbearing age.

Poor Folate Intake in a North Italian Pregnant Population: an Epidemiological Survey

“…Our findings on the correct FA consumption before pregnancy are different from those of other epidemiological studies previously conducted in Italy, as well as in other European and non‐European countries . The studies published in Europe over the past 10 years have reported different results on the intake of FA.…”

Race and ethnicity and preconception folic acid supplement use among pregnant women in Georgia, PRAMS 2009 to 2011

“…Other PRAMS‐based studies have reported similar findings as noted in our study. Maryland PRAMS data (2009–2011) reported significant racial/ethnic differences in the prevalence of preconception folic acid use, where only 20% of Hispanic women reported taking folic acid before conception compared with 35% non‐Hispanic whites (Bixenstine et al, ). Data combined from 29 surveillance systems participating in PRAMS during the year 2009 indicated daily folic acid supplement use differed significantly by race/ethnicity, where the intakes among non‐Hispanic white and Hispanic women were 34% and 22%, respectively (Robbins et al, ), adding support to our findings.…”

“…Apart from race/ethnicity, factors associated with preconception folic acid use among women of child‐bearing age are well researched in the past. Studies have reported lower use among women who were younger, less than high school educated, unmarried, received WIC benefits, had a low family income, had a public insurance or no insurance, had a previous live birth, smokers, or those who used alcohol before pregnancy, did not intend to be pregnant at the time of index pregnancy (McDonnell et al, ; Chacko et al, ; Green‐Raleigh et al, ; D'Angelo et al, ; Khodr et al, ; Robbins et al, ; Bixenstine et al, ). Our results are consistent with findings from these previous studies.…”

Effects of Folic Acid-Fortified Milk Consumption on Serum Folate Levels in Japanese Female Students: a Randomized Controlled Trial Stratified by Methylenetetrahydrofolate Reductase C677T Genetic Polymorphism

“…Generally speaking, women notice signs of pregnancy after 8-12 weeks of gestation and deliberately begin to consume folic acid supplements [10][11][12][13][14][15][16], but it may be too late by then. Folate should be consumed from 4 weeks before to 12 weeks after gestation when neural tubes are formed and closed.…”

“…Supplement consumption rates during the early pregnancy period ranged from 50% to 70% in Japanese women [15,16], which is lower than the 70% to 96% reported in women in western countries [11][12][13][14]. The consumption rates before pregnancy were as low as 20% to 30% in both western countries and Japan [10][11][12][13][14][15][16].…”