Dietary Folate Intake and Folic Acid Supplements among Pregnant Women from Southern Italy: Evidence from the “Mamma &amp; Bambino” Cohort

Barchitta, Martina; Maugeri, Andrea; Lio, Roberta Magnano San; Favara, Giuliana; Mastra, Claudia La; Rosa, Maria Clara La; Agodi, Antonella

doi:10.3390/ijerph17020638

Cited by 28 publications

(23 citation statements)

References 72 publications

(95 reference statements)

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“… 5 However, the finding is higher than studies conducted in Dembia (52.9%), 15 Aykel (47.6%), 24 North Wollo (43.1%), 25 Hawassa (38.3), 26 Debre Tabor town, 17 and Southern Italy (22.4%). 38 This difference might be due to multiple ANC visits (three and above) (55.8%) and majority of them are multigravid (80%) in this study; this leads them to receive counseling from health care providers about IFA. In contrast the finding is lower than studies conducted in India (80.5%), 27 the Philippines (85%) 28 and Vietnam (85%).…”

Section: Discussionmentioning

confidence: 79%

Adherence to Iron with Folic Acid Supplementation Among Pregnant Women Attending Antenatal Care in Public Health Centers in Simada District, Northwest Ethiopia: Using Health Belief Model Perspective

Mekonnen¹,

Alemnew²,

Zegeye³

et al. 2021

PPA

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Introduction Even though the World Health Organization recommends daily oral iron with folic acid (IFA) supplementation as part of the antenatal care to prevent anemia, still the utilization remains low in Sub-Saharan Africa, particularly in Ethiopia. Therefore, the aim of this study was to assess the magnitude of adherence of iron with folic acid supplementation and associated factors among pregnant women who were attending antenatal care (ANC). Methods A facility-based cross-sectional study was conducted from February 24 to March 23, 2020. Four hundred and twenty-two participants were selected using systematic random sampling technique. Data were collected using a structured questionnaire through face-to-face interview. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Bivariate and multivariable logistic regression analyses were done to identify associated factors of adherence, and P <0.05 was used as cutoff to determine statistical significance at multivariable logistics regressions. Results In this study, 414 (98%) pregnant women participated. The mean age of the respondents was 28.69 ±SD 5.49 years. The magnitude of adherence of IFA supplementation among pregnant women was 67.6% (95%CI: 63.3–72.5). Pregnant women who had a past history of preterm delivery (AOR=3.70; 95%CI: 1.46–9.37), counseling on IFA supplementation (AOR=2.28; 95%CI: 1.15–4.53), high perceived benefit (AOR=2.72; 95%CI: 1.25–5.90) and high self-efficacy (AOR=2.91; 95%CI: 1.40–6.04) were found to be significant associated factors of adherence to IFA supplementation. Conclusion In this study, adherence to IFA supplementation among pregnant women is relatively high. Past history of preterm delivery, counseling on IFA supplementation, perceived benefit and self-efficiency had association with adherence to IFA supplementation. Proper counseling and health education should be given to pregnant women to increase their adherence.

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Section: Discussionmentioning

confidence: 79%

Adherence to Iron with Folic Acid Supplementation Among Pregnant Women Attending Antenatal Care in Public Health Centers in Simada District, Northwest Ethiopia: Using Health Belief Model Perspective

Mekonnen¹,

Alemnew²,

Zegeye³

et al. 2021

PPA

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“…We used data from the “Mamma & Bambino” cohort, an ongoing Italian birth cohort whose study design and protocols are fully described elsewhere [ 20 , 21 , 22 , 23 ]. Further information can be also found at the website .…”

Section: Methodsmentioning

confidence: 99%

The Impact of Socio-Demographic Factors on Breastfeeding: Findings from the “Mamma & Bambino” Cohort

et al. 2021

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Background and objectives: The World Health Organization (WHO) recommends women (1) to initiate breastfeeding within one hour of birth; (2) to exclusively breastfeed for the first six months; and (3) to continue breastfeeding until two years of age. However, women do not always adhere to these recommendations, threatening the health of their children. The present study aims to evaluate breastfeeding status and the main maternal factors associated with exclusive breastfeeding for six months among women from the “Mamma & Bambino” study, a prospective cohort settled in Catania, Italy. Materials and Methods: We used data from 220 women (median age = 37 years) enrolled in the “Mamma & Bambino” cohort during prenatal obstetric counselling. Self-reported breastfeeding status was collected during the follow-up interviews at 1 and 2 years, referring to breastfeeding status (i.e., yes or no) and type of breastfeeding (i.e., exclusive or predominant). We also collected data about duration of breastfeeding to classify women into those who adhered to the WHO recommendation and those who did not. Results: In the general population, we noted that the proportion of women who have breastfed increased with increasing educational level. Accordingly, logistic regression analysis demonstrated that medium (OR = 3.171; 95% CI = 1.285–7.822; p = 0.012) and high educational levels (OR = 4.549; 95% CI = 1.525–13.570; p = 0.007) were positively associated with breastfeeding if compared to low educational level. Among women who have breastfed, instead, the proportion of adherents to the WHO recommendation was higher among those with medium–high educational level and those who were employed. In line with this, we demonstrated that full-time employment (OR = 2.158; 95% CI = 1.033–4.508; p = 0.041) and medium educational level (OR = 4.632; 95% CI = 1.227–17.484; p = 0.024) were positively associated with exclusive breastfeeding for the first six months. Conclusions: Socio-demographic factors should be taken into account through public health strategies for improving maternal knowledge about health benefits of exclusive breastfeeding.

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“…Though it is clear that obese women have a lower intake of folate, obesity is associated with other factors that are subsequently determinants of a lower intake of folate. Earlier studies indicated that smoking, lifestyle, age, parity, educational level, income level, and whether the pregnancy was planned were determinants of folate intake [ 20 , 21 ]. In a multivariable model, maternal weight status was independently associated with adequate use of folic acid, even after excluding women with an unplanned pregnancy [ 20 ].…”

Section: Epidemiology Of Folate Deficiency In Obese (Pre)pregnant mentioning

confidence: 99%

Epidemiology and (Patho)Physiology of Folic Acid Supplement Use in Obese Women before and during Pregnancy

et al. 2021

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Preconception folic acid supplement use is a well-known method of primary prevention of neural tube defects (NTDs). Obese women are at a higher risk for having a child with a NTD. As different international recommendations on folic acid supplement use for obese women before and during pregnancy exist, this narrative review provides an overview of epidemiology of folate deficiency in obese (pre)pregnant women, elaborates on potential mechanisms underlying folate deficiency, and discusses considerations for the usage of higher doses of folic acid supplements. Women with obesity more often suffer from an absolute folate deficiency, as they are less compliant to periconceptional folic acid supplement use recommendations. In addition, their dietary folate intake is limited due to an unbalanced diet (relative malnutrition). The association of obesity and NTDs also seems to be independent of folate intake, with studies suggesting an increased need of folate (relative deficiency) due to derangements involved in other pathways. The relative folate deficiency, as a result of an increased metabolic need for folate in obese women, can be due to: (1) low-grade chronic inflammation (2) insulin resistance, (3) inositol, and (4) dysbiotic gut microbiome, which plays a role in folate production and uptake. In all these pathways, the folate-dependent one-carbon metabolism is involved. In conclusion, scientific evidence of the involvement of several folate-related pathways implies to increase the recommended folic acid supplementation in obese women. However, the physiological uptake of synthetic folic acid is limited and side-effects of unmetabolized folic acid in mothers and offspring, in particular variations in epigenetic (re)programming with long-term health effects, cannot be excluded. Therefore, we emphasize on the urgent need for further research and preconception personalized counseling on folate status, lifestyle, and medical conditions.

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Dietary Folate Intake and Folic Acid Supplements among Pregnant Women from Southern Italy: Evidence from the “Mamma & Bambino” Cohort

Cited by 28 publications

References 72 publications

Adherence to Iron with Folic Acid Supplementation Among Pregnant Women Attending Antenatal Care in Public Health Centers in Simada District, Northwest Ethiopia: Using Health Belief Model Perspective

Adherence to Iron with Folic Acid Supplementation Among Pregnant Women Attending Antenatal Care in Public Health Centers in Simada District, Northwest Ethiopia: Using Health Belief Model Perspective

The Impact of Socio-Demographic Factors on Breastfeeding: Findings from the “Mamma & Bambino” Cohort

Epidemiology and (Patho)Physiology of Folic Acid Supplement Use in Obese Women before and during Pregnancy

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