Factors associated with not using folic acid supplements preconceptionally

Abstract

Objective: Neural tube defects are among the most common birth defects worldwide. Folic acid intake from one month before to three months after conception reduces the likelihood of neural tube defects by at least 50 %. Since 1995, several campaigns have been organised in the Netherlands which resulted in 51 % of pregnant women using folic acid supplements during the entire recommended period in the northern part of the Netherlands in 2005. Our research question was to gain insight into the current prevalence and factors associated with inadequate pregnancy-related use of folic acid supplements. Design: Data from the DELIVER study were used, which is a population-based cohort study. Setting: Twenty midwifery practices across the Netherlands in 2009 and 2010. Subjects: In total 5975 pregnant women completed a questionnaire covering items on sociodemographic and lifestyle factors, including folic acid intake. Results: Of our study population, 55?5 % (3318/5975) used folic acid supplements before conception. Several sociodemographic and lifestyle factors were associated with no preconception use of folic acid, of which non-Western ethnicity and not having a partner had the largest effect size. Conclusions: In the Netherlands, the folic acid intake before conception is suboptimal and has not improved over recent years. Fortification of staple foods with folic acid should be reconsidered as it would provide a more effective means of ensuring an adequate intake, especially for those groups of women who are unlikely to plan their pregnancies or to receive or respond to health promotion messages.

Periconceptional folic acid supplementation and vitamin B₁₂ status in a cohort of Chinese early pregnancy women with the risk of adverse pregnancy outcomes

“…(22–24) It indicated that health education should be strengthened, specially making more efforts on prepregnancy education and cooperating with public media. Agreement with other studies, (23,25) the ones with higher education levels, income, multiparous and age were more likely to take folic acid before pregnancy. Therefore, preconceptional health education should take more concern on the pregnant women with lower education levels, income and nulliparous.…”

Patterns and Determinants of Preconception Health Behaviors in Iranian Women

“…Riazi reported that although 80% of women had planned pregnancies, only 9% used folic acid in the preconception period (18). In the Mannien et al's study, 55.5% of women used folic acid in the preconception period (27). In the present study, 48% of women who attended a PCC clinic routinely used folic acid supplements, while this rate was 20% in women who did not attend the clinic before pregnancy.…”

Determinants of prenatal health care utilisation by low-risk women: A prospective cohort study

“…Both folic acid utilisation and passive smoking may act as proxy indicators for a less healthy lifestyle. 24,25 Inadequate health care utilisation can also be an expression of a less healthy lifestyle or less health consciousness. 24 However, we were not able to test this hypothesis, and thus it requires further research.…”