Predictors of preconceptional folic acid or multivitamin supplement use: a cross-sectional study of Danish pregnancy planners

Abstract

PurposeCompliance with the Danish preconceptional folic acid (FA) recommendation – a daily supplement of 400 μg – is reported to be poor. Uncertainty remains, however, about the prevalence of compliers and health-related predictors of compliance in the preconceptional period.MethodsWe used self-reported baseline data from 5383 women, aged 18–40 years, enrolled in an Internet-based prospective cohort study of Danish pregnancy planners during 2007–2011. We estimated the prevalence proportions of FA or multivitamin (MV) use in relation to selected sociodemographic, lifestyle, reproductive, and medical characteristics. Multivariate binomial regression was used to obtain prevalence proportion differences with 95% confidence intervals for each level of study predictors, adjusted for all other predictors.ResultsOverall, 7.7% of women used FA supplements, 20.4% used MV supplements, 34.0% used both, 1.5% used other single vitamins or minerals, and 36.4% did not use any dietary supplements. The prevalence of FA or MV supplement use was higher among older women, women with higher education and income, and women with healthy lifestyle factors such as being a nonsmoker, nondrinker, physically active, maintaining a normal body mass index and having regular pap smears. Greater intercourse frequency and a history of spontaneous abortion were also positively associated with FA or MV supplement use. We found no clear association between use of FA or MV supplements and a diagnosis of hypertension, diabetes, thyroid disease, pelvic inflammatory disease, or chlamydia.ConclusionA large proportion of pregnancy planners do not use FA or MV supplements. Pregnancy planners with generally risky lifestyle behaviors are less likely to comply with the FA recommendation.

Limited knowledge about folic acid and iodine nutrition in pregnant women reflected in supplementation practices

“…The cost of supplements ranged widely at the time of our study, from $5.95 to $65.95. These findings are confirmed by another Australian study, as well as studies from other countries (USA, Denmark, China, Canada), and similar findings have been reported where education level is lower …”

Maternal and health care determinants of preconceptional use of folic acid supplementation in France: results from the 2010 National Perinatal Survey

“…In our study, the fairly low prevalence of folic acid use among these women suggests that the medical visits did not have an important effect on folic acid use. 10 On the other hand, the highest percentage of folic acid use in our population was observed among women who underwent in vitro fertilisation. French hospital fertility programmes usually include folic acid in the prescription for ovulation induction.…”

“…[6][7][8][9][10]14,[16][17][18][19][20] This may be explained by the lower importance attributed to prevention and limited access to medical information in less advantaged social classes. In particular, knowledge about folic acid is lower among women of lower social position and of high parity.…”

“…Moreover, studies of the determinants of folic acid intake have rarely considered the role of the medical providers consulted before conception. 9,10 We hypothesised that, in addition to maternal sociodemographic characteristics, 9 healthcare providers can play an important role in women's decision to use folic acid supplementation before pregnancy. To test this hypothesis, we examined the prevalence of folic acid use for women who had to have specific medical visits before pregnancy.…”

Folic acid supplement use and menstrual cycle characteristics: a cross-sectional study of Danish pregnancy planners

“…37 Such health behaviors also may be related to menstrual cycle function which may confound the estimates. 7;8;10;14 In the regression models we adjusted for several lifestyle factors, and it seems unlikely that an underlying health factor would meaningfully affect the associations.…”