Prevalence of periconceptional folic acid use and perceived barriers to the postgestation continuance of supplemental folic acid: Survey results from a Teratogen Information Service

Goldberg, Beck; Alvarado, Sonia; Chavez, Carmen; Chen, Brian H.; Dick, Lyn M.; Felix, Robert J.; Kao, Kelly; Chambers, Christina D.

doi:10.1002/bdra.20239

Cited by 32 publications

(28 citation statements)

References 31 publications

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“…We found the most common reasons for not taking folic acid were “not planning pregnancy” and “didn't think needed to take.” These findings are similar to those of two smaller-scale studies, one focused on folic acid intake among women with recent pregnancies 16 and another on women reporting to gynecologic visits, 22 which found “not planning pregnancy” to be the most common reason for not taking folic acid. Surveys of women 18-45, who may or may have been planning pregnancy, have also found “not think needed” as a common reason, endorsed by 16-20% of women among this population, second only after “forgetting.” 17 …”

Section: Discussionsupporting

confidence: 84%

“…The most recent national estimates suggest that only 30% of women with a recent pregnancy used folic acid daily before they became pregnant, 11 with lower rates among those who are non-White, younger, or have unintended pregnancies. 13,14 Prior studies of the reasons women do not take folic acid have been limited in size 15,16 or have not focused on women before pregnancy, when use is most important. 17 …”

Section: Introductionmentioning

confidence: 99%

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

Bixenstine

Cheng

et al. 2015

Matern Child Health J

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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.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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

Bixenstine

Cheng

et al. 2015

Matern Child Health J

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“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Generally, fewer than half the women took any folic acid, comparable with our findings. In some studies less than 10% of women reported having taken folic acid.…”

Section: Comparison With Other Studiessupporting

confidence: 88%

“…Various surveys have asked pregnant women or those who have recently delivered a baby about their lifestyle and folic acid intake around conception. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] However, the information obtained in this way is subject to recall bias. To our knowledge no studies have assessed women drawn from the general population when they were not pregnant and followed to pregnancy and beyond.…”

Section: Introductionmentioning

confidence: 99%

Women's compliance with nutrition and lifestyle recommendations before pregnancy: general population cohort study

Inskip¹,

Crozier²,

Godfrey³

et al. 2009

BMJ

179

131

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Objective To examine the extent to which women planning a pregnancy comply with recommendations for nutrition and lifestyle. Design Prospective cohort study. Setting Southampton, United Kingdom. Participants 12 445 non-pregnant women aged 20-34 recruited to the Southampton Women's Survey through general practices, 238 of whom became pregnant within three months of being interviewed. Main outcome measures Folic acid supplement intake, alcohol consumption, smoking, diet, and physical activity before pregnancy. Results The 238 women who became pregnant within three months of the interview were only marginally more likely to comply with recommendations for those planning a pregnancy than those who did not become pregnant in this period. Among those who became pregnant, 2.9% (95% confidence interval 1.2% to 6.0%) were taking 400 μg or more of folic acid supplements a day and drinking four or fewer units of alcohol a week, compared with 0.66% (0.52% to 0.82%) of those who did not become pregnant. 74% of those who became pregnant were nonsmokers compared with 69% of those who did not become pregnant (P=0.08). Women in both groups were equally likely to consume five or more portions of fruit and vegetables a day (53% in each group, P=1.0), but only 57% of those who became pregnant had taken any strenuous exercise in the past three months compared with 64% in those who did not become pregnant (P=0.03). Conclusion Only a small proportion of women planning a pregnancy follow the recommendations for nutrition and lifestyle. Greater publicity for the recommendations is needed, but as many pregnancies are unplanned, improved nutrition and lifestyles of women of childbearing age is also required.

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“…Between 2000 and 2002, the proportion of FA compliers among DNBC participants who planned their pregnancy increased from 14% to only 22%, and thus remained low even after the campaigns 4,5. Several retrospective studies of pregnant women in other countries also reported poor compliance, with 12% of women in the UK,6 17% in Norway,7 23–30% in Australia8,9 and 44% in the US10 reporting FA supplement use in the preconception period. In addition, a prospective cohort study reported that only 6% of the women who became pregnant within 3 months of being interviewed in a general woman’s survey in the UK followed the FA recommendation 11…”

Section: Introductionmentioning

confidence: 99%

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

Cueto¹,

Riis²,

Hatch³

et al. 2012

CLEP

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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.

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Prevalence of periconceptional folic acid use and perceived barriers to the postgestation continuance of supplemental folic acid: Survey results from a Teratogen Information Service

Cited by 32 publications

References 31 publications

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

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

Women's compliance with nutrition and lifestyle recommendations before pregnancy: general population cohort study

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

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