Are migrants during the periconception period less likely to be supplementing with folic acid: An Australian cohort study

Abstract

BackgroundFolic acid (FA) supplementation before and in early pregnancy is known to improve outcomes such as reducing neural tube defects; however, little is known about groups in Australia at risk of low FA use. AimTo determine whether differences exist in FA supplementation rates between Australian-born women and migrant women, with a secondary aim of examining the sociodemographic characteristics of women who are not supplementing with FA in early pregnancy. MethodsA retrospective cohort study from January 2018–July 2022 in a high-migrant population in Western Sydney, Australia. Multivariate logistic regression analysis was conducted adjusting for confounders including place of birth, age, ethnicity, parity, history of diabetes, and type of conception. FindingsThere were 48,045 women who met inclusion criteria; 65% of whom were migrants. We identified that 39.4% of the study population did not report FA supplementation by early pregnancy. Women who were migrants were more likely to report FA usage than those born in Australia (aOR 1.24; 95%CI 1.17–1.31). Women least likely to report use of FA were women < 20 years of age (aOR 0.54; 95%CI 0.44–0.67) and multiparous women (aOR 0.84; 95%CI 0.82–0.86). Women with type 1 or type 2 diabetes were more likely to report FA use (aOR 1.66; 95%CI 1.11–2.48, aOR 1.30; 95%CI 1.05–1.61). ConclusionA significant proportion of the population did not report FA supplementation before or during early pregnancy. To increase uptake of FA supplementation, clinicians and public health messaging should target at-risk groups.