Preconception Folic Acid Supplement Use in Immigrant Women (1999-2016).

Roy M Nilsen,Vigdis Aasheim,Anne K Daltveit,Ragnhild B Strandberg,Marjolein M Iversen,Rhonda Small,Marit G Sandberg,Erica Schytt,Eline S Vik

doi:10.3390/nu11102300

Roy M Nilsen, Vigdis Aasheim + Show 7 more

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https://doi.org/10.3390/nu11102300

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This study examines how preconception folic acid supplement use varied in immigrant women compared with non-immigrant women. We analyzed national population-based data from Norway from 1999–2016, including 1,055,886 pregnancies, of which 202,234 and 7,965 were to 1st and 2nd generation immigrant women, respectively. Folic acid supplement use was examined in relation to generational immigrant category, maternal country of birth, and length of residence. Folic acid supplement use was lower overall in 1st and 2nd generation immigrant women (21% and 26%, respectively) compared with Norwegian-born women (29%). The lowest use among 1st generation immigrant women was seen in those from Eritrea, Ethiopia, Morocco, and Somalia (around 10%). The highest use was seen in immigrant women from the United States, the Netherlands, Denmark, and Iceland (>30%). Folic acid supplement use increased with increasing length of residence in immigrant women from most countries, but the overall prevalence was lower compared with Norwegian-born women even after 20 years of residence (adjusted odds ratio: 0.63; 95% confidence interval: 0.60–0.67). This study suggests that immigrant women from a number of countries are less likely to use preconception folic acid supplements than non-immigrant women, even many years after settlement.

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Maternal use of folic acid supplements before and in early pregnancy can prevent a child from having a neural tube defect (NTD) [1]
Compared with non-immigrant women, 1st and 2nd generation immigrant women overall had a higher proportion of the lowest educational level (Table 1)
First generation immigrant women overall had the highest proportion of the lowest income category, while 2nd generation immigrant women had younger age at birth and were more often primiparous (Table 1)

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Introduction

Maternal use of folic acid supplements before and in early pregnancy can prevent a child from having a neural tube defect (NTD) [1] This has led numerous countries worldwide to fortify their foods with folic acid to increase the uptake of this B vitamin in women of reproductive age [2]. Nutrients 2019, 11, 2300 begin folic acid supplementation before becoming pregnant, in addition to consuming food folate from a varied diet [3,4] Despite these recommendations having been in place for years, the use of preconception folic acid supplements among pregnant women is overall still low, and many women start supplementation too late with respect to NTD prevention [5,6]. Folic acid supplement use varies considerably among countries [9], and several studies suggest that being an immigrant or having a foreign background is a strong determinant for low use [10,11,12,13,14,15,16]

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