Abstract
BackgroundWomen in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants. This study aimed to update the prevalence and to identify possible determinants of preconception folic acid supplement use in Italian women.MethodsThe study was based on cross-sectional data from seven maternity clinics located in six Italian regions from January to June, 2012. Data on maternal characteristics and supplement use were collected for 2,189 women using a self-administered questionnaire.ResultsPreconception folic acid use was reported by 23.5 % (n = 515) of the participants. Of these, 479 (93 %) women had taken folic acid supplements on a daily basis as recommended by the health authorities. Women who both had intended their pregnancy and had requested a preconception health visit to a doctor/gynecologist were substantially more likely than the reference group to initiate folic acid supplementation before their pregnancy (48.6 versus 4.8 %). Preconception folic acid use was also associated with higher maternal age, higher education, marriage/cohabitation, lower parity, infertility treatments, and chronic disease.ConclusionsData from seven maternity clinics located in six Italian regions indicate that preconception folic acid supplement use in many Italian women is low. Women who do not plan their pregnancy or do not request a preconception health visit to their doctor have among the lowest prevalence of preconception folic acid use. Improving folate status in these and other supplemental non-users may have important disease preventive effects.
Highlights
Women in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants
Of the 2,189 participating women, the mean maternal age was 33 (IQR: 29–37; range 13–50) years; only 6 % were younger than 25 years while 40 % were older than 35 years (Table 1)
Our study showed that 84 % of women had taken folic acid supplements at some time point before and/or during the pregnancy but that only 23.5 % of the participants had initiated use before the onset of pregnancy
Summary
Women in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants. The recommendations usually indicate a dose of 0.4 mg folic acid daily from at least one month before pregnancy until the third month of gestation. In addition to such recommendations, a number of countries have introduced mandatory food fortification of grains with folic acid to increase intake of this B-vitamin in fertile. The total prevalence of neural tube defects in Europe has not declined markedly over the Nilsen et al Italian Journal of Pediatrics (2016) 42:65 years [3, 10, 11] This has led to a debate regarding the efficiency of folic acid recommendations in Europe and other countries [12, 13]
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