Serum Levels of Folic Acid, Nutritional Folic Acid Consumption and Reported Adherence with Folic Acid Supplementations among Pregnant Women

Abstract

ISEE-0654 Background and Objective: Folic acid (FA) taken adequately reduces the risk of open neural tube defects. Israeli Ministry of Health recommends daily dose of 400 mcg of FA by women of childbearing age with emphasis on 3 preconception months and first trimester of pregnancy. This study examined: 1) serum level of FA among Jewish and Bedouin pregnant women; 2) reported adherence with recommended FA supplementations; 3) association between serum level of FA and reported adherence with FA supplementations. Methods: Cross-sectional study. 260 low SES women (134 Jewish and 126 Bedouin) who began pregnancy follow-up in antenatal Maternal and Child clinic in desert of southern Israel during 2005–2006, were included. After giving written informed consent, women were interviewed regarding their socio-demographic status, obstetric history and adherence with FA supplementations. Assessment of dietary consumption of FA was carried out in Jewish women using food frequencies questionnaire. Serum levels of FA were obtained. Results: Serum level of FA was higher in Jewish (15.0 ± 6.5ng/ml) than in Bedouin (9.6 ± 5.3 ng/ml) women, P < 0.001. 27% of Bedouins women had a marginal FA deficiency (serum level < 6 ng/ml), compared with 7% of Jewish women (P < 0.001). 77.6% of Jewish and 38.4% of Bedouin reported consuming FA supplementations (P < 0.001). Mean nutritional FA consumption in Jewish group was 354 ± 195 mcg/day (recommendation of 600 mcg /day). 18.5% of women were found to both consume less than 600 mcg /day and show poor compliance to FA supplementations. From multivariate linear regression model, independent risk factors for lower FA serum level were: reported non-adherence with FA supplementations, Bedouin origin, younger age, higher order of present pregnancy and higher gestational age (P < 0.001, P = 0.018, P = 0.002, P = 0.005, P = 0.004, respectively). Conclusions: Development of strategies to increase awareness about FA supplementation using at childbearing age and environmental changes such as fortification methods is urgent in low SES populations.