The use of folic acid and other vitamins before and during pregnancy in a group of women in Melbourne, Australia

Abstract

Objective to explore the use of folic acid and other vitamin supplements before and during pregnancy, including type, dosage and form; who recommended supplement use and for what reason; and women's understanding of why they took folic acid. Design cross-sectional survey. Setting a public tertiary referral hospital in Melbourne, Australia. Participants consecutive pregnant women at 36–38-weeks gestation completed a self-administered survey (available in English, Cantonese, Vietnamese, Turkish and Arabic). Measurements a structured questionnaire was used. Descriptive statistics are presented, with stratified and regression analyses to compare sub-groups. Findings of 705 eligible women, 588 (83%) agreed to participate. Of these, 88 (15%) completed the questionnaire in a language other than English. Twenty-nine per cent (168/588) of women took pre-pregnancy folic acid supplements. Only 23% reported taking a folic acid supplement for at least 4 weeks before pregnancy. During pregnancy, 79% of women took folic acid, most of whom commenced before 13 weeks. Other vitamin supplements taken during pregnancy were iron (52%), calcium (24%), Vitamin B6 (14%), pregnancy multivitamins (35%) and zinc (7%). Only 8% took no supplements at all in pregnancy. Factors associated with an increased risk of not taking folic acid were income ⩽$30,000 (AUD) (adjusted odds ratio (OR) 2.85, 95% CI 1.84, 4.40), smoking during pregnancy (adjusted OR 2.3, 95% CI 1.26, 4.48) and having other than a first baby (adjusted OR 1.89, 95% CI 1.22, 2.93). Key conclusions uptake of folic acid supplementation in the periconceptional period was well below the target that all women planning pregnancy consume 0.4–0.5 mg of folate per day. Less than one-third of this sample took a pre-pregnancy folic acid supplement, with differences in uptake by group. A large proportion of respondents also took a range of other vitamin supplements during pregnancy. Implications for practice it is important to target women who are less likely to take periconceptional folic acid as well as to increase awareness among women of childbearing age in general.