A survey of preconceptional folic acid use in a group of Canadian women.
BACKGROUND
Randomized controlled trials have demonstrated that periconceptional folic acid supplementation has a dramatic effect in reducing neural tube defects, one of the most serious congenital anomalies. Unfortunately, supplementation tends to be suboptimal in disadvantaged populations.


OBJECTIVE
The primary objective was to determine patient factors associated with a lack of use of periconceptional folic acid among Canadian women in a multi-ethnic, urban setting. Our secondary objective was to assess patient knowledge about folic acid tablet supplementation and its link to reduced birth defects.


METHODS
We undertook a cross-sectional study to survey postpartum Toronto women on their use and knowledge of periconceptional folic acid.


RESULTS
Of the 383 women surveyed, only 28% took folic acid or a multivitamin containing folic acid during the periconceptional period. Multivariate analysis revealed that the use of periconceptional folic acid was more common among women of Jewish descent (adjusted relative risk [RR] 0.3; 95% confidence interval [CI], 0.04-0.9) and those who had 1 or no children (adjusted RR 0.6; 95% CI, 0.4-0.8). Not taking folic acid was associated with unplanned pregnancy (adjusted RR 1.5; 95% CI, 1.4-1.6) and a lack of knowledge about when folic acid should be taken (adjusted RR 1.8; 95% CI, 1.6-1.8).


CONCLUSIONS
Ethnic background is an independent predictor of periconceptional folic acid use.
Tam
Larissa E
LE
Department of Obstetrics and Gynecology, Scarborough General Hospital, Toronto, Ontario, Canada.
McDonald
Sarah D
SD
Wen
Shi Wu
SW
Smith
Graeme N
GN
Windrim
Rory C
RC
Walker
Mark C
MC
D002170:Canada; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care; D011795:Surveys and Questionnaires; D014505:Urban Population
D005492:Folic Acid