title: Folate concentrations and folic acid supplementation among women in their first trimester of pregnancy in a rural area with a high prevalence of neural tube defects in Shanxi, China.
abstract: BACKGROUND
  Although an information campaign concerning periconceptional folic acid supplementation was launched in 1998 in Shanxi Province, China, the prevalence of neural tube defects in rural areas was reported as high as 140 per 10,000 births in 2002. The blood folate concentrations and the practice of folic acid supplementation among pregnant women in rural areas of the province are described.
  
  
  METHODS
  A total of 483 pregnant women (mean gestation, 8.1 weeks) in a rural area of Shanxi were interviewed. Nonfasting blood samples and information on folic acid supplementation were collected. Folate concentrations in plasma and erythrocytes were determined by a microbiological assay.
  
  
  RESULTS
  The mean concentrations of plasma and erythrocyte folate for pregnant women was 10.4 nmol/liter and 375.8 nmol/liter, respectively. Deficiencies of plasma and erythrocyte folate were observed in 20.9% and 47.6% of women, respectively. Seasonal variations were noted in the prevalence of folate deficiency, with significantly lower plasma folate concentrations in spring and summer and lower erythrocyte folate concentrations in seasons other than summer. Among pregnant women, <10% reported having taken or currently taking folic acid, and virtually no women (0.6%) took folic acid as recommended.
  
  
  CONCLUSIONS
  Women in rural areas had low plasma and erythrocyte folate levels, and folate deficiency was highly prevalent in the area. Few women followed the recommendations regarding folic acid supplementation, and the information campaign in Shanxi was unsuccessful. These findings suggest the urgent need for combined strategies in rural areas to fortify grain with folic acid and promote folic acid supplements for childbearing-age women.
authors.affiliation: Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing, China.
authors.forename: Le
authors.initials: L
authors.lastname: Zhang
authors.forename: Aiguo
authors.initials: A
authors.lastname: Ren
authors.forename: Zhiwen
authors.initials: Z
authors.lastname: Li
authors.forename: Ling
authors.initials: L
authors.lastname: Hao
authors.forename: Yihua
authors.initials: Y
authors.lastname: Tian
authors.forename: Zhu
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D002681:China; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D015995:Prevalence
chemical_list: D005492:Folic Acid