title: Dietary folate intake, use of folate supplements, lifestyle factors, and serum folate levels among pregnant women in Tokyo, Japan.
abstract: OBJECTIVE
  The aim of this study was to determine the folate status of pregnant women and how it is affected by dietary folate, use of folate supplements, and lifestyle factors (smoking and drinking habits).
  
  
  METHODS
  This cross-sectional study involved 537 healthy, pregnant women attending an obstetric clinic in a Tokyo suburb. Morning blood samples were taken to determine serum folate levels. A brief, self-administered diet history questionnaire and another questionnaire were used to obtain information about food intake and demographic data. Logistic regression was used to identify factors associated with a normal serum folate level (> 6 ng/mL), taking women with a low serum folate level (< or = 6 ng/mL) as the reference group.
  
  
  RESULTS
  The median dietary folate intake was 207.2 microg/day; the median serum folate level was 3.9 ng/ml. A normal serum folate level was significantly associated with increased dietary folate intake (odds ratio = 1.003, P < 0.05), use of folate supplements (odds ratio = 8.152, P < 0.001), and more than four cups of green tea (odds ratio = 0.467, P < 0.05), but not with lifestyle factors in the adjusted analysis.
  
  
  CONCLUSIONS
  Most pregnant women (79.3%) in the present study had a low serum folate level, reflecting a low dietary intake of folate and a low proportion of women taking folate supplements. Supplement use had a much stronger association with a normal serum folate level than dietary folate intake. Since this study was not population-based, further studies are needed to confirm the results.
authors.affiliation: Department of Midwifery and Women's Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. msumi-tky@umin.ac.jp
authors.forename: Masayo
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Megumi
authors.initials: M
authors.lastname: Haruna
authors.forename: Erika
authors.initials: E
authors.lastname: Ota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nagai
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Murashima
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007564:Japan; D009436:Neural Tube Defects / Q000517:prevention & control*; D011247:Pregnancy; D014041:Tokyo
chemical_list: D005492:Folic Acid