title: Social and ethnic differences in folic acid use preconception and during early pregnancy in the UK: effect on maternal folate status.
abstract: BACKGROUND
  The role of folate supplementation in preventing neural tube defects is well known; however, preconception supplement use continues to be low, especially amongst the socially disadvantaged. The present study explored periconception folic acid supplement use in a socially deprived, ethnically diverse population.
  
  
  METHODS
  Pregnant women (n = 402) in the first trimester of pregnancy were recruited in East London. Using a researcher led questionnaire, details were obtained regarding social class, ethnicity and folic acid use. Red cell folate levels were determined for 367 participants during the first trimester.
  
  
  RESULTS
  Although 76% of participants reported using folic acid supplements during the first trimester, only 12% started preconception and a further 17% started before neural tube closure. Mothers from higher social groups or with higher levels of education were more likely to use folic acid and started taking it earlier. Ethnic differences were also seen in preconception usage (Africans, 5%; West Indians, 8%; Asians, 12%; Caucasians, 19%; P = 0.038). Participants who took folic acid supplements had significantly higher mean (SD) red cell folate concentrations than those who took none [936 (*\1.6) and 579 (*\1.6) nmol L(-1), respectively; P < 0.001].
  
  
  CONCLUSIONS
  Folic acid supplement use preconception and prior to neural tube closure continues to be low, exhibiting both social and ethnic disparities.
authors.affiliation: Institute of Food Nutrition and Human Health, Massey University, Palmerston North, New Zealand. l.brough@massey.ac.nz
authors.forename: L
authors.initials: L
authors.lastname: Brough
authors.forename: G A
authors.initials: GA
authors.lastname: Rees
authors.forename: M A
authors.initials: MA
authors.lastname: Crawford
authors.forename: E K
authors.initials: EK
authors.lastname: Dorman
mesh_terms: D000328:Adult; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D054624:Health Status Disparities; D006801:Humans; D008131:London; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology*; D009436:Neural Tube Defects / Q000208:ethnology / Q000517:prevention & control; D016742:Preconception Care; D011247:Pregnancy; D011295:Prenatal Care; D012959:Socioeconomic Factors; D014803:Vitamin B Complex / Q000008:administration & dosage* / Q000097:blood; D055815:Young Adult
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid