title: Validation of self-reported folic acid use in a multiethnic population: results of the Amsterdam Born Children and their Development study.
abstract: OBJECTIVE
  To assess folic acid supplementation rates and validate the self-reporting of folic acid supplement use among pregnant women in a multiethnic cohort.
  
  
  METHODS
  Secondary analysis of a prospective cohort study.
  
  
  METHODS
  Self-reported folic acid supplement use in the Amsterdam Born Children and their Development study cohort was compared with serum folate concentrations using non-parametric trend analysis and linear and logistic regression.
  
  
  METHODS
  A total of 4234 pregnant women of various ethnic backgrounds.
  
  
  RESULTS
  Serum folate levels showed a significant positive linear trend as reported use of folic acid increased (P < 0·001), which was supported by linear regression (r = 0·49). Odds of having low serum folate concentration decreased with reported early start of folic acid intake. Young, multiparous or non-Western women reported less pre-conception folic acid intake. Non-Western women showed lower serum folate concentrations. The overall rate of over-reporting, i.e. serum folate concentrations ≤20 nmol/l while reporting the use of folic acid supplements, was 20·7 %. Women of Surinamese and Moroccan ancestry had higher odds of over-reporting (OR = 2·3; 95 % CI 1·5, 3·5 and OR = 2·3; 95 % CI 1·3, 4·0, respectively). The odds for Surinamese women remained significant after adjusting for the onset of supplement use, parity and age (OR = 1·7; 95 % CI 1·1, 2·6).
  
  
  CONCLUSIONS
  Although self-reporting is a valid method for assessing folic acid supplement use in a multiethnic population, some participants do over-report. Surinamese and possibly Moroccan women appear to over-report more often. Rates of supplementation are low, especially in non-Western women. This suggests the need for intensifying current campaigns or perhaps even additional advice to start or continue to use folic acid post-conceptionally.
authors.affiliation: Department of Clinical Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, BS7, D423, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: Jonne J
authors.initials: JJ
authors.lastname: Sikkens
authors.forename: Manon
authors.initials: M
authors.lastname: van Eijsden
authors.forename: Gouke J
authors.initials: GJ
authors.lastname: Bonsel
authors.forename: Martina C
authors.initials: MC
authors.lastname: Cornel
mesh_terms: D000293:Adolescent; D000328:Adult; D019587:Dietary Supplements; D005006:Ethnicity; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood*; D006291:Health Policy; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D009018:Morocco / Q000208:ethnology; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011446:Prospective Studies; D057566:Self Report; D013532:Suriname / Q000208:ethnology; D055815:Young Adult
chemical_list: D005492:Folic Acid