title: Maternal and health care determinants of preconceptional use of folic acid supplementation in France: results from the 2010 National Perinatal Survey.
abstract: OBJECTIVE
  To estimate the national prevalence and analyse the factors associated with preconceptional folic acid supplementation, including maternal sociodemographic characteristics, region of residence, birth control use and chronic diseases requiring medical care before conception.
  
  
  METHODS
  Cross-sectional population-based study.
  
  
  METHODS
  All maternity units in France.
  
  
  METHODS
  A nationally representative sample of women giving birth in 2010 (n = 12,646).
  
  
  METHODS
  Data came from mothers' interviews 2-3 days after delivery. Statistical analyses included multivariable logistic regressions.
  
  
  METHODS
  Folic acid supplementation starting at least 1 month before conception.
  
  
  RESULTS
  14.8% (95% confidence interval [95% CI] 14.2-15.4) of women used folic acid before pregnancy; this percentage varied from 10.4% to 18.7% across regions. Supplementation was more frequent in primiparae, French citizens, women with higher educational levels and those needing medical monitoring or treatment before conception. Women who stopped contraception to become pregnant (75% of our population) used folic acid more often (intrauterine device or implant: 19%, pill: 17%, other methods which did not need medical monitoring: 17%) than other women (7%). The adjusted odds ratios were 3.3 (95% CI 2.6-4.3) for intrauterine device and implant, 2.2 (95% CI 1.8-2.6) for pill and 1.9 (95% CI 1.5-2.4) for other methods, compared with women who did not use birth control.
  
  
  CONCLUSIONS
  The absence of preconceptional folic acid supplementation for most women, even those needing consultations with healthcare professionals before pregnancy, shows that campaigns to promote folic acid supplementation should address not only women but also healthcare professionals involved in birth control and obstetric care before pregnancy.
authors.affiliation: INSERM UMRS 953, Epidemiological Research Unit on Perinatal and Women's and Children's Health, Paris, France; UPMC University, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Tort
authors.forename: N
authors.initials: N
authors.lastname: Lelong
authors.forename: C
authors.initials: C
authors.lastname: Prunet
authors.forename: B
authors.initials: B
authors.lastname: Khoshnood
authors.forename: B
authors.initials: B
authors.lastname: Blondel
mesh_terms: D000328:Adult; D003268:Contraception Behavior; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005602:France; D006306:Health Surveys; D006801:Humans; D015999:Multivariate Analysis; D010298:Parity; D016742:Preconception Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid
keywords: Chronic diseases; fertility treatments; folic acid; maternal characteristics; preconception; pregnancy planning; region