An analysis of folic acid supplementation in women presenting for antenatal care.
BACKGROUND
Neural tube defects (NTDs) are major congenital malformations that are potentially preventable if the woman takes periconceptional folic acid (FA) supplements. A recent report found that NTD incidence had increased in Ireland. This study examined the usage of FA supplementation in women presenting for antenatal care in a maternity hospital.


METHODS
Women were recruited at their convenience in the first trimester. Their clinical and sociodemographic details were computerized. Maternal weight and height were measured before calculating body mass index. Detailed FA questionnaires were completed under supervision of a trained researcher.


RESULTS
While 96.1% (n = 564) out of 587 reported that they took FA after they became pregnant, only 24.7% (n = 145) took it for >12 weeks preconceptionally as recommended. Only 5.7% (n = 6) of obese women took high-dose FA as recommended. On univariate analysis, the strongest predictors of preconceptional FA usage were higher maternal age, higher education and income, being married, being nulliparous, not smoking, infertility treatment and planned pregnancy. On multivariate analysis, both planned pregnancy and nulliparity were the most important predictors of preconceptional FA use.


CONCLUSIONS
Our study shows that current recommendations to prevent NTDs by FA supplementation pre-pregnancy are not being fully implemented in Ireland. We recommend a review of current public health policies on FA supplementation.
School of Biological Science, Dublin Institute of Technology, Dublin 8, Ireland.
Shona
S
Cawley
School of Biological Science, Dublin Institute of Technology, Dublin 8, Ireland.
Laura
L
Mullaney
UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Aoife
A
McKeating
UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Maria
M
Farren
School of Biological Science, Dublin Institute of Technology, Dublin 8, Ireland.
Daniel
D
McCartney
UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Michael J
MJ
Turner
D000293:Adolescent; D000328:Adult; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
D005492:Folic Acid
Ireland; folic acid supplementation; neural tube defects; planned pregnancy