title: Prevalence and determinants of preconception folic acid use: an Italian multicenter survey.
abstract: BACKGROUND
  Women in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants. This study aimed to update the prevalence and to identify possible determinants of preconception folic acid supplement use in Italian women.
  
  
  METHODS
  The study was based on cross-sectional data from seven maternity clinics located in six Italian regions from January to June, 2012. Data on maternal characteristics and supplement use were collected for 2,189 women using a self-administered questionnaire.
  
  
  RESULTS
  Preconception folic acid use was reported by 23.5 % (n = 515) of the participants. Of these, 479 (93 %) women had taken folic acid supplements on a daily basis as recommended by the health authorities. Women who both had intended their pregnancy and had requested a preconception health visit to a doctor/gynecologist were substantially more likely than the reference group to initiate folic acid supplementation before their pregnancy (48.6 versus 4.8 %). Preconception folic acid use was also associated with higher maternal age, higher education, marriage/cohabitation, lower parity, infertility treatments, and chronic disease.
  
  
  CONCLUSIONS
  Data from seven maternity clinics located in six Italian regions indicate that preconception folic acid supplement use in many Italian women is low. Women who do not plan their pregnancy or do not request a preconception health visit to their doctor have among the lowest prevalence of preconception folic acid use. Improving folate status in these and other supplemental non-users may have important disease preventive effects.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway. roy.nilsen@uib.no.|Alessandra Lisi International Centre on Birth Defects and Prematurity, Rome, Italy. roy.nilsen@uib.no.
authors.forename: Roy M
authors.initials: RM
authors.lastname: Nilsen
authors.affiliation: Alessandra Lisi International Centre on Birth Defects and Prematurity, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Leoncini
authors.affiliation: Unit (UOC) Obstetrics and Gynecology, Santo Spirito in Saxia Hospital, Roma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gastaldi
authors.affiliation: Unit (U.O.) of Pediatrics, Vaio Hospital, Fidenza, Parma, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Allegri
authors.affiliation: Department of Mother and Child Health, S. Giovanni Calibita-Fatebenefratelli Hospital, Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Agostino
authors.affiliation: Medical Genetics Unit, Galliera Hospital, Genova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Faravelli
authors.affiliation: Unit of Neonatology, Santo Spirito in Saxia Hospital, Roma, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ferrazzoli
authors.affiliation: Unit of Obstetrics and Gynecology, Castelli Hospital, Verbania, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Finale
authors.affiliation: Unit of Neonatology and Neonatal Intensive Care, Azienda Ospedaliero-Univesitaria Pisana, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ghirri
authors.affiliation: Department of Medical Genetics, Gaetano Rummo Hospital, Benevento, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Scarano
authors.affiliation: Alessandra Lisi International Centre on Birth Defects and Prematurity, Rome, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Mastroiacovo
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D007558:Italy; D009436:Neural Tube Defects / Q000517:prevention & control*; D016742:Preconception Care; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D005492:Folic Acid
keywords: Folic acid; Italy; Neural tube defects; Predictors; Pregnancy; Supplementation