Periconceptional folic acid use: still room to improve.

BACKGROUND Folic acid use before and during pregnancy prevents neural tube defects. Since 1995, six surveys have been carried out among pregnant women to measure their knowledge and use of folic acid. The results of the most recent survey in 2009 will be discussed and compared with earlier surveys. METHODS Pregnant women in the Northern Netherlands were asked to fill out a questionnaire when visiting their midwife or gynecologist. RESULTS Of the 515 participating women, 87.0% knew of folic acid before they became pregnant. Of all respondents, 51.6% reported to have used folic acid during the entire recommended period. Multivariate analysis showed that planned pregnancy (odds ratio [OR], 7.1; 95% confidence interval [CI], 2.4-20.7), smoking (OR, 0.2; 95% CI, 0.1-0.7), folic acid use during a former pregnancy (OR, 22.6; 95% CI, 5.5-92.8) and the number of previous children (per child OR, 0.5; 95% CI, 0.3-0.9) were predicting factors for the recommended use of folic acid; 89.9% of women were sufficiently knowledgeable to start to use folic acid before pregnancy. CONCLUSIONS The knowledge about folic acid has declined over recent years, and the use during the recommended period did not improve since the survey of 2005. Based on this survey, there is still room for improvement in the knowledge and actual use of folic acid before pregnancy. Attention to these aspects should focus on younger, low-educated women and should include information about family planning and contraceptives.

[1]  M. Loane,et al.  Paper 2: EUROCAT public health indicators for congenital anomalies in Europe. , 2011, Birth defects research. Part A, Clinical and molecular teratology.

[2]  Livia Kapusta,et al.  Protective effect of periconceptional folic acid supplements on the risk of congenital heart defects: a registry-based case-control study in the northern Netherlands. , 2010, European heart journal.

[3]  A. Czeizel,et al.  Possible association of folic acid supplementation during pregnancy with reduction of preterm birth: a population-based study. , 2010, European journal of obstetrics, gynecology, and reproductive biology.

[4]  M. Crone,et al.  Clustering of Socioeconomic, Behavioural, and Neonatal Risk Factors for Infant Health in Pregnant Smokers , 2009, PloS one.

[5]  A. Czeizel.  Periconceptional folic acid and multivitamin supplementation for the prevention of neural tube defects and other congenital abnormalities. , 2009, Birth defects research. Part A, Clinical and molecular teratology.

[6]  L. Stockley,et al.  Use of folic acid supplements, particularly by low-income and young women: a series of systematic reviews to inform public health policy in the UK , 2008, Public Health Nutrition.

[7]  L. de Jong-van den Berg,et al.  Ten years after the Dutch public health campaign on folic acid: the continuing challenge , 2008, European journal of clinical pharmacology.

[8]  Lolkje T. W. Jong-van den Berg,et al.  Ten years after the Dutch public health campaign on folic acid: the continuing challenge , 2008, European Journal of Clinical Pharmacology.

[9]  Young-In Kim.  Folic acid fortification and supplementation--good for some but not so good for others. , 2007, Nutrition reviews.

[10]  L. de Jong-van den Berg,et al.  Growing Gap in Folic Acid Intake with Respect to Level of Education in the Netherlands , 2007, Public Health Genomics.

[11]  S. Larsson,et al.  Folate and risk of breast cancer: a meta-analysis. , 2007, Journal of the National Cancer Institute.

[12]  C. Ulrich,et al.  Folate Supplementation: Too Much of a Good Thing? , 2006, Cancer Epidemiology Biomarkers & Prevention.

[13]  A. Berghold,et al.  Preventing neural tube defects in Europe: a missed opportunity. , 2005, Reproductive toxicology.

[14]  L. de Jong-van den Berg,et al.  Folic acid--the scientific debate as a base for public health policy. , 2005, Reproductive toxicology.

[15]  S. Vollset,et al.  International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working? , 2005, BMJ : British Medical Journal.

[16]  de Hermien Walle,et al.  Insufficient folic acid intake in the Netherlands: what about the future? , 2002 .

[17]  Z. Li,et al.  Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. , 2000, The New England journal of medicine.

[18]  Hong Wang,et al.  Correction: Prevention of Neural-Tube Defects with Folic Acid in China. , 1999, The New England journal of medicine.

[19]  M. Cornel,et al.  Periconceptional folic acid intake in the northern Netherlands , 1999, The Lancet.

[20]  L. de Jong-van den Berg,et al.  Increasing awareness of and behaviour towards periconceptional folic acid consumption in The Netherlands from 1994 to 1995 , 1998, European Journal of Clinical Pharmacology.

[21]  A. Czeizel,et al.  Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. , 1992, The New England journal of medicine.

[22]  de Lolkje Jong-van den Berg,et al.  Growing Gap in Folic Acid Intake with Respect to Level of Education in the Netherlands , 2007, Public Health Genomics.

[23]  L. de Jong-van den Berg,et al.  Insufficient folic acid intake in the Netherlands: what about the future? , 2002, Teratology.