Periconceptional folic acid supplement use among women of reproductive age and its determinants in central rural Germany: Results from a cross sectional study

Folic acid supplementation use during the peri-conceptional period among professionals of a hospital in France

Folic acid insufficiency is an important risk factor for congenital neural tube defects. Despite recommendations and national campaigns, the proportion of women taking folic acid in the peri-conceptional period remains insufficient worldwide. We describe in this study the proportion of peri-conceptional folic acid supplementation use and its determinants among a population of hospital workers during the course of a prevention campaign. We performed a single-center cross sectional study in a university hospital in France. Data were collected during 2 months in 2019 by an online questionnaire sent to all professionals. We collected information about folic acid supplementation use, its modalities (form, period, frequency and dosage) and reason for initiating or not supplementation. Response rate was 11.4 % (n = 1,075/9,447). Among the 748 women who reported at least one pregnancy, 72.7 % (95 % CI: 69.4-76.0 %) reported taking folic acid during their last pregnancy. Main reason for initiating supplementation was information given by a health professional (87.8 %), especially by gynaecologists-obstetricians. Principal factors associated with folic acid supplementation use were age between 25 and 35 years, high level of education and recent pregnancy. Folic acid supplementation use is still not systematic before and during pregnancy, even among health professionals. There is a case for mandatory folic acid fortification for the French general population.

Adherence to recommendations for nutrient supplementation related to pregnancy in Germany

Supplementation of certain micronutrients is recommended to ensure their adequate supply during pregnancy and lactation. In Germany, this applies particularly to folic acid and iodine. There is no nationwide data on adherence to the supplementation guidelines. The aim of this cross-sectional study was to determine the prevalence and predictors of the recommended supplementation of both folic acid and iodine in mothers of a nationwide birth cohort. Data on supplementation, before, during, and shortly after pregnancy, were collected retrospectively 14 days postpartum in a sample of 962 mother-infant pairs participating in the second nationwide study on breastfeeding and infant nutrition in Germany, called "SuSe II" (2017-2019). Folic acid and iodine supplementation were classified as recommended according to the German guidelines if supplementation was provided for both essential periods: for folic acid before and during pregnancy and for iodine during pregnancy and lactation. Univariable tests and multivariable logistic regression analysis were performed. The vast majority of mothers did not adhere to the recommendations, with only 36.2% supplementing folic acid and 31.9% supplementing iodine during the recommended periods, and only 15.2% adhering to the recommendations for both nutrients. Main predictors of adherence to recommendations of both nutrients were lifestyle attributes and nutrition-related intentions like previous breastfeeding experience and breastfeeding intentions, but not common sociodemographic characteristics. The data suggest widespread dissemination of the time-specific recommendations covering the entire period from preconception to lactation that could help to sensitize women and healthcare providers.

Peri-conception folic acid supplementation knowledge and associated factors among women visiting Maternal and Child Health clinics in Addis Ababa, Ethiopia

Back ground

Peri-conception care plays an essential and vital role for the health of the mother, her child and her family. Taking folic acid orally prior to conception and during the early stages of pregnancy plays a significant role in preventing Neural Tube Defects and has been associated with preventing other folic acid sensitive congenital anomalies. There exists problem in different parts of the globe on women's understanding of the importance of folic acid making them not to take this supplement in peri-conception period.

Objective

This study aimed at assessing the knowledge of peri-conception folic acid supplementation among women visiting Maternal and Child Health clinics of public health facilities in Addis Ababa, Ethiopia.

Methods

Institution based cross-sectional study was conducted from May 15 to June 20/2020 among 226 women visiting Maternal and Child Health clinics of health centers in Addis Ababa. Consecutive sampling technique was used to select study participants. Data were collected through interviewer administered structured questionnaire and analyzed using Statistical Package for Social Sciences version 24. Tables, charts and graphs were used for data presentation. Multivariable logistic regression analysis was done to identify the independent predictors of women's knowledge of folic acid at p-value ≤ 0.05.

Results

More than two-third of the study participants, 156 (69.0%) had good knowledge on peri-conception folic acid supplementation and its health benefits. Participants with age 25–30 years were 2.14 times more likely to have good knowledge compared to those aged less than 25 years while women with age greater than 30 years were 5.20 times more likely to have good knowledge compared to those with age less than 25 years. Women who had attended high school were 2.93 times more likely to have good knowledge compared to those with no formal education. Likewise, women who had attended college and above were 4.18 times at odd of having good knowledge on periconception folic acid supplementation compared to those with no formal education. Women who had information on prenatal care were 1.48 times more likely to have good knowledge compared to those who never had no information.

Conclusion

Folic acid supplementation knowledge in more than two third of the study participants was good. Participants' age, educational status and information on prenatal care were the independent predictors of knowledge on folic acid supplementation. The Ministry of health, Addis Ababa city health bureau, the study facilities’ management as well as Non-Governmental Organizations working on health in the city should focus on means to increase knowledge of peri-conception folic acid health benefits for women with poor knowledge on the same.

Attitude and Practice of Folic Acid Consumption Among Saudi Pregnant Women at Yanbu City, Kingdom of Saudi Arabia

Background

Folic acid (FA) intake is important for pregnant women for the healthy growth and development of their babies. It is well known that the intake of FA before and during pregnancy help in reducing the risks of congenital anomalies.

Methods

A quantitative cross-sectional design was used to assess pregnant women's attitudes and practices related to FA. This study was conducted in the Antenatal Clinic at Yanbu General Hospital from February 2021 to May 2021. Structured questionnaires were used for data collection from a sample of pregnant women (n=65).

Results

The study revealed that less than half of the study sample consumed FA daily and only 46.2% of women started consuming FA during the first month of pregnancy.

Conclusion

Action should be taken by the Saudi Health Organization for empowering child-bearing women to consume adequate sources of FA at the appropriate time and frequency.

The role of education and migration background in explaining differences in folic acid supplementation intake in pregnancy: results from a German birth cohort study

OBJECTIVE

Official German recommendations advise women to start taking folic acid supplementation (FAS) before conception and continue during the first pregnancy trimester to lower the risk of birth defects. Women from lower socio-economic background and ethnic minorities tend to be less likely to take FAS in other European countries. As little is known about the determinants of FAS in Germany, we aimed to investigate the association between FAS and formal education and migration background, adjusting for demographic factors.

DESIGN

We used data (2013-2016) on nutrition and socio-economic and migration background from the baseline questionnaire of the BaBi cohort study. We performed multivariate regressions and mediation analyses.

SETTING

Bielefeld, Germany.

PARTICIPANTS

Nine-hundred forty-seven women (pregnant or who had given birth in the past 2 months).

RESULTS

16.7% of the participants (158/947) did not use FAS. Migration-related variables (e.g. language, length of stay) were not associated with FAS in the adjusted models. FAS was lower in women with lower level of formal education and in unplanned pregnancies. Reasons given by women for not taking FAS were unplanned pregnancy and lack of knowledge of FAS.

CONCLUSIONS

Health practitioners may be inclined to see migrant women as an inherently at-risk group for failed intake of FAS. However, it is primarily women who did not plan their pregnancy, and women of lower formal education level, who are at risk. Different public health strategies to counter low supplementation rates should be supported, those addressing the social determinants of health (i.e. education) and those more focused on family planning.

Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland

The aim of this study was to evaluate the knowledge regarding a healthy lifestyle and prophylaxis during pregnancy among women from rural and urban areas and how this changed within a 5-year period. Analyses of the population of pregnant women in Poland were made using a questionnaire survey. The survey was conducted in the years 2010-2012 and 2017. Questionnaires from 6128 pregnant women were collected. The statistical analyses were conducted using IBM SPSS. The examined population was comprised of 41% women from rural areas and 59% women from urban areas. Alcohol consumption was lower among women from rural areas than among urban inhabitants in 2010-2012; in 2017 a trend of even lower consumption was observed. Folic acid supplementation was more broadly developed in the urban population; however, in 2017, higher percentage rates of both populations admitted taking folates before pregnancy. More women in urban than in rural areas performed physical activity during pregnancy, but the differences decreased in 2017. Knowledge of a healthy lifestyle and prophylaxis during pregnancy increased regardless of place of residence; however, the most evident change could be observed among women from rural areas.