Folic acid supplementation in younger and older nonpregnant women of reproductive age: findings from the Central Pennsylvania Women's Health Study (CePAWHS)

Abstract

Introduction and background: This study explores variables associated with daily folic acid supplementation among nonpregnant women ages 18-24, in comparison with women ages 25-45. Health-related behaviors, reproductive status, health care access, and sociodemographic variables are included.

Methods: Data are from a cross-sectional population-based survey of 2,002 women ages 18-45 in the Central Pennsylvania Women's Health Study. The analytic sample included 246 women ages 18-24 and 1,636 women ages 25-45 who were not pregnant at the time of survey.

Results: Seventeen percent of women ages 18-24 and 27% of women ages 24-45 used daily folic acid supplements. In multiple logistic regression analysis, folic acid use was significantly associated with only two variables among younger women: fruit consumption at least daily and regular physical activity levels meeting recommended guidelines. Among older women, folic acid use was associated with these same two health-related behaviors in addition to not smoking, seeing an obstetrician-gynecologist, receiving diet/nutrition counseling, being married or living with a partner, and no prior pregnancy. Folic acid use was not associated with pregnancy intention in either age group.

Conclusions and discussion: Women ages 18-24 have significantly lower rates of folic acid supplementation compared with older women of reproductive age, but fewer variables are associated with folic acid use among younger women. Missed opportunities to educate younger women about the benefits of folic acid supplementation are identified.