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Multicenter Study
. 2015 Nov 24;5(11):e009202.
doi: 10.1136/bmjopen-2015-009202.

Use of high doses of folic acid supplements in pregnant women in Spain: an INMA cohort study

Eva María Navarrete-Muñoz  1 , Desirée Valera-Gran  2 , Manoli García de la Hera  1 , Daniel Gimenez-Monzo  2 , Eva Morales  3 , Jordi Julvez  3 , Isolina Riaño  4 , Adonina Tardón  5 , Jesus Ibarluzea  6 , Loreto Santa-Marina  6 , Mario Murcia  7 , Marisa Rebagliato  8 , Jesus Vioque  1 ; INMA Project
Collaborators, Affiliations
Multicenter Study

Use of high doses of folic acid supplements in pregnant women in Spain: an INMA cohort study

Eva María Navarrete-Muñoz et al. BMJ Open. .

Abstract

Objectives: We examined the use of low (<400 μg/day, including no use) and high folic acid supplement (FAS) dosages (≥1000 μg/day) among pregnant women in Spain, and explored factors associated with the use of these non-recommended dosages.

Design: Population-based cohort study.

Setting: Spain.

Participants: We analysed data from 2332 pregnant women of the INMA study, a prospective mother-child cohort study in Spain.

Main outcome measures: We assessed usual dietary folate and the use of FAS from preconception to the 3rd month (first period) and from the 4th to the 7th month (second period), using a validated food frequency questionnaire. We used multinomial logistic regression to estimate relative risk ratios (RRRs).

Results: Over a half of the women used low dosages of FAS in the first and second period while 29% and 17% took high dosages of FAS, respectively. In the first period, tobacco smoking (RRR=1.63), alcohol intake (RRR=1.40), multiparous (RRR=1.44), unplanned pregnancy (RRR=4.20) and previous spontaneous abortion (RRR=0.58, lower use of high FAS dosages among those with previous abortions) were significantly associated with low FAS dosages. Alcohol consumption (RRR=1.42), unplanned pregnancy (RRR=2.66) and previous spontaneous abortion (RRR=0.68) were associated with high dosage use. In the second period, only tobacco smoking was significantly associated with high FAS dosage use (RRR=0.67).

Conclusions: A high proportion of pregnant women did not reach the recommended dosages of FAS in periconception and a considerable proportion also used FAS dosages ≥1000 μg/day. Action should be planned by the Health Care System and health professionals to improve the appropriate periconceptional use of FAS, taking into consideration the associated factors.

Keywords: NUTRITION & DIETETICS; PUBLIC HEALTH.

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Figures

Figure 1
Figure 1
Folic acid supplements use among 2422 participants in all cohorts of the INMA Project, Spain (2003-2008). Percentage by months of pregnancy.
See this image and copyright information in PMC

Comment in

References

    1. MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991;338:131–7. 10.1016/0140-6736(91)90133-A - DOI - PubMed
    1. Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992;327:1832–5. 10.1056/NEJM199212243272602 - DOI - PubMed
    1. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington DC: The National Academies Press, 1998. - PubMed
    1. Grupo de trabajo de la Guía de práctica clínica de atención en el embarazo y puerperio. Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía. 2014, Guías de Práctica Clínica en el SNS: AETSA 2011/10. http://www.juntadeandalucia.es/salud/servicios/contenidos/nuevaaetsa/up/... (accessed Jul 2014).
    1. Pastor-Valero M, Navarrete-Muñoz EM, Rebagliato M et al. . Periconceptional folic acid supplementation and anthropometric measures at birth in a cohort of pregnant women in Valencia, Spain. Br J Nutr 2011;105:1352–60. 10.1017/S0007114510005143 - DOI - PubMed

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