A new UK study reports that less than one in three women take folic acid supplements before pregnancy to prevent birth defects.
The study questioned nearly half a million women about their use of folic acid supplements before pregnancy between 1999 and 2012 (1). The study results showed that the proportion of women taking folic acid supple- ments to prevent neural tube defects decreased from 35% in 1999-2001 to 31% in 2011-2012. The study also showed strong ethnic variations with only 17% of Afro-Caribbean women, 20% of South Asian women and 25% of East Asian women taking folic acid supplements, compared with 35% of Caucasian women. In addition, only 6% of women under the age of 20 were taking folic acid supplements compared with 40% of women aged 35 to 39. Women who had previously had a pregnancy involving neural tube defects were more likely to take folic acid supplements before pregnancy than women who had not, but still only half of them did in spite of their high risk of a recurrence.
The researchers added that the proportion of women who started taking folic acid supplements after finding out that they were pregnant increased to 62%. However, for the preventive benefits to be effective, folic acid supplements need to be taken before pregnancy. Each year in Britain there are about 1,000 pregnancies affected by spina bifida or other birth defects of the brain, spine, or spinal cord. Most of these lead to a ter- mination of pregnancy which is an agonizing decision for couples who want a child. Over 70 countries, inclu- ding the US and Australia, have introduced mandatory folic acid fortification to reduce the risk of women having a pregnancy affected with neural tube defects. Despite recommendations from the UK Food Standards Agency to fortify flour with folic acid, and evidence that folic acid fortification is effective, neither the UK nor any other EU country has mandated this.