Many Women Not Taking Folic Acid Before Pregnancy

Folic acid supplements to prevent spina bifida taken by one in three pregnant women

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Is it ever too early to start thinking about the health of a child? A new study suggests that more women should be thinking ahead and taking folic acid supplements before they become pregnant.

This new study showed that most women did not take folic acid prior to becoming pregnant but often began taking them after.

The researchers said that the use of folic acid supplements dropped over the course of the more than decade-long study.

"Consult with your doctor before beginning any supplement regimen."

This study was led by Jonathan Bestwick, researcher and Lecturer in Medical Statistics at Queen Mary University of London.

The research team screened 466,860 British women between 1999 and 2012 to determine the proportion of those taking folic acid supplements before pregnancy.

According to the American Academy of Pediatrics (AAP), spina bifida is one of a group of birth defects known as neural tube defects (NTDs), which are among the most common birth defects contributing to infant mortality and serious disability. NTDs occur in approximately 1 out of 1,000 births in the United States.

The AAP has endorsed the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 micrograms of folic acid daily to prevent NTDs.

Bestwick and colleagues broke the data up by year, patient age and patient ethnicity to show trends in the use of folic acid supplements.

The study showed that the number of women taking folic acid supplements decreased from 35 percent in 1999-2001 to 31 percent in 2011-2012.

In addition, the data revealed that women who had a previous pregnancy that involved the possibility of spinal bifida — a birth defect in which spinal cord development is incomplete — were more likely to take folic acid supplements than the general population, but only 51 percent did so.

The research team found that the number of women taking folic acid supplements after discovering they were pregnant rose from 45 percent to 62 percent over the period of the study. This team noted that for folic acid supplements to be effective, they must be taken before pregnancy occurs.

This study also showed considerable differences along ethnic lines, with only 17 percent of Afro-Caribbean women, 20 percent of South Asian women and 25 percent of East Asian women taking the folic acid supplements before pregnancy, compared with 35 percent of Caucasian women.

The researchers said that taking folic acid supplements before pregnancy may reduce the risk of spina bifida by as much as 72 percent.

This study was published February 19 in the journal PLoS ONE.

The authors reported no outside support or funding and no conflicts of interest.

Review Date: 
February 20, 2014
Last Updated:
February 21, 2014