Abstract
This research evaluates the prevalence of inadequate folate status in early pregnancy, the pattern of prenatal folic acid (FA) supplementation and associated factors in Spanish pregnant women from the ECLIPSES study, which included 791 participants prior gestational week 12. A cross-sectional evaluation of red blood cell (RBC) folate levels was performed at recruitment and used to calculate the prevalence of folate deficiency (RBC folate<340 nmol/L) and insufficiency (RBC folate<906 nmol/L). Sociodemographic and lifestyle data, as well as information on prenatal FA supplementation were recorded. Descriptive and multivariate statistical analyses were performed. The prevalence of folate deficiency and insufficiency were 9.6% and 86.5%, respectively. Most of women used prenatal FA supplements but only 6.3% did so as recommended. Supplementation with FA during the periconceptional period abolished folate deficiency and reduced folate insufficiency. Prenatal folic acid supplementation with ≥1000 µg/d in periconceptional time and pregnancy planning increased RBC folate levels. The main risk factor for folate insufficiency in early pregnancy were getting prenatal FA supplementation out of the periconceptional time (OR 3.32, 95%CI 1.02–15.36), while for folate deficiency they were young age (OR 2.02, 95%CI 1.05–3.99), and smoking (OR 2.39, 95%CI 1.30–4.37). In addition, social and ethnic differences according to folate status were also identified. As conclusion, periconceptional FA use is crucial for achieving optimal folate levels in early pregnancy. Pregnancy planning should focus on young women, smokers, those with low consumption of folate-rich foods, low socioeconomic status or from ethnic minorities.
The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh