scholarly journals Preconceptional folic acid supplement use in Lebanon

2009 ◽  
Vol 12 (5) ◽  
pp. 687-692 ◽  
Author(s):  
H Tamim ◽  
G Harrison ◽  
M Atoui ◽  
G Mumtaz ◽  
F El-Kak ◽  
...  

AbstractObjectiveThe objective of the present study was to assess the prevalence and determinants of preconceptional folic acid supplement use among pregnant women in Lebanon.Design/setting/subjectsThe study was a descriptive epidemiological study. Analysis was performed on 5280 deliveries admitted to twelve member hospitals of the National Collaborative Perinatal Neonatal Network during the period September 2003–January 2005. Information on folic acid intake and maternal and neonatal characteristics were obtained from obstetric charts along with direct interviews performed by trained personnel. Logistic regression was performed to determine the predictors of preconceptional folic acid use.ResultsThe overall use of preconceptional folic acid supplementation was 14·0 % (18·6 % in urban hospitals v. 2·7 % in rural hospitals). Higher socio-economic status, lower parity and having a history of previous spontaneous abortions were significantly associated with preconceptional folic acid use.ConclusionOur study shows that Lebanon currently has a low rate of preconceptional folic acid supplement use. Intervention through the means of awareness campaigns needs to be implemented on a national level.

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 331
Author(s):  
Melissa van der Windt ◽  
Sam Schoenmakers ◽  
Bas van Rijn ◽  
Sander Galjaard ◽  
Régine Steegers-Theunissen ◽  
...  

Preconception folic acid supplement use is a well-known method of primary prevention of neural tube defects (NTDs). Obese women are at a higher risk for having a child with a NTD. As different international recommendations on folic acid supplement use for obese women before and during pregnancy exist, this narrative review provides an overview of epidemiology of folate deficiency in obese (pre)pregnant women, elaborates on potential mechanisms underlying folate deficiency, and discusses considerations for the usage of higher doses of folic acid supplements. Women with obesity more often suffer from an absolute folate deficiency, as they are less compliant to periconceptional folic acid supplement use recommendations. In addition, their dietary folate intake is limited due to an unbalanced diet (relative malnutrition). The association of obesity and NTDs also seems to be independent of folate intake, with studies suggesting an increased need of folate (relative deficiency) due to derangements involved in other pathways. The relative folate deficiency, as a result of an increased metabolic need for folate in obese women, can be due to: (1) low-grade chronic inflammation (2) insulin resistance, (3) inositol, and (4) dysbiotic gut microbiome, which plays a role in folate production and uptake. In all these pathways, the folate-dependent one-carbon metabolism is involved. In conclusion, scientific evidence of the involvement of several folate-related pathways implies to increase the recommended folic acid supplementation in obese women. However, the physiological uptake of synthetic folic acid is limited and side-effects of unmetabolized folic acid in mothers and offspring, in particular variations in epigenetic (re)programming with long-term health effects, cannot be excluded. Therefore, we emphasize on the urgent need for further research and preconception personalized counseling on folate status, lifestyle, and medical conditions.


2006 ◽  
Vol 84 (5) ◽  
pp. 1134-1141 ◽  
Author(s):  
Roy M Nilsen ◽  
Stein E Vollset ◽  
Håkon K Gjessing ◽  
Per Magnus ◽  
Helle M Meltzer ◽  
...  

2018 ◽  
Author(s):  
Henok Dagne Derso ◽  
Gashaw Agegnehu ◽  
Azeb Atenafu ◽  
Baye Dagnew ◽  

Background: Iron deficiency is the leading nutrient deficiency in the world affecting the lives of more than 2 billion people, accounting to over 30% of the world’s population. Pregnant women are particularly at high risk of iron and folic acid deficiency. Objective The aim of this study was to assess Adherence to Iron and folic acid supplement during pregnancy and its associated factors among pregnant women attending antenatal care. Methods Institution based cross-sectional study was employed from February 2016 to March 2017. Systematic random sampling technique was used to select the study participants. Data was collected using a structured and pretested interviewer-administered questionnaire. Bivariable and multivariable logistic regression analysis were used to identify associated factors with Adherence to prenatal iron and folic acid supplement among pregnant women. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Those variables with a p-value less than 0.05 had been considered as significant. Result Adherence to Iron and folic acid was 28.7% with 95% C.I. (24.3, 33.6%). Educational status of mothers(AOR= 9.27 (95%CI: 2.47, 34.71), Educational status of husband (AOR= 0.31(95% CI: 0.11,0.88), Mothers who had a family size of four(AOR=3.70(1.08,12.76), Mothers who had family size of five and above (AOR= 4.88(95% CI: 1.20, 19.85),Mothers who had 2500-3500 birr household average monthly income (AOR= 0.46(95% CI: 0.24,0.89), Mothers who had registered at 17-24weeks with (AOR=0.40(95% CI: 0.22-0.74), registered at 25-28weeks (AOR=0.20(95% CI 0.10, 0.41), Mothers who had collected their iron and folic acid started at first visit at first month of pregnancy and duration of iron and folic acid is taken (AOR= 2.42(95% CI:1.05, 5.58) had significant association with iron and folic acid adherence. Conclusion and recommendation Adherence of Iron and folic acid was relatively low. Maternal and husband education status, family size, registration time, economic status and first visit in the first month with duration of iron and folic acid taken were factors significantly associated with adherence to iron and folic acid supplement. Educating pregnant mothers, improving economic status, early ANC registration can improve adherence to iron and folic acid supplement.


2017 ◽  
Vol 109 (1) ◽  
pp. 38-48 ◽  
Author(s):  
Ayesha Mukhtar ◽  
Michael R. Kramer ◽  
Godfrey P. Oakley ◽  
Vijaya Kancherla

2011 ◽  
Vol 14 (11) ◽  
pp. 2022-2028 ◽  
Author(s):  
Jonne J Sikkens ◽  
Manon van Eijsden ◽  
Gouke J Bonsel ◽  
Martina C Cornel

AbstractObjectiveTo assess folic acid supplementation rates and validate the self-reporting of folic acid supplement use among pregnant women in a multiethnic cohort.DesignSecondary analysis of a prospective cohort study.SettingSelf-reported folic acid supplement use in the Amsterdam Born Children and their Development study cohort was compared with serum folate concentrations using non-parametric trend analysis and linear and logistic regression.SubjectsA total of 4234 pregnant women of various ethnic backgrounds.ResultsSerum folate levels showed a significant positive linear trend as reported use of folic acid increased (P < 0·001), which was supported by linear regression (r = 0·49). Odds of having low serum folate concentration decreased with reported early start of folic acid intake. Young, multiparous or non-Western women reported less pre-conception folic acid intake. Non-Western women showed lower serum folate concentrations. The overall rate of over-reporting, i.e. serum folate concentrations ≤20 nmol/l while reporting the use of folic acid supplements, was 20·7 %. Women of Surinamese and Moroccan ancestry had higher odds of over-reporting (OR = 2·3; 95 % CI 1·5, 3·5 and OR = 2·3; 95 % CI 1·3, 4·0, respectively). The odds for Surinamese women remained significant after adjusting for the onset of supplement use, parity and age (OR = 1·7; 95 % CI 1·1, 2·6).ConclusionsAlthough self-reporting is a valid method for assessing folic acid supplement use in a multiethnic population, some participants do over-report. Surinamese and possibly Moroccan women appear to over-report more often. Rates of supplementation are low, especially in non-Western women. This suggests the need for intensifying current campaigns or perhaps even additional advice to start or continue to use folic acid post-conceptionally.


2015 ◽  
Vol 40 (10) ◽  
pp. 1025-1030 ◽  
Author(s):  
Cynthia K. Colapinto ◽  
Deborah L. O’Connor ◽  
Lise Dubois ◽  
Mark S. Tremblay

A distinct shift towards higher folate concentrations has emerged in Canada. These higher concentrations have known benefits, including prevention of neural tube defects, but concerns have been raised regarding potential associations with adverse health outcomes. The aim of this research was to propose cut-offs for high red blood cell (RBC) folate concentrations and identify their correlates. RBC folate was measured in a nationally representative cross-sectional sample of Canadians (N = 5248) aged 6 to 79 years. RBC folate concentrations were adjusted from the IMMULITE 2000 immunoassay to a microbiologic assay. The population was characterized at 3 RBC folate cut-offs: 1450 nmol/L, 1800 nmol/L, and 2150 nmol/L. We used t tests to examine differences by age, sex, income, and body mass index (BMI) at each cut-off and logistic regression to explore associations with folic acid supplement intake. The prevalence of high RBC folate was 16%, 6%, and 2% at thresholds of 1450 nmol/L, 1800 nmol/L, and 2150 nmol/L, respectively. Females, those aged 60 to 79 years, and overweight or obese participants had the greatest prevalence of having high RBC folate at each cut-off. Folic acid supplement users were more likely than non-users to have high RBC folate concentrations. Older age, higher BMI, and folic acid supplement use were identified as correlates of high folate status. A high RBC folate concentration cut-off will advance the field towards consistent measurement and reporting of high folate status. This may facilitate future investigation of associations between RBC folate concentrations at the upper end of the distribution and health outcomes.


Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Roberta Magnano San Lio ◽  
Giuliana Favara ◽  
Claudia La Mastra ◽  
...  

Folate requirement among women who plan to become pregnant should be raised to 600 μg/day during the periconceptional period. To meet this need, several countries began to promote the use of folic acid supplements before and during pregnancy. Here, we investigated prevalence and determinants of dietary folate intake and folic acid supplement use among 397 pregnant women (aged 15–50 years old, median = 37 years old). We also investigated their effects on neonatal outcomes in a subgroup of women who completed pregnancy. For doing that, we used data from the “Mamma & Bambino” project, an ongoing mother-child cohort settled in Catania (Italy). Inadequate folate intake was evaluated using a Food Frequency Questionnaire and defined as an intake < 600 μg/day. Women were also classified as non-users (i.e., women who did not use folic acid supplements), insufficient users (i.e., women who did not take folic acid supplements as recommended), and recommended users of folic acid supplements. Neonatal outcomes of interest were preterm birth (PTB) and small for gestational age (SGA). Nearly 65% of women (n = 257) reported inadequate folate intake, while 74.8% and 22.4% were respectively classified as insufficient or recommended users of supplements. We demonstrated higher odds of inadequate folate intake among smoking women (OR = 1.457; 95%CI = 1.046–2.030; p = 0.026), those who followed dietary restrictions (OR = 2.180; 95%CI = 1.085–4.378; p = 0.029), and those with low adherence to the Mediterranean Diet (OR = 3.194; 95%CI = 1.958–5.210; p < 0.001). In a subsample of 282 women who completed pregnancy, we also noted a higher percentage of SGA among those with inadequate folate intake (p < 0.001). Among 257 women with inadequate folate intake, those with low educational level were more likely to not take folic acid supplements than their more educated counterpart (OR = 5.574; 95%CI = 1.487–21.435; p = 0.012). In a subsample of 184 women with inadequate folate intake and complete pregnancy, we observed a higher proportion of SGA newborns among women who did not take supplement before pregnancy and those who did not take at all (p = 0.009). We also noted that the proportion of PTB was higher among non-users and insufficient users of folic acid supplements, but difference was not statistically significant. Our study underlined the need for improving the adherence of pregnant women with recommendations for dietary folate intake and supplement use. Although we proposed a protective effect of folic acid supplement use on risk of SGA, further research is encouraged to corroborate our findings and to investigate other factors involved.


2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Tarja I. Kinnunen ◽  
Line Sletner ◽  
Christine Sommer ◽  
Martine C. Post ◽  
Anne Karen Jenum

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