scholarly journals Inadequate Status and Low Awareness of Folate in Switzerland—A Call to Strengthen Public Health Measures to Ensure Sufficient Intakes

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3729
Author(s):  
Isabelle Herter-Aeberli ◽  
Nina Wehrli ◽  
Kurt Bärlocher ◽  
Maria Andersson ◽  
Janice Sych
Keyword(s):  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Online Survey ◽  
Elevated Risk ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Convenience Sample ◽  
Folate Concentration ◽  
Folate Status

Background: Folate plays an essential role in the prevention of neural tube defects, yet little is known about the folate status of women of reproductive age or to what degree the general population is aware of the importance of folate in early-life development. We aimed to determine folate status in women of reproductive age and pregnant women in Switzerland, and to assess folate awareness in the Swiss population. Methods: In a convenience sample of 171 women of reproductive age and 177 pregnant women throughout Switzerland, we measured red blood cell (RBC) folate concentration. In a second convenience sample (n = 784, men and women) we assessed folate knowledge with an online survey. Results: RBC folate concentration (median interquartile range) was 442 (366, 564) nmol/L in women of reproductive age and 873 (677, 1177) nmol/L in pregnant women. Folate deficiency (RBC folate <340 nmol/L) was found in 19.9% of women of reproductive age and 2.8% of pregnant women, while 91.8% of women of reproductive age and 52.0% of pregnant women showed folate concentrations indicating an elevated risk of neural tube defects (RBC folate <906 nmol/L). The online survey showed that a high proportion (≥88%) of participants were aware of folate’s role in neural tube defect (NTD) prevention and fetal development, yet knowledge about dietary sources and national recommendations of folate supplementation when planning pregnancy were limited. Conclusion: The high prevalence of folate inadequacy in Swiss women suggests an elevated risk of neural tube defects and calls for urgent measures to increase folate intakes.

scholarly journals Impact of Voluntary Folic Acid Fortification of Corn Masa Flour on RBC Folate Concentrations in the U.S. (NHANES 2011–2018)

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1325
Author(s):  
Arick Wang ◽  
Charles E. Rose ◽  
Yan Ping Qi ◽  
Jennifer L. Williams ◽  
Christine M. Pfeiffer ◽  
...  
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Hispanic Women ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Folic Acid Fortification ◽  
Folate Concentration ◽  
Corn Masa ◽  
The U.S

Surveillance data have highlighted continued disparities in neural tube defects (NTDs) by race-ethnicity in the United States. Starting in 2016, the Food and Drug Administration (FDA) authorized voluntary folic acid fortification of corn masa flour to reduce the risk of neural tube defects (NTDs) among infants of Hispanic women of reproductive age. To assess the impact of voluntary corn masa fortification, cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 for Hispanic women of reproductive age with available red blood cell (RBC) folate concentrations were analyzed, with additional analyses conducted among Hispanic women whose sole source of folic acid intake was fortified foods (enriched cereal grain products (ECGP) only), excluding ready-to-eat cereals and supplements. RBC folate concentration (adjusted geometric mean) among Hispanic women of reproductive age did not differ between 2011–2016 and 2017–2018, though RBC folate concentration increased significantly among lesser acculturated Hispanic women consuming ECGP only. Concentrations of RBC folate for those born outside the U.S and residing in the U.S <15 years increased from 894 nmol/L (95% CI: 844–946) in 2011–2016 to 1018 nmol/L (95% CI: 982–1162; p < 0.001) in 2017–2018. Primarily Spanish-speaking Hispanic women of reproductive age who only consumed ECGP saw an increase from 941 nmol/L (95% CI: 895–990) in 2011–2016 to 1034 nmol/L (95% CI: 966–1107; p = 0.03) in 2017–2018. By subpopulation, we observed no significant changes in the proportion at risk of NTDs (<748 nmol/L) and no changes in the model-based estimated NTD rates following voluntary corn masa fortification. This analysis suggests that there is a remaining risk among Hispanics for folate sensitive NTDs, though continued monitoring of folate status in future NHANES data cycles will help inform the long-term efficacy of voluntary fortification of corn masa flour.

Kinetics of myo-inositol loading in women of reproductive age

2003 ◽  
Vol 40 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Pascal M.W. Groenen ◽  
Hans M.W.M. Merkus ◽  
Fred C.G.J. Sweep ◽  
Ron A. Wevers ◽  
Fokje S.M. Janssen ◽  
...  
Keyword(s):  
Neural Tube ◽  
Neural Tube Defects ◽  
Plasma Insulin ◽  
Medical Center ◽  
Serum Glucose ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Loading Test ◽  
Intracellular Signalling Pathway ◽  
Urinary Glucose

Background: Myo-inositol plays a key role in an important intracellular signalling pathway. A deranged myo-inositol metabolism has been associated with neural tube defects. A myo-inositol loading test was performed to investigate the kinetics in healthy women of reproductive age. Methods: Five healthy non-obese females {mean age (standard deviation: SD) 22·8 (2·2) years} were recruited at the University Medical Center Nijmegen. Blood samples were drawn fasting and at 20, 40, 60, 90, 180 and 270 min after ingestion of 100 mg/kg body weight of myo-inositol. Urine samples were collected before myo-inositol loading and at 180 and 270 min post-loading. Samples were analysed for serum myo-, epi- and scyllo-inositol and glucose concentrations by gas chromatography. Plasma insulin concentrations were determined by radio-immunoassay. Random intercept models were fitted to evaluate the data. Results: The estimated myo-inositol and scyllo-inositol concentrations both reached maximum values at 180 min post-loading, respectively: mean (SD) 101·5 (9·2) µmol/L and 1·09 (0·11) µmol/L. The estimated plasma insulin and serum glucose concentrations decreased slightly but significantly during the experiment: P < 0·0001 and P < 0·05, respectively. At 180 and 270 min post-loading, urinary myo-inositol concentrations were increased and urinary glucose concentrations were unchanged. Conclusions: Myo-inositol enters the bloodstream quickly after oral ingestion and a small amount of myo-inositol is converted to scyllo-inositol. The synthesis of glucose from myo-inositol could not be detected by serum measurements. These data can be used in further research into the association between myo-inositol and neural tube defects.

scholarly journals Relationship between pregnant women and their partners during COVID-19 and the role of accompanying persons during childbirth

2021 ◽  
Vol 10 (4) ◽  
pp. 1
Author(s):  
Elizabete Pumpure ◽  
Dace Rezeberga ◽  
Gunta Lazdane ◽  
Ieva Briedite ◽  
Darja Mihailova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Online Survey ◽  
Research Question ◽  
Reproductive Age ◽  
World Health ◽  
Anxiety And Depression ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Support Person

Objective: Although the World Health Organization (WHO) recommends the presence of a support person, several hospitals in Latvia have restricted the presence of supporting persons due to COVID-19. This study was conducted to understand the importance of partnership and the role of the accompanying person in childbirth in the context of COVID-19 in Latvia.Methods: A mixed method study with sequential explanatory design was conducted from 26 July to 30 October 2020. The quantitative study consisted of a behavioral cross-sectional online survey with convenience sampling. The survey items, methods, and implementation were performed as part of the I-SHARE study carried out in 33 countries, with standardized survey instruments that were focused on sexual and reproductive health issues. In Latvia it was supported by the National Research Program to lessen the effects of COVID-19. Our study analyses only one part of all data. To answer the research question besides quantitative data the qualitative study that consisted of 7 semi-structured in-depth interviews and 11 focus group discussions was integrated.Results: 1,173 people of Latvia have participated in the I-SHARE online survey. The answers of 662 women of reproductive age and 70 pregnant women have been analyzed. Pregnant women had less tension with their partners and received higher partner emotional support before the COVID-19 pandemic than other women of reproductive age, and pregnant women were less frustrated during COVID-19 than non-pregnant women of reproductive age (p < .05). More than half (61.4%) of the pregnant women felt anxiety and depression due to COVID-19 restrictions. The qualitative part of the study revealed that having a partner during childbirth was an important aspect when choosing a facility to give birth in, as the lack of an accompanying person caused anxiety and additional stress.Conclusions: COVID-19 has increased anxiety and depression among pregnant women. Birth companions should not be considered third parties, and establishing a delivery unit visitor policy is necessary to balance the benefits and risks in an evidence-based and compassionate manner.

scholarly journals Folate and vitamin B12status of women of reproductive age living in Hanoi City and Hai Duong Province of Vietnam

2009 ◽  
Vol 12 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Vu Thi Thu Hien ◽  
Nguyen Thi Lam ◽  
Nguyen Cong Khan ◽  
Nguyen Tri Dung ◽  
C Murray Skeaff ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Vitamin B ◽  
Plasma Vitamin ◽  
Women Of Reproductive Age ◽  
Fortified Foods ◽  
Folate Concentration ◽  
Folate Status ◽  
Vietnamese Women ◽  
Increased Risk ◽  
Periconceptional Period

AbstractObjectivesTo assess the folate and vitamin B12status of a group of Vietnamese women of reproductive age and to estimate the rate of neural tube defects (NTD) based on red blood cell (RBC) folate concentrations.Design and subjectsA representative sample of non-pregnant women (15–49 years) living in Hanoi City (n244) and Hai Duong Province (n245).MeasuresRBC folate, plasma vitamin B12and plasma holo-transcobalamin (holoTC), a sensitive indicator of vitamin B12status.ResultsMean (95 % CI) concentrations of RBC folate, plasma B12and plasma holoTC were 856 (837, 876) nmol/l, 494 (475, 513) pmol/l and 78 (74, 82) pmol/l, respectively. Only 3 % and 4 % of women had plasma B12and holoTC concentrations indicative of deficiency. No woman had an RBC folate concentration indicative of deficiency (<317 nmol/l). Only 47 % of women had an RBC folate concentration ≥905 nmol/l. Accordingly, we predict the NTD rate in these regions of Vietnam to be 14·7 (14·2, 15·1) per 10 000 pregnancies.ConclusionThere was no evidence of folate and vitamin B12deficiency among this population of Vietnamese women. However, suboptimal folate status may be placing three out of five women at increased risk of NTD. Reductions in NTD rates are still possible and women would benefit from additional folic acid during the periconceptional period from either supplements or fortified foods.

scholarly journals Anemia and Vitamin B12 and Folate Status in Women of Reproductive Age in Southern India (P10-101-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Julia Finkelstein ◽  
Amy Fothergill ◽  
Christina Johnson ◽  
Heather Guetterman ◽  
Beena Bose ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Neural Tube ◽  
Reproductive Age ◽  
Southern India ◽  
Women Of Reproductive Age ◽  
Total Vitamin ◽  
Blood Samples ◽  
Folate Status ◽  
Defect Prevention ◽  
Study Population

Abstract Objectives To conduct a biomarker survey to examine the anemia burden and vitamin B12 and folate status in women of reproductive age as part of an ongoing periconceptional surveillance program in Southern India. Methods Participants were women of reproductive age (15–40 y) who were not pregnant or lactating and resided in households within the 50 km2 catchment area of our community-based research site in Southern India. Venous blood samples were collected at enrollment (n = 813), and whole blood samples were analyzed for hemoglobin using an automated Coulter counter. Plasma, serum, and red blood cells (RBC) were separated by centrifugation, processed, and stored <-80ºC until analysis. Total vitamin B12 was measured via chemiluminescence, and erythrocyte and serum folate concentrations were measured using the World Health Organization-recommended microbiological assay and chemiluminescence in a pilot sub-sample (n = 75) at our laboratory at St. John's Research Institute in Bangalore, India. Anemia and severe anemia were defined as hemoglobin <12.0 g/dL and <8.0 g/dL, respectively. Vitamin B12 deficiency and insufficiency were defined as total vitamin B12 < 148.0 pmol/L and <221.0 pmol/L, respectively. Folate insufficiency was defined as RBC folate <748.0 nmol/L the recommended calibrator adjusted equivalent of the optimal neural tube defect prevention threshold. Results A total of 39.1% of women in the overall study population were anemic and 2.7% had severe anemia. In the biomarker sub-sample, 18.9% of women were vitamin B12 deficient and 55.4% were vitamin B12 insufficient. Average RBC folate concentration was 486 (standard deviation: 227) nmol/L and the prevalence of RBC folate insufficiency, which is below the threshold for optimal neural tube defect prevention, was 83%. Conclusions The substantial burden of anemia, as well as vitamin B12 and folate insufficiency in this pilot study population, suggest an opportunity for prevention of neural tube defects and anemia. Findings from the biomarker survey will inform the development of a randomized efficacy trial for the prevention of anemia and birth defects in Southern India. Funding Sources Centers for Disease Control and Prevention ILSI North America Future Leader Grant AF was supported by the National Institutes of Health #5 T32 HD087137

Changes in folic acid supplementation behaviour among women of reproductive age after the implementation of a massive supplementation programme in China

2014 ◽  
Vol 18 (4) ◽  
pp. 582-588 ◽  
Author(s):  
Jufen Liu ◽  
Lei Jin ◽  
Qinqin Meng ◽  
Lili Gao ◽  
Le Zhang ◽  
...  
Keyword(s):  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Rural Areas ◽  
Chinese Women ◽  
Folic Acid Supplementation ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Acid Supplementation ◽  
Low Prevalence

AbstractObjectiveTo examine changes in periconceptional folic acid supplementation behaviour among Chinese women of reproductive age after the implementation of a folic acid supplementation programme.DesignTwo cross-sectional surveys were conducted.SettingOne survey was before (2002–2004) and the other was after (2011–2012) implementation of the programme, both were conducted in two areas of China with different prevalence of neural tube defects. Information on supplementation behaviours was collected in face-to-face interviews with women early in their pregnancy.SubjectsA total of 1257 and 1736 pregnant women participated before and after the programme, respectively.ResultsThe rate of periconceptional folic acid supplementation increased from 15 % to 85 % in the high-prevalence population and from 66 % to 92 % in the low-prevalence population. However, more than half of the women began taking the supplement after learning they were pregnant. The proportion of women who began taking folic acid before their last menstrual period decreased after the programme in rural areas with both a high and low prevalence of neural tube defects.ConclusionsAlthough periconceptional folic acid supplementation among Chinese women increased substantially after the programme, supplementation was often initiated too late to be effective in preventing neural tube defects. Educational and promotional campaigns should focus on how to increase the rate of folic acid supplementation before pregnancy.

Knowledge and Use of Folic Acid: In Women of Reproductive Age

2011 ◽  
Vol 72 (4) ◽  
pp. 197-200 ◽  
Author(s):  
Kelly R.S. Fehr ◽  
Kelsey D.H. Fehr ◽  
Jennifer Lisa Penner Protudjer
Keyword(s):  
Health Care ◽  
Folic Acid ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Health Care Professionals ◽  
Household Income ◽  
Reproductive Age ◽  
Sources Of Information ◽  
Childbearing Age ◽  
Women Of Reproductive Age

Folic acid reduces the risk of neural tube defects. As approximately 50% of pregnancies are unintended, women of reproductive age should be aware of the importance of folic acid. We reviewed the existing literature on these women’s knowledge of folic acid and neural tube defects. Databases searched were PubMed, CINAHL, and Health Reference Center Academic. We used terms such as “folic acid knowledge” and “folic acid awareness” to search articles published from 1998 to 2010. Awareness of the benefits of folic acid before conception and during pregnancy was low, although knowledge levels were associated with education and household income. Women who were already knowledgeable about folic acid cited health care professionals, magazines and newspapers, and radio and television as common sources of information. Effective knowledge translation is needed to ensure that women are informed about the benefits of folic acid during the reproductive years. This knowledge will allow them to make informed decisions about folic acid consumption. Health care professionals play an influential role in promoting folic acid knowledge among women of childbearing age. Lower levels of knowledge among women with lower levels of education and/or household income must be addressed.

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