In 2007, the Society of Obstetricians and Gynaecologists of Canada (SOGC) introduced new guidelines on periconceptional folic acid supplementation.
To evaluate the concordance between the SOGC guidelines and actual vitamin/folic acid supplementation, and to identify maternal determinants of concordant folic acid use.MethodsFrom May to July 2010, pregnant women attending the outpatient clinic at CHU Ste-Justine in Montreal were surveyed to assess use of folic acid. Data on socio-demographic factors, lifestyles, family and personal medical history, and periconceptional folic acid supplementation were collected using a self-administrated questionnaire. Concordance between maternal reported intake of folic acid and SOGC guidelines was estimated accounting for pregnancy history, comorbidities, and lifestyles.
A total of 361 eligible women gave informed consent; of these, 97 (27%) had periconceptional folic acid supplementation intake that was concordant with guidelines. Women with no personal history of neural tube defects (NTDs) were the most concordant with guidelines (36%), followed by women with a previous child with NTD (26%), and women with health risk factors for NTDs (18%). Women who smoked and drank alcohol had the lowest concordance with guidelines (4%). Women with planned pregnancies and higher income were more likely to be concordant with guidelines; whereas, smokers, alcohol and recreational drug user and women with health risk for NTDs were less likely to be concordant.
Concordance with clinical guidelines was low, even for women with a history of NTDs. Our findings highlight the need for public health programs to inform women to consume folic acid every day before and during pregnancy.