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Published online: 2021-11-10
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Evaluation of the prevalence of folic acid supplementation before conception and through the first 12 weeks of pregnancy in Polish women at high risk of fetal anomalies

Anna Wojtowicz1, Dorota Babczyk1, Aleksander Galas1, Malgorzata Skalska-Swistek1, Magdalena Gorecka1, Rafal Witkowski1, Hubert Huras1
DOI: 10.5603/GP.a2021.0192
Affiliations
  1. Collegium Medicum, Jagiellonian University, Cracow, Poland

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ORIGINAL PAPERS Obstetrics
Published online: 2021-11-10

Abstract

Objectives: Local and international organizations recommend folic acid (FA) supplementation in the periconceptional period. This study aimed to analyse the prevalence of periconceptional supplementation with FA in women at high risk of fetal anomalies refferred for first trimester screening. 

Material and methods: Our analysis involved 1,455 women at high risk of fetal anomalies refferred for first trimester screening. FA supplementation was assessed by face-to-face interviews conducted by doctors performing first trimester screening for aneuploidy.

Results: FA supplementation before pregnancy was reported by 46.8% of the women and during the first trimester by 57.2% of those studied. Women used FA supplementation more frequently if they had a history of at least one miscarriage (OR 2.2, 95% CI 1.70–2.83; p < 0.001), a history of assissted reproductive techniques (OR 2.25, 95% CI 1.18–4.31; p = 0.014), or were aged between 30 and 34 (OR 2.87, 95% CI 1.47–5.58; p = 0.002). Among 122 women with a history of fetal defects only 50% confirmed FA supplementation before pregnancy and 62.2% during pregnancy (p = 0.488). A similar frequency of FA supplementation was noted among women with epilepsy, diabetes, and hypertension. Less frequent taking of FA was noted among women at least third and subsequent pregnancies (p < 0.001). In the current pregnancy, neural tube defects (NTDs) were less frequent by 86% in the group of women with FA supplementation than in the non-supplementation group (1 case vs 6 cases, respectively) and for other fetal defects by 62.5% (24 vs 40 cases, respectively).

Conclusions: We found an unsatisfactory compliance with recommendations for the use of folic acid supplementation during periconceptional period among women at high risk of fetal defects and folate deficiency, that could have negative effects on the health of child and mother. The study results show the need to increase the awareness of FA supplementation during periconceptional period especially in women with high risk of fetal anomalies.

Abstract

Objectives: Local and international organizations recommend folic acid (FA) supplementation in the periconceptional period. This study aimed to analyse the prevalence of periconceptional supplementation with FA in women at high risk of fetal anomalies refferred for first trimester screening. 

Material and methods: Our analysis involved 1,455 women at high risk of fetal anomalies refferred for first trimester screening. FA supplementation was assessed by face-to-face interviews conducted by doctors performing first trimester screening for aneuploidy.

Results: FA supplementation before pregnancy was reported by 46.8% of the women and during the first trimester by 57.2% of those studied. Women used FA supplementation more frequently if they had a history of at least one miscarriage (OR 2.2, 95% CI 1.70–2.83; p < 0.001), a history of assissted reproductive techniques (OR 2.25, 95% CI 1.18–4.31; p = 0.014), or were aged between 30 and 34 (OR 2.87, 95% CI 1.47–5.58; p = 0.002). Among 122 women with a history of fetal defects only 50% confirmed FA supplementation before pregnancy and 62.2% during pregnancy (p = 0.488). A similar frequency of FA supplementation was noted among women with epilepsy, diabetes, and hypertension. Less frequent taking of FA was noted among women at least third and subsequent pregnancies (p < 0.001). In the current pregnancy, neural tube defects (NTDs) were less frequent by 86% in the group of women with FA supplementation than in the non-supplementation group (1 case vs 6 cases, respectively) and for other fetal defects by 62.5% (24 vs 40 cases, respectively).

Conclusions: We found an unsatisfactory compliance with recommendations for the use of folic acid supplementation during periconceptional period among women at high risk of fetal defects and folate deficiency, that could have negative effects on the health of child and mother. The study results show the need to increase the awareness of FA supplementation during periconceptional period especially in women with high risk of fetal anomalies.

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Keywords

folic acid supplementation; pregnancy; fetal defects; epidemiology

About this article
Title

Evaluation of the prevalence of folic acid supplementation before conception and through the first 12 weeks of pregnancy in Polish women at high risk of fetal anomalies

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-11-10

DOI

10.5603/GP.a2021.0192

Keywords

folic acid supplementation
pregnancy
fetal defects
epidemiology

Authors

Anna Wojtowicz
Dorota Babczyk
Aleksander Galas
Malgorzata Skalska-Swistek
Magdalena Gorecka
Rafal Witkowski
Hubert Huras

References (31)
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