Characteristics Associated with Adequate Folic Acid Supplementation in a Multicultural Urban Setting

ABSTRACT Objective: To determine the proportion of pregnant women taking folic acid supplementation as recommended and to determine their demographic characteristics. Methods: From June to December 2002, women attending their first prenatal visit to an outpatient clinic at a 500-bed tertiary mother–child hospital in Montreal were surveyed about their use of folic acid. Demographic data, including age, country of origin, education level, maternal diseases, parity, marital status, and family income, were recorded. The hospital serves a multicultural local population and the high-risk population in a larger geographic area. Results: Of the 75 women recruited, only 29 (39%) were taking adequate folic acid supplementation. Four demographic differences were observed between those taking folic acid as recommended and those who were not. The proportion born in Canada was higher among those with adequate folic acid supplementation than among those with inadequate supplementation (76% and 43% respectively, p = 0.008), as were the proportions involved in a stable relationship (100% and 80%, p = 0.006), with a postsecondary education (86% and 46%, p = 0.001), and with a household income of $40 000 or more (72% and 37%, p = 0.004). Conclusion: Just over one-quarter of the women in this sample were taking folic acid supplementation adequate to prevent neural tube defects. More effort is required to inform the public of the need for and proper use of folic acid. Such efforts should focus on identified groups who tend not to take folic acid or who take such supplements incorrectly. RESUME Objectif : Determiner la proportion de femmes enceintes qui prennent des supplements d’acide folique, comme recommande, ainsi que leurs caracteristiques demographiques. Methodes : De juin a decembre 2002, les femmes qui se presentaient a leur premiere visite de suivi prenatal en consultation externe dans un hopital de soins tertiaires mere-enfant de 500 lits a Montreal ont fait l’objet d’un sondage a propos de leur utilisation d’acide folique. Les donnees demographiques, y compris l’âge, le pays d’origine, le niveau de scolarite, les maladies maternelles, la parite, l’etat matrimonial et le revenu familial ont ete recueillies. L’hopital dessert une population locale multiethnique et la population a haut risque dans une zone geographique plus etendue. Resultats : Des 75 femmes sondees, seulement 29 (39 %) prenaient un supplement adequat d’acide folique. Quatre differences au plan demographique ont ete observees entre les femmes qui prenaient leur supplement d’acide folique comme recommande et celles qui ne le prenaient pas comme recommande. En comparaison avec celles dont la supplementation etait insuffisante, une plus grande proportion des femmes qui prenaient un supplement suffisant d’acide folique etaient nees au Canada (respectivement 76 % vs 43 %, p = 0,008), vivaient une relation stable (100 % vs 80 %, p = 0,006), avaient une formation postsecondaire (86 % vs 46 %, p = 0,001) et avaient un revenu familial superieur a 40 000 $ (72 % vs 37 %, p = 0,004). Conclusion : Un peu plus du quart des femmes de cet echantillon prenaient un supplement adequat d’acide folique afin de prevenir les anomalies du tube neural. Plus d’efforts devront etre investis pour informer la population du besoin de prendre des supplements d’acide folique de facon adequate. Ces efforts devront etre diriges sur des groupes cibles qui ont tendance a ne pas prendre de supplements d’acide folique ou a en prendre incorrectement.