herald

Saturday 21 September 2019

Less than half of Irish mothers taking folic acid before pregnancy

Women ‘should be taking folic acid before pregnancy’
Women ‘should be taking folic acid before pregnancy’

Less than half of Irish mothers take folic acid before becoming pregnant, a new survey suggests.

Women are advised to take the B vitamin for at least a month before conception and up to the 12th week of pregnancy.

A deficiency is linked to serious birth conditions, including spina bifida and anencephaly, which affects the brain.

Some 54pc of the women surveyed after giving birth at Coombe Women and Infants University Hospital had not taken folic acid before conception.

The average point of commencement of folic acid was more than six weeks after the last menstrual period.

The most commonly selected reason for not taking folic acid prior to conception was that the women "did not expect to get pregnant".

One of the authors of the survey, Dr Eimer O'Malley, said: "Only half the women started taking folic acid before pregnancy to prevent neural tube defects.

"Nearly all of the remaining women started it in the first trimester, which is usually too late."

She said that the survey, carried out in 2018, found there was also great variation in the consumption of iron supplements during pregnancy.

"All women should adhere to a healthy diet during pregnancy, but a healthy diet alone does not provide enough folic acid and may not provide enough iron for mother and baby," Dr O'Malley added.

Regarding the source of advice on folic acid, six out of 10 women surveyed were advised by their family doctor.

Just over a third of them said they chose to take folic acid "to prevent or reduce spina bifida".

Cereals

Trials in the 1990s found that folic acid supplementation that started before pregnancy and continued until after closure of the neural tube after the first month prevented about two thirds of neural tube defects, which include spina bifida and anencephaly.

As a result, more than 80 countries around the world decided to introduce the mandatory folic acid fortification of cereals.

Ireland, however, is not among those countries.

Britain is currently in the process of consulting on plans to add folic acid to flour to help prevent birth defects such as spina bifida.

"In countries like Ireland, where the dietary intake of folate is inadequate, supplementation would be required for two to three months pre-pregnancy", Dr O'Malley said.

"The advice to take folic acid all the time arises because the pregnancy may not be planned," she added.

The questionnaire used in the Coombe Hospital survey was completed by women in the postnatal wards after delivering a live healthy baby.

Just over half of the respondents were first-time mothers, with an average age of 30. Just over three quarters were Irish-born.

Use of folic acid before conceiving their baby was reported by 44pc of the women and the average duration of folic acid use before becoming pregnant was 32 weeks.

Some 60pc of the women reported taking iron at some point during pregnancy.

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