Awareness of the benefits of folic acid and prevalence of the use of folic acid supplements to prevent neural tube defects among Thai women

Objective To determine the level of knowledge about the usefulness of periconceptional folic acid supplementation among pregnant women. Materials and methods An anonymous questionnaire was completed by selected subjects to assess folic acid awareness. The questionnaire was administered to pregnant women who were seeking antenatal care at King Chulalongkorn Memorial Hospital May to December 2005. The questions covered their knowledge and use of folic acid supplements, pregnancy intention, and demographic and socioeconomic characteristics. Results Out of 401 women surveyed, 76.1% of them reported that they had heard of folate. Of these, only 24.4% of the total subjects knew that folate was something important. Overall, 9.7% of the total women took folic acid during periconceptional period. The most common information sources on folate were the media. Logistic regression analysis showed that education of mother was the strongest predictor of having taken folic acid during the correct period. Conclusion Although some pregnant women are aware of the need to take folic acid, the actual impact of the present recommendations is almost negligible. Information to specifically inform patients about the need to take folic acid to prevent neural tube defects by medias and healthcare personnel seem to improve the final intake of folic acid during the protective period.     

The regional campaign for women on awareness of neural tube defects and folic acid in Narlidere,Izmir: a community-based intervention

Objectives To create an awareness among women and to update the knowledge of health personnel about neural tube defects (NTDs) and folate in order to reduce the incidence of NTD in Narlidere, ?zmir.

Methods In 2006, a regional campaign was organized in Narlidere, Izmir that aimed at informing women of child-bearing age on folic acid and prevention of NTD. Nearly 4400 women participated in the study. By means of questionnaires the level of knowledge before and after the intervention was evaluated.

Results Before the campaign was carried out, 18% of women had heard of folic acid. Their level of knowledge increased after the campaign (p < 0.0001). Post-intervention scores of high school and university graduates and women with high or middle income, as well as those having a friend or kin with spina bifida were found to have significantly improved.

Conclusions The pilot community-based training programme was very successful. Similar programmes, integrated within routine health care services, promoting the use of folic acid will be fostered in the whole country.     

Periconceptional folic acid use among women giving birth at Queen Mary Maternity Hospital in Dunedin

BACKGROUND: The New Zealand Ministry of Health advises that all women planning a pregnancy take a folic acid supplement to reduce the risk of having a neural tube defect (NTD)-affected pregnancy. There is little information available to determine if women are following this advice. OBJECTIVE: The purpose of this study was to determine periconceptional folic acid use among women in the postnatal ward of Queen Mary Maternity Hospital in Dunedin. METHODS: A questionnaire was administered to women in the postnatal ward between 14 November and 22 December 2004. RESULTS: One hundred and six women were interviewed during the study period. Forty women (39%) used folic acid supplements before conception. Sixty-seven women (64%) planned their pregnancy. The proportion of women (P<0.001) who planned their pregnancy (53%) and used folic acid before conception was higher than those who did not (11%). The proportion of women 30 years of age (55%) who took folic acid supplements before conception was higher than women aged 17 to <25 years (10%). CONCLUSION: Despite a lack of a public health campaign in New Zealand, a high proportion of participants, especially those who planned their pregnancy, took folic acid during the periconceptional period. A comprehensive public health campaign is needed to increase folic acid use. Fortification may be required to reach those women who do not plan their pregnancies.     

Folate intake in young women and their knowledge of pre- conceptional folate supplementation to prevent neural tube defects

Objectives: To ascertain knowledge of periconceptional folate for prevention of neural tube defect (NTD) and to estimate folate intake in young women. Study design: Three hundred young women were questioned about their knowledge of folate for prevention of NTD. Their folate intake was assessed by food frequency questionnaire. Results: Fourteen per cent of 16–19 year olds and 41% of undergraduates were aware of the need to increase folate intake before conception. Median folate intake was estimated to be 235 μg/d in 16–19 year olds and 248.5 μg/d in undergraduates. More than a quarter of women in both groups had folate intakes less than the reference nutrient intake (RNI) (200 μg/d) below which prevalence of NTD rises dramatically and these women would therefore be at increased risk of having a child with NTD should they have an unplanned pregnancy. Conclusions: Strategies are required to increase folate intake among young women and inform them of the benefit of peri-conceptional folate supplementation.     

Application of the social ecological model in folic acid public health initiatives

All women of childbearing age who are capable of becoming pregnant should consume 0.4 mg/400 microg of folic acid daily. Folic acid decreases the incidence of neural tube defects in newborns. Despite continued public health initiatives, many women still do not consume the recommended daily requirement. This article analyzes the use of the social ecological model in folic acid public health initiatives and emphasizes assessing the outcomes of such initiatives.     

Trends and predictors of folic acid awareness and periconceptional use in pregnant women

OBJECTIVE: The purpose of this study was to describe recent trends in folic acid awareness and use in the periconceptional period among pregnant women in relation to maternal sociodemographic and other relevant factors. STUDY DESIGN: From 1988 to 2002, 16,555 women from the Slone Epidemiology Center Birth Defects Study were interviewed about medication use before and during pregnancy (which included multivitamins and folic acid), about whether they were aware of any vitamins that might decrease the risk of birth defects, and about sociodemographic and medical factors. RESULTS: Awareness of folic acid benefits increased from 0 in 1988 to 50% in 1996 and thereafter. The use of folic acid in the periconceptional period increased from 15% in 1988 to 40% in the last few years. Maternal education was a strong independent predictor of both awareness and use as were ethnicity, whether the pregnancy was wanted, family income, and whether a health care provider was consulted before planning. CONCLUSION: Promoting the use of folic acid supplements, particularly among these disadvantaged groups, is essential to further decrease the prevalence of neural tube defects.     

The effect of folic acid supplementation on serum homocysteine of egyptian post menopausal women: A randomized controlled trial

ObjectiveTo evaluate the effect of folic acid supplementation on serum homocysteine (HCY) level in Egyptian post-menopausal women.Patients and methodsThe current randomized controlled trial was conducted at the Ain Shams University Maternity Hospital, Cairo, Egypt. 100 included women were divided into three groups: group C; 20 premenopausal women while the rest 80 women were postmenopausal (who were randomly divided into two groups; group A who received 5 mg folic acid for 6 weeks and group B who received placebo). Blood samples were collected from 100 women. Other samples were collected from 80 women (postmenopausal) 6 weeks after treatment. Serum was analyzed for HCY.ResultsSerum HCY was significantly higher in postmenopausal than premenopausal women (14.7 ± 6.4 μmol/L versus 6.3 ± 1.4 μmol/L, in group A and group C, respectively) and (15.3 ± 5.4 μmol/L versus 6.3 ± 1.4 μmol/L, in group B and group C, respectively).HCY was significantly reduced in postmenopausal women after receiving folic acid (14.7 ± 6.4 μmol/L versus 12.4 ± 6.4 μmol/L, before and after treatment, respectively), while there was a decrease in serum HCY level of postmenopausal women after receiving placebo but not to reach a statistical significant level (15.3 ± 5.4 μmol/L versus 14.9 ± 7.6 μmol/L, before and after placebo, respectively). There was a statistical significant reduction in serum HCY in group A after receiving 5 mg folic acid compared to group B after receiving placebo (12.4 ± 6.4 μmol/L versus 14.9 ± 7.6 μmol/L, respectively).ConclusionSerum HCY level was significantly higher in Egyptian postmenopausal than premenopausal women. Postmenopausal Folic acid supplementation seems to reduce serum HCY, but not to premenopausal level.     

Periconceptional folic acid supplementation among women attending antenatal clinic in Anhui, China: data from a population-based cohort study

Objectives

to examine the rate of periconceptional and optimal folic acid supplementation, and to characterise their patterns and determinants among antenatal women in central China.

Design

data from 4290 women in the Anhui Birth Defects and Child Development Cohort Study recruited between October 2008 and September 2009 were analysed.

Setting

seven Maternal and Child Health Centres of two cities (Hefei and Maanshan) in Anhui province of central China.

Participants

women initiating prenatal care were included and asked to complete a structured questionnaire regarding folic acid supplementation.

Findings

sixty-eight per cent (2905/4290) of pregnant women reported taking folic acid supplementation periconceptionally (i.e. at some point before or during early pregnancy), and 32.8% (1405/4290) and 65.2% (2797/4290) had taken it before or during early pregnancy, respectively. However, only 16.1% (690/4290) used it optimally (i.e. regularly from four weeks before pregnancy throughout four weeks after pregnancy). Use of periconceptional folic acid was significantly associated with educational level, household income, registered residence, age, gestational age at recruitment, and planning of pregnancy.

Conclusion

optimal folic acid supplementation was relatively low.

Implications for practice

further efforts are needed to inform the population and promote the use of folic acid supplementation.     

母体叶酸水平与子代生长发育状况相关性的研究进展

叶酸是一种重要的人体必需营养素。研究表明,孕期补充叶酸可以预防多种出生缺陷的发生,已有多个国家全面推行了叶酸强化政策。但有证据指出,过量补充叶酸不仅无法预防疾病,还会适得其反。目前研究聚焦在母体叶酸补充剂量与子代健康的相关性上,特别是孕期过量补充叶酸是否会对子代造成副作用。本文拟从叶酸的代谢、人群叶酸营养水平、临床常见的叶酸检测方法、应用以及母体叶酸摄入异常对后代生长发育的影响4个方面进行综述。     

A randomized controlled trial examining the addition of folic acid to iron supplementation in the treatment of postpartum anemia

Objective

To evaluate the efficacy of adding folic acid to oral iron supplementation in postpartum women with anemia.

Methods

A randomized controlled trial was conducted in the Netherlands between April 8, 2008, and August 31, 2010. A total of 112 postpartum women with anemia (hemoglobin < 10.5 g/dL) were randomly allocated to receive 600 mg/day ferrous fumarate plus 1 mg/day folic acid (FFFA group) or 600/day ferrous fumarate alone (FF group) for 4 weeks. Primary outcome measures were hemoglobin and health status. Secondary outcome measures were fatigue, compliance, and adverse reactions.

Results

No between-group differences were observed in hemoglobin and health status after treatment, and no differences were found in fatigue scores. Approximately 75% of all women reported having at least one symptom resulting from ferrous fumarate use. Constipation caused by ferrous fumarate was significantly associated with non-compliance (P = 0.014).

Conclusion

The addition of folic acid to iron supplementation is not beneficial in women with postpartum anemia, as it has no effect on hematologic or health status parameters. Clinical Trial Registration: CCMO website NL21797.028.08 and Netherlands Trial Register NTR2232.     

Folic acid supplementation among diabetic, overweight, or obese women of childbearing age

OBJECTIVE: To examine whether obese, overweight, or diabetic women were equally likely to supplement with folic acid as normal-weight or nondiabetic women. DESIGN: Texas Behavioral Risk Factor Surveillance System was used to compare folic acid supplementation rates among obese, overweight, or diabetic women to those of normal-weight or nondiabetic women. PARTICIPANTS: Responses from nonpregnant Texas women of ages 18 to 44 were analyzed. MAIN OUTCOME MEASURES: Odds ratios were calculated for association between diabetes, body mass index, and folic acid supplementation. RESULTS: Of 6,835 participants, 35% reported daily folic acid supplementation. Obese women were less likely to supplement, even after adjustment for other factors. CONCLUSIONS: All women of childbearing age, but especially those who are obese or diabetic, should be encouraged to take folic acid daily to reduce the risk of neural tube defects.     

叶酸偶联纳米紫杉醇靶向治疗卵巢癌的细胞实验研究

目的:研究叶酸(FA)偶联纳米紫杉醇对卵巢癌的体外治疗效果,并初步探讨其作用机制。方法:共孵育法制备FA偶联纳米紫杉醇,荧光显微镜和流式细胞仪定性和定量测定其对SKOV3细胞的靶向作用,绘制细胞生长曲线;噻唑蓝法、流式细胞术及电子显微镜下观察FA偶联纳米紫杉醇对SKOV3细胞和SKOV3/TAX细胞的体外杀伤效应。结果:(1)FA偶联纳米紫杉醇的粒径为(140.5±10.3)nm,包封率为97%;(2)FA偶联纳米紫杉醇在FA受体(FR)介导下对SKOV3细胞有靶向杀伤作用,并且随时间延长,细胞内药物浓度逐渐增加;(3)FA偶联纳米紫杉醇对SKOV3细胞及SKOV3/TAX细胞的药效显著强于纳米紫杉醇,SKOV3/TAX细胞对FA偶联纳米紫杉醇的耐药指数有下降趋势。结论:FA偶联纳米紫杉醇可能利用FR为作用靶点,将药物主动靶向肿瘤细胞,提高药物在肿瘤细胞内的分布。其抗肿瘤疗效优于传统的紫杉醇。     

Effect of folic acid in women with and without insulin resistance who have hyperhomocysteinemic polycystic ovary syndrome.

OBJECTIVE: To study the effect of folic acid on homocysteine (Hcy) levels in women with insulin resistance and polycystic ovary syndrome (PCOS) in a prospective clinical trial. METHOD: Of 210 women with PCOS, 70 were hyperhomocysteinemic; and of these, 32 were insulin resistant and 38 were not. The 70 women were treated with folic acid for 3 months. Baseline and serum levels of Hcy and insulin were measured in both groups. RESULTS: In both groups Hcy concentrations were significantly decreased following folic acid supplementation. The mean+/-SD levels before and after treatment were 14.03+/-1.5 micromol/L and 12.53+/-1.72 micromol/L in group 1 (P<0.001), and they were 12.07+/-0.87 micromol/L and 8.83+/-0.78 micromol/L in group 2 (P<0.001). CONCLUSION: The Hcy levels of hyperhomocysteinemic women with PCOS were reduced after 3 months of folic acid supplementation, and the rate of reduction was higher among women without insulin resistance. No change was found in fasting insulin levels.     

The relationship of homocyteine,B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women

Objective  The relationship of homocyteine, B12 and folic acid with osteoporosis has already been studied in various populations. We compared the important factors in the metabolism of homocysteine, such as homocysteine, B12 and folic acid levels, of Turkish postmenopausal women, and their relationship with the femur and lumbar spine bone mineral density. Methods  This cross-sectional study was conducted at Gazi University, Department of Obstetrics and Gynecology. The study group consisted of 178 postmenopausal women. Serum homocysteine, folic acid and Vitamin B12 were measured. BMD was measured using DEXA at the right femoral neck and lumbar spine (L1–L4). Results  Upon evaluation of both the femur and lumbar spine, it was determined that osteoporosis could be associated with a homocysteine level above the median and with a B12 value under the lowest quintile value. Conclusion  Plasma Hcy and vitamin B12, but not folate levels, were associated with osteoporosis. Future interventional studies are needed to determine methods to reduce Hcy levels with dietary supplements and extra vitamin B12, which will restore bone health and reduce risk of fractures.