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Optimization of folic acid supplementation in the prevention of neural tube defects.
J Public Health (Oxf). 2018 12 01; 40(4):827-834.JP

Abstract

Background

We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs).

Methods

Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate.

Results

Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 μg 4-8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4-8 weeks after their LMP (P < 0.001).

Conclusions

This study provides, for the first time, information on both the timing and duration of FA that will achieve the optimum RBC folate levels associated with the prevention of NTDs. Women who are taking FA (400 μg) need to start before they conceive.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Cawley S
UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. School Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin, Ireland.
McCartney D
School Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin, Ireland.
Woodside JV
CRC Centre of Excellence for Public Health Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
Sweeney MR
School of Nursing and Human Sciences, Dublin City University, Dublin Ireland.
McDonnell R
Health Intelligence Unit, Dr Steevens Hospital, Health Service Executive, Dublin, Ireland.
Molloy AM
School of Medicine, Trinity College Dublin, Dublin, Ireland.
Turner MJ
UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.

MeSH

AdultAnencephalyDietary SupplementsDrug Administration ScheduleFemaleFolic AcidHumansNeural Tube DefectsPregnancy

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29059388

Citation

Cawley, Shona, et al. "Optimization of Folic Acid Supplementation in the Prevention of Neural Tube Defects." Journal of Public Health (Oxford, England), vol. 40, no. 4, 2018, pp. 827-834.
Cawley S, McCartney D, Woodside JV, et al. Optimization of folic acid supplementation in the prevention of neural tube defects. J Public Health (Oxf). 2018;40(4):827-834.
Cawley, S., McCartney, D., Woodside, J. V., Sweeney, M. R., McDonnell, R., Molloy, A. M., & Turner, M. J. (2018). Optimization of folic acid supplementation in the prevention of neural tube defects. Journal of Public Health (Oxford, England), 40(4), 827-834. https://doi.org/10.1093/pubmed/fdx137
Cawley S, et al. Optimization of Folic Acid Supplementation in the Prevention of Neural Tube Defects. J Public Health (Oxf). 2018 12 1;40(4):827-834. PubMed PMID: 29059388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimization of folic acid supplementation in the prevention of neural tube defects. AU - Cawley,Shona, AU - McCartney,Daniel, AU - Woodside,Jayne V, AU - Sweeney,Mary Rose, AU - McDonnell,Robert, AU - Molloy,Anne M, AU - Turner,Michael J, PY - 2017/05/04/received PY - 2017/10/24/pubmed PY - 2019/11/26/medline PY - 2017/10/24/entrez SP - 827 EP - 834 JF - Journal of public health (Oxford, England) JO - J Public Health (Oxf) VL - 40 IS - 4 N2 - Background: We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs). Methods: Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate. Results: Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 μg 4-8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4-8 weeks after their LMP (P < 0.001). Conclusions: This study provides, for the first time, information on both the timing and duration of FA that will achieve the optimum RBC folate levels associated with the prevention of NTDs. Women who are taking FA (400 μg) need to start before they conceive. SN - 1741-3850 UR - https://www.unboundmedicine.com/medline/citation/29059388/Optimization_of_folic_acid_supplementation_in_the_prevention_of_neural_tube_defects_ DB - PRIME DP - Unbound Medicine ER -