Folic Acid Supplementation in Italian Women During Pregnancy: A Cross Sectional Study Conducted in General Practice

Abstract Background The association between folate insufficiency and congenital neural tube defects has been extensively investigated since 1990s. To reach an adequate intake of folic acid (FA), it is suggested to improve folate status through periconceptional supplementation with FA, promotion of the consumption of foods rich in natural folates, and the appropriate use of fortified foods. Aim The aim of the present study was to investigate the supplementation of folic acid in a sample of pregnant women referring to general practice services in Italy focusing on the quality of information received by fertile women. Design and settings Participants were recruited from patients admitted to 44 GP offices enrolled in the SIMPeSV (Italian Society of Preventive Medicine and Lifestyle) and distributed in Italy throughout the national territory. Methods A questionnaire for the evaluation of FA supplementation was administered by the GPs. The interviewed subjects were asked to provide information about pregnancy characteristics, nutritional habits, lifestyle and risk factors, information sources, knowledge about folic acid. Results This study included 328 participants. The percentage of women who did not assume any FA supplements was 16.8%, and 66.4% of women started FA supplementation only after finding out to be pregnant. Only 16.8% of women started folic acid supplementation 12 weeks before the beginning of pregnancy. The lack of supplementation with FA, as well as the incorrect adherence to the extant FA supplementation protocol are attributable to different social (immigration, place of residence, job employment) and cultural factors (educational level, knowledge about FA), to the relatively poor planning of pregnancies, and to the lack of information concerning the need for FA supplementation already in the pre-pregnancy period. Finally, GPs and gynecologists basically represent the only sources of information on the importance of FA supplementation. Conclusion The adherence of women to FA supplementation before pregnancy is still insufficient. GPs’ role in preconception care, and thus in promoting FA supplementation, needs to be emphasized and further promoted.