Use of high doses of folic acid supplements in pregnant women in Spain: an INMA cohort study
Por:
Navarrete E, Valera-Gran D, García de la Hera M, Gimenez-Monzo D, Morales E, Julvez J, Riaño I, Tardón A, Ibarluzea J, Santa-Marina L, Murcia M, Rebagliato M, Vioque J and INMA Project
Publicada:
1 ene 2015
Categoría:
Medicine (miscellaneous)
Resumen:
Objectives: We examined the use of low (<400 mu g/day, including no use) and high folic acid supplement (FAS) dosages (>= 1000 mu g/day) among pregnant women in Spain, and explored factors associated with the use of these non-recommended dosages.
Design: Population-based cohort study.
Setting: Spain.
Participants: We analysed data from 2332 pregnant women of the INMA study, a prospective mother-child cohort study in Spain.
Main outcome measures: We assessed usual dietary folate and the use of FAS from preconception to the 3rd month (first period) and from the 4th to the 7th month (second period), using a validated food frequency questionnaire. We used multinomial logistic regression to estimate relative risk ratios (RRRs).
Results: Over a half of the women used low dosages of FAS in the first and second period while 29% and 17% took high dosages of FAS, respectively. In the first period, tobacco smoking (RRR=1.63), alcohol intake (RRR=1.40), multiparous (RRR=1.44), unplanned pregnancy (RRR=4.20) and previous spontaneous abortion (RRR=0.58, lower use of high FAS dosages among those with previous abortions) were significantly associated with low FAS dosages. Alcohol consumption (RRR=1.42), unplanned pregnancy (RRR=2.66) and previous spontaneous abortion (RRR=0.68) were associated with high dosage use. In the second period, only tobacco smoking was significantly associated with high FAS dosage use (RRR=0.67).
Conclusions: A high proportion of pregnant women did not reach the recommended dosages of FAS in periconception and a considerable proportion also used FAS dosages >= 1000 mu g/day. Action should be planned by the Health Care System and health professionals to improve the appropriate periconceptional use of FAS, taking into consideration the associated factors.
Filiaciones:
Navarrete E:
Departamento Salud Pública, Universidad Miguel Hernández, San Juan de Alicante, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
Valera-Gran D:
Departamento Salud Pública, Universidad Miguel Hernández, San Juan de Alicante, Spain
García de la Hera M:
Departamento Salud Pública, Universidad Miguel Hernández, San Juan de Alicante, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
Gimenez-Monzo D:
Departamento Salud Pública, Universidad Miguel Hernández, San Juan de Alicante, Spain
Morales E:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
Julvez J:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
Riaño I:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Servicio de Pediatria, Hospital San Agustin-Aviles, Asturias, Spain
Tardón A:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Universidad de Oviedo, Asturias, Spain
Ibarluzea J:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Subdirección de Salud Pública y Adicciones de Gipuzkoa, San Sebastian, Spain Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain
Santa-Marina L:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Subdirección de Salud Pública y Adicciones de Gipuzkoa, San Sebastian, Spain Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain
:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO/CSISP), Public Health, Valencia, Spain
:
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain Departamento de Medicina, Universitat Jaume I, Castellón de la Olana, Spain
Vioque J:
Departamento Salud Pública, Universidad Miguel Hernández, San Juan de Alicante, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
Open Access
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