Folic Acid: Are they getting enough? (infographic)

What we know

Age, education, geographic location and income affect what women know about the importance of folic acid. According to the Canadian Community Health Survey (2015) women aged 15–45 years who had given birth in the past 5 years:

• Before their pregnancy, 71% of women knew that taking folic acid before conception can lower the risk of neural tube defects (NTD).
• 60% of women reported taking folic acid in the three months before conception. 98% of these women took it daily or almost daily.

Recommended Dietary Allowance

Women of reproductive age: 400 mcg dietary folate equivalents per day

Pregnant women: 600 mcg dietary folate equivalents per day

What you need to know

To reduce the risk of fetal neural tube defects, women of reproductive age (12-45 years of age) who could become pregnant need to be advised on the benefits of folic acid in a multivitamin supplement. Promote the following, regardless of whether the client is planning a pregnancy or not:

1. A diet high in folate should be encouraged, but as dietary intake is not enough to reach red blood cell folate levels associated with maximal protection against neural tube defects, a daily multivitamin containing 0.4 mg of folic acid is needed for low risk women who are of reproductive age and could become pregnant.
2. Higher intake of folic acid for women with these risk factors:
   • Previous pregnancy affected with NTD
   • Personal or male partner family history of NTD
   • Personal or family history of other folic acid related congenital anomalies
   • Pre-pregnancy diabetes (type 1 or 2)
   • Kidney dialysis
   • GI malabsorption condition such as inflammatory bowel disease, celiac disease and gastric bypass surgery
   • Antiepileptic or other folate inhibiting medications
   • Advanced liver disease
   • Alcohol overuse

Where you can learn more

• Canada.ca
• SOGC Clinical Practice Guideline—Pre-conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies (2015)
• Health Canada—Prenatal Nutrition Guidelines for Health Professionals: Folate (2009)

Where women can learn more

• Canada.ca
• Pregnancyinfo.ca

Sources:

• Health Canada. Prenatal nutrition guidelines for health professionals - Folate contributes to a healthy pregnancy. Ottawa (ON): HC; 2009.
• Society of Obstetricians and Gynaecologists of Canada. Clinical Practice Guideline. Preconception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid—sensitive congenital anomalies. Number 324, May 2015. J Obstet Gynaecol Can. 2015;37(6):534–49.
• Statistics Canada. Canadian Community Health Survey annual component, 2015.