Periconceptional folic acid (FA) supplementation among pregnant women in Bosnia and Herzegovina: A cross-sectional study

Abstract

Folic acid (FA) supplementation is recommended for all women of childbearing age and pregnant women. Still, women's adherence to these recommendations is often low. This crosssectional survey aimed to assess FA supplementation among pregnant women in Bosnia and Herzegovina (BiH) since no such data exist to date. Data were collected by a voluntary, anonymous, self-administered internet-based questionnaire. The inclusion criteria were current pregnancy, BiH origin, and BiH residence for at least the past 5 years. The vast majority (82.1%) of women reported inadequate periconceptional FA supplementation, and only 26.9% reported supplementation during the critical period for neural tube closure. The use of a high dose (≥5 mg/day) FA beyond the first trimester was reported by 9.0% of women. Women's age was significantly associated with adequate folic acid use for the prevention of neural tube defects (OR=1.207, p<0.05). The periconceptional FA supplementation in the studied population is suboptimal. These preliminary data call for action, especially because BiH is a lower-middleincome country without mandatory FA food fortification program. Further research on folate dietary intake and folate status in the target group, as well as possible predictors of the low prevalence of supplementation, is recommended.

Comparative Scoping Review of Prenatal Care Resources for Families of Children With Spinal Dysraphism and Hydrocephalus in High-Income Countries and Low- and Middle-Income Countries

“…Up to half of all NTDs are preventable by folic acid fortification, and periconceptional supplementation has been shown to decrease the prevalence of NTDs by up to 70%. 34,35 A variety of campaigns to increase folate intake have been proposed and attempted, including prenatal education, because limited awareness contributes to low intake. [36][37][38][39][40] For example, at one hospital in Nigeria, only 25% of women knew that folic acid can prevent birth defects.…”