Epidemiology of folic acid/folates use in the preconceptional period and during pregnancy in Italy: results from a cross-sectional observational study

Objective: Preconceptional folic acid/folates supplementation is an important preventive measure to reduce the risk of neural tube defects and adverse pregnancy outcomes. To provide an estimate of the frequency and the determinants of folic acid/folates use in the preconceptional period and during pregnancy in Italy, we conducted a cross-sectional observational study. Study design: Women aged 18 years or older who gave birth on randomly selected days in the participating hospitals during the study period were eligible for the study. After obtaining informed consent, the women were interviewed by a qualified interviewer during their stay in hospital after giving birth. The questionnaire included general information such as age, education, previous pregnancies, and maternal diseases. Furthermore, the questionnaire specifically collected information on the use of folic acid/folates in the preconceptional period and during pregnancy. Results: A total of 958 women were interviewed. The 5.4% (95%CI: 4.1–7.1) of participants declared to use folic acid/folates from three months or more before conception to the end of the first trimester, 34.3% (95%CI: 31.3–37.5) from three months or more before conception to the end of pregnancy, 6.1% (95%CI: 4.6–7.8) from conception to the end of first trimester, 47.3% (95%CI: 44.1–50.5) from conception to the end of pregnancy, and 2.4% (95%CI: 1.5–3.6) only after the first trimester of pregnancy. Preconceptional use was more common in older women than in younger ones. Similarly, women who were trying to get pregnant were more likely to report preconceptional use of folic acid than women who were not. Conclusion: This study highlights the need for information campaigns to promote the preconceptional use of folic acid/folates for the prevention of neural tube defects.