Poverty limits knowledge of folic acid’s reproductive role - study

Poorer women and those recently arrived in Ireland have the lowest level of knowledge about the essential role of folic acid in preventing birth defects, a new study has found.

More affluent women and those living in Ireland for over five years had better knowledge of the reasons for taking the vitamin, according to the study.

Over half of the women surveyed in the Coombe Maternity Hospital said they did not take the supplement before becoming pregnant, as recommended. In most cases, this was because they did not expect to get pregnant.

Over one-third of the 587 women surveyed did not know they needed to take folic acid before conception in order to reduce the chances of birth defects such as spina bifida.

Renewed campaign recommended

The study, published in the European Journal of Clinical Nutrition, recommends a renewed public health campaign in Ireland on the importance of folic acid. This should focus on women living in deprivation and women who have recently come to live in Ireland, as their awareness levels were found to be lowest.

All-Ireland food body Safefood ran a further awareness campaign on folic acid last year which focused on social media.

The rate of neural tube defects in Ireland is increasing, and this is almost certainly because the folic acid intake of pregnant women is declining. Plans to introduce mandatory fortification of food with folic acid were shelved some years back and the EU has been slow to introduce common standards.

The Food Safety Authority of Ireland has said the mandatory fortification of bread or flour with folic acid is the most effective way of reducing Ireland's high rate of birth defects.

It said the mandatory fortification of bread or flour to provide about 150µg of folic acid per day in women of childbearing age would reduce the prevalence of neural tube defects by about 30 per cent. However, this would require legislation.

Voluntary fortification

The authority suggested a second option of continuing with the present policy of voluntary fortification of foodstuffs by manufacturers.

An estimated 40 cases of spina bifida could be prevented each year by ensuring women take folic acid before pregnancy. Michael Turner, professor of obstetrics at UCD and one of the authors of the latest study, said this could result in savings of €20 million for the health service.

Folic acid, when taken before and during pregnancy, prevents the occurrence of most forms of neural tube defects.

In more than 50 countries, governments oblige food manufacturers to fortify products but in other countries, including Ireland, the addition of folic acid is voluntary.