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Maternal nutrition, infants and children

Determinants of folate status in pregnant women: results from a national cross-sectional survey in Belgium

European Journal of Clinical Nutrition volume 66, pages 1172–1177 (2012)Cite this article

Subjects

Abstract

Background/Objectives:

Folic acid deficiency during pregnancy can lead to neural tube defects (NTD) in the fetus. Folate status was determined in a representative sample of Belgian pregnant women and determinants of folate status were assessed.

Subjects/Methods:

The women were selected using a multi-stage proportionate-to-size sampling design. Blood samples were collected and a questionnaire was completed face-to-face with a study nurse. Erythrocyte (red blood cell (RBC)) folate concentration was measured by chemoluminescence.

Results:

In total, 1311 pregnant women participated and women with a lower socio-economic status were well represented. Median RBC folate concentration was 436 ng/ml (95% confidence interval=425–452 ng/ml) among first trimester and 496 ng/ml (95% confidence interval=474–515 ng/ml) among third trimester women. Few women had a RBC folate concentration below 140 ng/ml, indicating depletion of folate stores. In the first trimester, 39% of women had a RBC concentration below 400 ng/ml, whereas 15% of the first trimester women had a RBC concentration below 300 ng/ml. Among women in the first trimester, 69.1% reported taking folic acid-containing supplements of which 41.2% started taking them before pregnancy. For third trimester women, these percentages were 76.2% and 21.9%, respectively. In both trimesters, folate status increased significantly with education level and was significantly higher among women who planned the pregnancy and who did not smoke.

Conclusions:

It was found that 39% of the first trimester pregnant women had a folate status that might not be optimal to prevent NTD. Some groups of women need to be targeted as they are at higher risk of inadequate folate status.

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Acknowledgements

We acknowledge the financial support from the Federal Public Service of Health, Food Chain Safety and Environment. We thank the hospitals and gynaecologists who agreed to participate and all the participating pregnant women.

Author contributions

SV and RMR coordinated the study. SV performed the statistical analyses and drafted the manuscript. SA participated in the field work. All authors contributed to the data interpretation of the results and critically revised the draft versions of the manuscript.

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Authors and Affiliations

  1. Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium

    S Vandevijvere & H Van Oyen

  2. Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

    S Amsalkhir & R Moreno-Reyes

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  1. S Vandevijvere
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  2. S Amsalkhir
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Correspondence to S Vandevijvere.

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Vandevijvere, S., Amsalkhir, S., Van Oyen, H. et al. Determinants of folate status in pregnant women: results from a national cross-sectional survey in Belgium. Eur J Clin Nutr 66, 1172–1177 (2012). https://doi.org/10.1038/ejcn.2012.111

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