Women are ignoring expert advice to take folic acid supplements before pregnancy to protect their unborn children, a study has shown.
Researchers who questioned nearly 500,000 women attending antenatal clinics in England and the Isle of Man found that fewer than one in three took folic acid prior to getting pregnant.
This was despite strong evidence that most cases of spina bifida and other birth defects affecting the brain, spine or spinal cord can be prevented by boosting pre-pregnancy levels of the B-vitamin.
The study showed that the proportion of women who heed the guidelines when planning a family had actually fallen, from 35 per cent in the years 1999 to 2001, to 31 per cent in 2011-2012. Even among women with previous experience of a pregnancy involving a neural tube birth defect such as spina bifida, only just over half (51 per cent) took the supplements.
The findings prompted calls for the introduction of mandatory folic acid fortification of flour in the UK – a policy already adopted in more than 70 countries including the US and Australia.
Professor Sir Nicholas Wald, from Queen Mary, University of London, one of the study authors whose original work uncovered the protective effect of folic acid, said: “It’s a public health tragedy that in spite of the folic acid fortification initiative in many countries, the UK has not introduced mandatory folic acid fortification.
“The failure to fortify flour with folic acid is like having a polio vaccine and not using it.”
The research, published in the online journal Public Library of Science ONE, was conducted by a team from Queen Mary’s Wolfson Institute of Preventive Medicine between 1999 and 2012.
More women took folic acid once they discovered they were pregnant, the proportion rising from 45 per cent to 62 per cent between the periods looked at in the study. But for effective protection, the supplements need to be taken before pregnancy.
The study also showed strong ethnic variations, with only 17 per cent of Afro-Caribbean women, 20 per cent of South Asian women and 25 per cent of East Asian women taking folic acid, compared with 35 per cent of white Caucasian women.