Does Folic Acid Intake Play Role as a Potential Indicator of Modifiable Maternal Risk Factors in Preconception Period?: A Cross-Sectional Study.

PURPOSE: Folic acid is essential for preventing neural tube defects and for normal fetal development. This study aims to evaluate the rate and trends of folic acid intake among women completing the questionnaire to enroll in the preconception care program and examine its role as a potential indicator associated with modifiable biomedical, behavioral, and social health risk factors.

METHODS

This is a cross-sectional study. A total of 42,730 women seeking to enroll in preconception care program of Seoul City, Korea, between Nov. 2017 and Dec. 2023. Folic acid intake among women planning pregnancy and modifiable risk factors, including biomedical, behavioral, and social risks, were obtained from an organized questionnaire on online. We exclude cases having incomplete data for analysis.

RESULTS

The proportion of participants taking folic acid is 35.1% (15,003/42,730).Factors associated with greater folic acid use included advanced maternal age, higher body mass index, greater gravidity, previous spontaneous abortion, previous artificial abortion, regular exercise, and higher family income. Conversely, factors associated with less folic acid use included depression, insomnia, bulimia, social drinking, positive screening for risky drinking, cigarette smoking, unmarried status, and white-collar employment.

CONCLUSIONS

Our study found that folic acid intake during the preconception period remains low at 35.1%. Annual trends show the modest improvement but remain insufficient. And preconception folic acid intake was significantly associated with greater or lesser likelihoods of several modifiable biomedical, behavioral, and social risk factors. Therefore, folic acid use may serve as a surrogate marker of health awareness and engagement in preconception care. Future studies should assess folic acid as a marker of preconception care effectiveness.