Only one-in-four Australian pregnant women adhere to folic acid and iodine guidelines

By Gary Scattergood contact

- Last updated on GMT

Overall, 43% and 54% of pregnant women, respectively, were unable to identify any good dietary sources of folate and iodine. ©iStock
Overall, 43% and 54% of pregnant women, respectively, were unable to identify any good dietary sources of folate and iodine. ©iStock
Australian women are well aware that folic acid (PFS) and iodine (IS) are recommended supplements to take during pregnancy, but only a quarter of them adhere to the recommendations, scientists report. 

A cross-sectional analysis published online in the Australia and New Zealand Journal of Public Health​ found that around 90% of the 857 participants knew that folic acid should be taken, but only 27% ended up taking the correct dosage, or even knew how much they needed.

Knowledge of iodine requirements was lower at 56-69%, but an even lower 23% knew about the dosage, they say.

The authors believe that healthcare providers are going to have to play a bigger part in enforcing the requirements during GP visits.

“In Australia, the recommended nutrients for supplementation are folic acid and iodine. Folic acid is a B vitamin that is essential for DNA synthesis and is especially important during periods of rapid growth such as embryonic and foetal development,”​ the paper, by Lenka Malek et al, states.

“It is well documented that folic acid supplementation reduces the risk of neural tube defects (NTD).  Iodine is also an essential micronutrient, required for the production of thyroid hormones that are critical for normal foetal growth and cognitive development. Iodine deficiency in pregnancy can lead to irreversible brain damage in severe deficiency,”​ it adds.

National sample

Despite supplement use becoming common practice during pregnancy in Australia, previous studies have consistently shown poor adherence to the recommendation for periconceptional folic acid supplementation, but this survey was the first to assess adherence to the PFS recommendation in a national sample of Australian women.

Overall, 43% and 54% of pregnant women, respectively, were unable to identify any good dietary sources of folate and iodine - either by answering they ‘didn’t know’ or listing incorrect sources. Vegetables were most commonly identified incorrectly as good sources of folate and iodine, followed by fruit and meat.

In relation to supplements, while almost all women believed folic acid supplements are recommended in preconception (92%) and during pregnancy (94%), fewer women were aware of recommendations for iodine supplementation (56% and 69%, respectively).

“Of the 95% and 71% women, respectively, who indicated that supplementation with folic acid or iodine is recommended for all women in preconception and/or pregnancy, over three-quarters (78%) were aware of the importance of folic acid and just over one-half (54%) were aware of the importance of iodine,” ​the report states.

Dose deficit

“While 33% and 10% of women correctly identified the recommended daily dose of folic acid and iodine, respectively, a further 25% and 30% reported that the amount recommended is, ‘however much is in the supplement I am taking’.”

With more than half of pregnancies in Australia unplanned, the authors said there needed to be more awareness of the recommended timing and duration of PFS and IS need among childbearing aged women, and that women should be encouraged to maintain an optimal folate and iodine intake throughout their childbearing years, through natural and nutritionally-fortified dietary sources.

“Determining which methods of communication are most effective among women of childbearing age warrants further investigation, especially as women may seek health information from a range of sources,”​ they added.

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