Folic acid-containing supplement use among females aged 15-55 in the Canadian Community Health Survey 2015-2018.

Abstract

Introduction: In Canada, those who are or who could become pregnant are recommended to consume a daily multivitamin containing 400 μg of folic acid to help prevent neural tube defects.

Objectives: To report the prevalence and determinants of folic acid-containing supplement use among females of childbearing age in Canada.

Methods: Data were combined from cycles 2015/16 and 2017/18 of the maternal experiences module of the cross-sectional Canadian Community Health Survey, which was completed by females aged 15-55 years. Representative weighted estimates (means/percentages, 95% CI) were generated for folic acid-containing supplement use among all pregnant, non-pregnant, and lactating respondents. For those who had given birth in the preceding 5 years, estimates were also generated for supplement use in the 3 months before and first 3 months of their most recent pregnancy, and pre-pregnancy awareness of the link between folic acid and some birth defects. We examined associations with sociodemographic factors using multivariable logistic regression.

Results: Overall, 16.5% (15.9-17.0%) of non-pregnant, 80.3% (77.1-83.5%) of pregnant, and 58.4% (54.8-61.9%) of lactating females aged 15-55 reported using a folic acid-containing supplement. Among those who had given birth in the preceding 5 years, 63.7% (62.2-65.1%) consumed a folic acid-containing supplement in the 3 months prior to pregnancy, while 89.9% (88.8-90.9%) did so during the first trimester. Lower prevalence of supplement use before or during pregnancy was reported among the 23.7% (22.4-25.1%) of respondents unaware of the relationship between folic acid and birth defects. Younger age, single marital status, lower educational attainment, income below the median, and smoking were associated with lower odds of awareness or supplement use.

Conclusion: While most females living in Canada reported using folic acid-containing supplements prior to and during pregnancy, use of these supplements among non-pregnant females of childbearing age is low, and sociodemographic inequalities exist.

Clinical trial registry number: not applicable REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OF META-ANALYSIS: not applicable.