Delaying mandatory folic acid fortification policy perpetuates health inequalities: results from a retrospective study of postpartum New Zealand women.

Study answer

What this study found

33% of women reported taking folic acid supplements as recommended during the periconceptional period. Modelled mandatory bread fortification at 135 μg folic acid per 100 g bread would deliver 118–150 μg/day for three or more slices per day and increase the proportion with adequate folic acid intake to 59%. Fully adjusted odds for planning pregnancy predicting adequate supplement intake fell from 17.24 to 2.61 (P<0.001) with fortification, and socio-demographic predictors of low intake were substantially attenuated or non-significant. Authors conclude that mandatory bread fortification could…

Study & population

Retrospective cross-sectional survey (VAMPS) of postpartum women aged 18+ who delivered a healthy term infant, across New Zealand maternity centers; data collected March 7–April 15, 2011; anonymous self-administered questionnaire; 758 agreed to participate; 723 included after excluding 33 for maternal age or gestational duration; logistic regression used…

Intervention

Supplements containing ≥400 mg of folic acid daily or on most days for the periconceptional period (1 month before conception until end of the third month post-conception).

Key limitation

Retrospective design with potential recall bias; self-reported supplement and bread intake; possible misreporting and missing brand/dose information; not fully representative of all NZ regions (Northland excluded) and language-limited to English speakers.

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Original abstract