Women still not taking folate at the right time.

According to a study in the Journal of Nutrition's April issue, adequate folate and iron intake during pregnancy is critical for maternal and fetal health. Researchers analyzed data on 1296 pregnant women from 1999 to 2006 to characterize overall supplement use, iron and folic acid use, and red blood cell (RBC) folate status.

The majority of pregnant women (77%) reported use of a supplement in the previous 30 days, most frequently a multivitamin/mineral containing folic acid and iron. Approximately 55–60% of women in their first trimester reported taking a folic acid- or iron-containing supplement compared with 76–78% in their second trimester and 89% in their third trimester. RBC folate was lowest in the first trimester and differed by supplement use across all trimesters. Among all pregnant women, RBC folate increased with trimester. 

Given the role of folic acid in the prevention of neural tube defects, it is notable that supplement use and median RBC folate was lowest in the first trimester of pregnancy, with 55% of women taking a supplement containing folic acid. Future research is needed to determine the reasons for low compliance with supplement recommendations, particularly folic acid, in early pregnancy.

Bonnie: Of course, folic acid is most important prenatally and during the first trimester, so the results of this study are baffling. I worked with the March of Dimes on this issue back in the 1980's, and we still cannot get even get close to 100% compliance! Absolutely baffling.