Experts Call for More Innovative Public Health Campaigns to Improve Folate Supplementation in Women Planning a Pregnancy, as Prevalence of Neural Tube Defects in Europe Remains Largely Undiminished in a Decade[1]

PARIS, November 22, 2011 -

European researchers are urging the region’s governments and healthcare organisations to create new and more innovative public health campaigns that encourage the uptake of folate supplementation prior to and during pregnancy and highlight the consequences of non-compliance. The move follows startling evidence that, due to a troubling lack of awareness, one in two women of child-bearing age are still not taking supplements as recommended by their doctors, thereby risking the health of their babies.^[2] The rate of women taking folate supplements prior to conception is even lower.^[3]

The researchers were talking at a media briefing during the 14^th World Congress on Controversies in Obstetrics, Gynecology & Infertility, entitled ‘The Hidden Truth: Assessing the disconnect in prenatal nutrition care in Europe‘, on 18^th November in Paris, France.

Delegates, who had earlier attended the satellite symposium on “Primary prevention of anomalies during pregnancy: Are we missing something?” heard that women’s folate requirements increase by 50 per cent during pregnancy,which explains why most European health associations recommend a dietary folate intake of 600 micrograms (mcg) during pregnancy. In addition to the dietary folate, folic acid supplements 1 - 3 months prior to conception and during the first trimester of pregnancy are recommended. One of the event’s main focuses was that more than 4,500 European pregnancies are affected by neural tube defects (NTDs) such as spina bifida and anencephaly. Despite being preventable in up to 70 per cent of cases simply through timely folate supplementation^[4], the prevalence of European NTDs has declined only marginally in the past 10 years, which suggests a worrying lack of awareness. In addition to preventing NTDs, folate is also acknowledged to benefit women beyond the first trimester by reducing the risk of low-birth weight^[5] and pre-term delivery^[6] - the latter still being one of the largest risk factors for child death in the first year of life. Additionally, low blood folate levels may increase the risk of miscarriages.^[7] Adequate folate supply also benefits the nursing period. New born babies need sufficient quantities of folate for cell division and growth, and a greater red blood cell folate level helps to preserve women’s folate levels during lactation.^[8]

Professor Klaus Pietrzik, an expert in folate metabolism from Rheinische Friedrich-Wilhelms University in Bonn, Germany explained that a 600mcg consumption of folate through diet alone during pregnancy is challenging. “When you consider that the average European woman’s daily folate intake ranges from 122mcg to 339mcg per day, improved folate status through supplementation is an essential prerequisite for optimal pregnancy and infant development. Women would do well to take folate supplements not only prior to conception and during the first trimester of pregnancy, but also during the entire course of pregnancy and until the end of the nursing period.”

 ”Women don’t appear to be taking folate early enough - in other words before the neural tube closes within 28 days of conception,” added Dr Emma Derbyshire, a nutrition scientist from the UK’s Manchester Metropolitan University. “Women need to understand why folate is necessary and how it will benefit them and their babies. It is essential that gynecologists explain to their patients regularly why folate is important during pregnancy - even when a woman is not planning to conceive. Particularly as we know half of all pregnancies are unplanned.”

Another reason behind the large numbers of women not taking folate supplements may be the assumption that a balanced diet is enough for a healthy baby. However, dietary folate intake can hardly meet folate requirements during pregnancy.

Thus, Professor Wolfgang Henrich, director of the Department of Obstetrics at the Charité Campus Virchow Clinical Centre in Berlin, Germany, argued that, “an optimum supply of folic acid or folate through supplementation plays a central role in the prevention of NTDs.”

He continued, “Besides being the correct ethical and medical decision, the use of folate supplements is also beneficial in terms of health costs - in the US, for example, medical care for a patient with NTDs is estimated to cost $185,000 each year - and is the much better option compared to the termination of a pregnancy following an unwelcome pre-natal diagnosis.”

Folic acid is the synthetic form of the vitamin which is then metabolised in the body into the bioavailable form, L-5-MTHF (L-5-Methyltetrahydrofolate). However, one in two women cannot optimally metabolise folic acid into the active form and therefore supplementation is efficient when not only folic acid supplements are used but also the already biologically active form of folate. Metafolin^® (available in the Femibion Healthy Pregnancy products) is the calcium salt of the biologically active folate form and is directly available without metabolisation.

The researchers added that a good way to encourage the necessary engagement of women on the topic of folate are national consumer PR campaigns on and offline, endorsed by healthcare professionals, to drive awareness and educate women on the benefits of folate supple-mentation through pregnancy to improve compliance and reduce the number of NTDs. Gynaecologists’ counselling of the benefits and timely use of folic acid/ folate supplementation is critical as they are the most trusted source of advice for pregnant women and as pregnant women follow their recommendation.

“There need to be engaging communications programmes in each European country,” said Dr Frank Chen, Obstetrician and Gynecologist from the Charité University Medicine Berlin, Campus Virchow. “We need to use alternative ways of expressing the messages, thereby maximising the potential for women to engage in them.”

Femibion®

Femibion® is a women’s health brand dedicated to their wellbeing. Femibion® offers them a range of nutritional supplements specifically formulated to provide the right nutrients to support women physically and emotionally at each age and each stage of their lives. Femibion® Healthy Pregnancy is the n°1 selling pregnancy supplement in Europe.

References:

1 Busby A et al. BMJ 2005 ; 12,  330:574-575

2 Rofail D et al. J Public Health (Oxf) 2011 [Epub ahead of print]

3 Brough L et al. J Hum Nutr Diet 2009; 22: 100-107

4 Czeizel AE & Dudas I N Engl J Med 1992; 327; 1832-1835

5 Timmermanns S et al. Br J Nutr 2009; 102: 777-785

6 Bukowski R et al.: PLOS Medicine 2009; 6: 1-11

7 D’Ùva M et al. Thrombosis Journal 2007; 5:10

8 Houghton L et al. Am J Clin Nutr 2006; 83 (4): 842-850

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