Folate deficiency epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Epidemiology and Demographics
The prevalence of folate deficiency across the world is quite variable. The deficiency is more common in countries without folic acid fortification of cereal-grain products. Surveys conducted in several countries show that without fortification, folate deficiency can be a public health problem. The primary age groups affected include preschool children, pregnant women and older people. In the US, folate deficiency was present in school-age children (2.3% of the folate-deficient population), adults (24.5%), and older people (10.8%) before folic acid fortification was introduced. Mandatory folic acid fortification of cereal-grain products was initiated in the US in 1996. Subsequent surveys have shown that serum and RBC folate concentrations have increased in the general population.
DEMOGRAPHICS
Each year in the United States
- There are 3,000 pregnancies affected by spina bifida or anencephaly, which are neural tube defects (NTDs) caused by the incomplete closing of the spine and skull. [Read article]
- About 1,300 babies are born without a neural tube defect since folic acid fortification. [Read article]
- Many, but not all, neural tube defects could be prevented if women took 400 mcg of folic acid daily, before and during early pregnancy. [Read article]
- Half of all pregnancies are unplanned. [Read article]
Hispanic/Latina Women
- Have the highest rate among women having a child affected by these birth defects. [Read summary]
- Have lower blood folate levels and are less likely to consume foods fortified with folic acid. [Read article]
- Are less likely to have heard about folic acid, to know it can prevent birth defects, or take vitamins containing folic acid before pregnancy. [Read article]
Use of Supplements Containing Folic Acid Among Women of Childbearing Age — United States
2007 Survey Data
Among all women of childbearing age:
- 40% reported taking folic acid daily.
- 81% reported awareness of folic acid.
- 12% reported knowing that folic acid should be taken before pregnancy.
Women of childbearing age who were aware of folic acid reported hearing about it from:
- Health care provider (33%)
- Magazine or newspaper (31%)
- Radio or television (23%)
- Women aged 18-24 years were more likely to hear about folic acid from a magazine or newspaper (25%) or school or college (22%) than from their health care provider (17%). Whereas 37% of women aged 25-34 years and 36% of women 35-45 years reported hearing about folic acid from their health care provider.
Among women who reported not taking a vitamin or mineral supplement on a daily basis, the most common reasons were:
- “Forgetting” (33%)
- “No need” (18%)
- “No reason” (14%)
- “Already get balanced nutrition” (12%)
2005 Survey Data
Among all women of childbearing age:
- 33% reported taking folic acid daily.
- 84% reported awareness of folic acid.
- 7% reported knowing that folic acid should be taken before pregnancy.
Among women who reported not taking a vitamin or mineral supplement on a daily basis, the most common reasons were:
- Forgetting to take supplements (28%)
- Perceiving they do not need them (16%)
- Believing they get needed nutrients and vitamins from food (9%)
When asked, “For what specific need would you start taking a vitamin or mineral supplement?” The most common reported needs were:
- Being sick or in poor health (20%)
- A doctor’s recommendation (20%)
- The need for energy (9%)
- Being pregnant (8%)
- Being deficient in any vitamins or minerals (7%)
- Balancing the diet (6%)
- Keeping bones strong (6%)
- In addition, 11% cited no specific need that would motivate them to begin taking a vitamin or supplement. Among women who reported not consuming a vitamin or mineral supplement daily, 31% indicated they had received a doctor’s recommendation.
Top of Page
Economic Cost
- The annual medical care and surgical costs for people with spina bifida exceed $200 million. [Read article]
- The total lifetime cost of care for a child born with spina bifida is estimated to be $791,900.1