Folic Acid-Containing Supplement Use among Females Aged 15-55 in the Canadian Community Health Survey 2015-2018

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.

This study aims to report the prevalence and determinants of folic acid-containing supplement use among females of childbearing age in Canada.

Data were combined from cycles 2015/2016 and 2017/2018 of the maternal experiences module of the cross-sectional Canadian Community Health Survey, which was completed by females aged 15-55 y. Representative weighted estimates (means/percentages, 95% confidence interval) were generated for folic acid-containing supplement use among all pregnant, nonpregnant, and lactating respondents. For those who had given birth in the preceding 5 y, estimates were also generated for supplement use in the 3 mo before and first 3 mo of their most recent pregnancy, and prepregnancy awareness of the link between folic acid and some birth defects. We examined associations with sociodemographic factors using multivariable logistic regression.

Overall, 16.5% (15.9%, 17.0%) of nonpregnant, 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 y, 63.7% (62.2%, 65.1%) consumed a folic acid-containing supplement in the 3 mo before pregnancy, whereas 89.9% (88.8%, 90.9%) did so during the first trimester. A 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.

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