Related Experiment Video

Updated: May 15, 2026

Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
03:19

Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes

Published on: June 28, 2024

Advancing Understanding of Racial and Ethnic Disparities in Folic Acid Supplementation via National Institutes of

Isabel F Almeida1, Yael Marks2, Brian Vu2

  • 1Department of Chicano/Latino Studies, University of California, Irvine, USA; Department of Psychology, University of California, Irvine, USA.

Sexual & Reproductive Healthcare : Official Journal of the Swedish Association of Midwives
|May 13, 2026
PubMed

Insights

Folic acid supplementation is crucial for preventing neural tube defects (NTDs). This study found that factors like age, insurance, and pregnancy influence supplementation rates, with disparities noted across racial and ethnic groups.

Area of Science:

  • Public Health
  • Reproductive Health
  • Health Disparities

Background:

  • Neural tube defects (NTDs) are major congenital anomalies contributing to significant childhood morbidity and mortality.
  • Folic acid supplementation is a proven preventive measure for NTDs, but adherence is suboptimal, especially among Hispanic and non-Hispanic Black women.
  • Social Determinants of Health (SDOH) are increasingly recognized as critical factors influencing health behaviors and outcomes.

Purpose of the Study:

  • To examine the patterns of folic acid supplementation among women of childbearing age.
  • To investigate the influence of race/ethnicity, nativity, and SDOH on folic acid supplementation.
  • To identify disparities in folic acid supplementation to inform targeted interventions.

Main Methods:

  • Utilized data from the National Institutes of Health All of Us Research Program (Registered Tier Dataset v7).
  • Included participants enrolled between May 2018 and June 2022, focusing on women aged 18-49 years.
  • Employed adjusted multivariable logistic regression models to assess folic acid supplementation, controlling for age, income, education, insurance, and pregnancy status.

Main Results:

  • Older age, pregnancy, and being Non-Hispanic Black were associated with higher odds of folic acid supplementation compared to younger age, non-pregnancy, and Non-Hispanic White women, respectively.
  • Lack of insurance was significantly associated with lower odds of folic acid supplementation.
  • Among Hispanic women, age and pregnancy increased supplementation odds, while lack of insurance decreased them; nativity showed no association.

Conclusions:

  • Social Determinants of Health play a significant role in folic acid supplementation adherence.
  • Equitable interventions are necessary to address disparities in folic acid supplementation across the entire reproductive lifespan.
  • Targeted strategies are needed to improve folic acid adherence among underserved populations.
Abstract

Keywords:
Birth Defect PreventionFolic AcidMaternal Health DisparitiesNeural Tube Defects (NTDs)Social Determinants of Health (SDOH)

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