Navarrete-Muñoz, Eva MaríaValera-Gran, DesireeGarcia de la Hera, ManoliGimenez-Monzo, DanielMorales, EvaJulvez, JordiRiano, IsolinaTardon, AdoninaIbarluzea, JesusSanta-Marina, LoretoMurcia, MarioRebagliato, MarisaINMA Project2024-07-042024-07-042015Navarrete-Muñoz EM, Valera-Gran D, Garcia De La Hera M, Gimenez-Monzo D, Morales E, Julvez J, et al. Use of high doses of folic acid supplements in pregnant women in Spain: an INMA cohort study. BMJ Open. 2015;5(11):e009202.2044-6055http://hdl.handle.net/20.500.13003/17188http://hdl.handle.net/20.500.12105/20085Objectives: We examined the use of low (<400 mu g/day, including no use) and high folic acid supplement (FAS) dosages (>= 1000 mu g/day) among pregnant women in Spain, and explored factors associated with the use of these non-recommended dosages. Design: Population-based cohort study. Setting: Spain. Participants: We analysed data from 2332 pregnant women of the INMA study, a prospective mother-child cohort study in Spain. Main outcome measures: We assessed usual dietary folate and the use of FAS from preconception to the 3rd month (first period) and from the 4th to the 7th month (second period), using a validated food frequency questionnaire. We used multinomial logistic regression to estimate relative risk ratios (RRRs). Results: Over a half of the women used low dosages of FAS in the first and second period while 29% and 17% took high dosages of FAS, respectively. In the first period, tobacco smoking (RRR=1.63), alcohol intake (RRR=1.40), multiparous (RRR=1.44), unplanned pregnancy (RRR=4.20) and previous spontaneous abortion (RRR=0.58, lower use of high FAS dosages among those with previous abortions) were significantly associated with low FAS dosages. Alcohol consumption (RRR=1.42), unplanned pregnancy (RRR=2.66) and previous spontaneous abortion (RRR=0.68) were associated with high dosage use. In the second period, only tobacco smoking was significantly associated with high FAS dosage use (RRR=0.67). Conclusions: A high proportion of pregnant women did not reach the recommended dosages of FAS in periconception and a considerable proportion also used FAS dosages >= 1000 mu g/day. Action should be planned by the Health Care System and health professionals to improve the appropriate periconceptional use of FAS, taking into consideration the associated factors.enghttp://creativecommons.org/licenses/by-nc/4.0/Maternal Nutritional Physiological PhenomenaYoung AdultAlcohol DrinkingPregnancy, UnplannedSpainAdultHumansSmokingAdolescentAbortion, SpontaneousPregnancyFolic AcidProspective StudiesFemaleOdds RatioPrenatal CareDietary SupplementsLogistic ModelsParityresearch articleAttribution-NonCommercial 4.0 International26603248511e00920210.1136/bmjopen-2015-009202BMJ Openopen accessModelos LogísticosFenómenos Fisiologicos Nutricionales MaternosOportunidad RelativaÁcido FólicoFemeninoEmbarazo no PlaneadoAdolescenteFumarAborto EspontáneoHumanosEstudios ProspectivosAdulto JovenEmbarazoParidadAdultoSuplementos DietéticosConsumo de Bebidas AlcohólicasAtención PrenatalEspaña2-s2.0-85006817994368840100120L613789174