It is well known that taking folate and multivitamins around the time of conception reduces the risk of several congenital anomalies in babies and the province of Newfoundland and Labrador has a very high rate of neural tube defects in Canada. Dr. James House and colleagues report that this may be due to the fact that approximately 27% of the women they surveyed in the province in 1997 had low red blood cell folate levels.
Dr. House and colleagues collected blood samples from 1424 pregnant women at the time of their first prenatal visit (at approximately 16 weeks' gestation) and found that serum levels indicated that less than 4% of the women had deficient or indeterminate folate levels. However, in measuring the red blood cell folate levels the authors found that 27% had a deficient or indeterminate folate level. The authors were unable to correlate the low folate levels with relevant patient variables such as dietary preferences, multivitamin usage or other factors.
"Nevertheless," writes Dr. House, "the fact that 27% of the pregnant women presented with deficient or indeterminate red blood cell folate levels is a serious public health concern and should be addressed." In a related editorial, Dr. Judith Hall laments the missed opportunities for taking daily supplements of folic acid.
Contact: Dr. James Friel, Department of Biochemistry, Memorial University of Newfoundland, St. John's; tel. 709 737-7954
Dr. Judith Hall, Professor and Head, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver; tel. 604 875-2315
Journal
Canadian Medical Association Journal