Peri‐conceptual folic acid supplementation in type 1 diabetes

To document peri‐conceptual folic acid supplementation in women with type 1 diabetes mellitus (DM) attending the diabetic ante‐natal clinic of a university teaching hospital.

Women with pre‐existing type 1 DM who booked at the diabetes antenatal clinic at University Hospital, Nottingham over 3 years (1996–98) took part in a telephone survey about folic acid supplements.

Data was available on 50 women, 65 pregnancies. Folic acid supplements were used before 50.7% (33) pregnancies, all planned, and started on confirmation of pregnancy in 34% (22), at a mean gestation of 5.8 weeks. No folic acid was used before or during 10 (15.4%) pregnancies. 75.4% (49) pregnancies were planned. 24 planned pregnancies were in women who had never had pre‐pregnancy counselling. 70.8%(17) of these were in multiparous women, and folic acid was taken before 41.1% (seven) of such pregnancies. Lack of awareness was the predominant reason for failure to take folic acid supplements in all groups.

Folic acid was taken before conception in only half of the pregnancies in the survey, due to lack of awareness of its importance.

Three‐quarters of pregnancies were planned but a disappointing number of women had pre‐pregnancy counselling, probably due to poor advertising and the assumption that women who had been pregnant before did not need such a session.

Women with DM should be informed about folic acid and offered pre‐pregnancy counselling. It should not be assumed that women who have had a pregnancy know about folic acid. Copyright © 2001 John Wiley & Sons, Ltd.

1. Folic acid supplementation prior to conception and in the first trimester helps to prevent neural tube defects.

2. Almost half of the women in this survey failed to take folic acid prior to conception.

3. Women who did not take folic acid were unaware of its importance.

4. We need to ensure that women with diabetes understand the importance of folic acid.