BMJ 1995;311:256 (22 July)

Letters

Preconceptional supplementation is impractical

EDITOR,--We agree with Nicholas J Wald and Carol Bower that the only way of ensuring an adequate intake of folic acid by pregnant women to prevent neural tube defects is by means of fortification of food as opposed to supplementation.1 Supplements need to be started within 30 days of conception, and women would therefore need educating before conception.2 There seems to be little demand for preconception clinics in primary care, and women of lower socioeconomic background (who are at higher risk of neural tube defects) are poor users of such preventive services.

It has been suggested that advice on folate supplementation could be given by general practitioners opportunistically at consultations about contraception. To see if this is a realisitic way of targeting information at those likely to benefit we undertook a study in our inner city group practice. The available case notes of women who delivered in 1993 were examined. . . . [Full text of this article]


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Relevant Article

Folic acid and the prevention of neural tube defects
Nicholas J Wald and Carol Bower
BMJ 1995 310: 1019-1020. [Extract] [Full Text]

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