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Folic acid: Is self reported use of supplements accurate?
  1. A Burtona,
  2. S Wilsonb,
  3. A J Gilliesb
  1. aCancer Research Campaign Trials Unit, Institute for Cancer Studies, The University of Birmingham, Edgbaston, Birmingham, UK, bDepartment of Primary Care and General Practice, The Medical School, The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
  1. Dr Wilson (S.Wilson{at}

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Low folate levels before conception and in early pregnancy are associated with an increased risk of neural tube defects (NTDs).1 Preconception folic acid supplements provide protection against NTDs.2 Self administered questionnaires are a simple and non-invasive method of obtaining estimates of preconception folic acid use,3 however, their accuracy is often dependent on the subject matter. Undesirable behaviours (for example, smoking, criminal offences) are generally under-reported while desirable behaviours (for example, exercise, condom use) are often over-reported. Taking folic acid supplements to prevent NTDs is a desirable outcome and therefore over-reporting may be apparent. Haematological measures for both current and cumulative use of folic acid supplement provide accurate indicators of a woman's folate status and therefore provide good tools against which to validate self reporting. If self reporting is a valid indicator of folic acid supplementation then this may be quicker, cheaper and more acceptable to patients than collecting blood samples. This study aimed to assess the validity of self reported supplement use by comparison with haematological measurements.


A questionnaire was self administered by consenting women, attending three hospital-based antenatal clinics within the West Midlands region of …

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  • Funding: NHSE (West Midlands).

  • Conflicts of interest: none.