Less than a quarter of Irish mothers-to-be comply with major public health recommendations, writes MICHELLE McDONAGH
A NEW study has found that a large number of women in Ireland continue to smoke and drink alcohol while pregnant.
In addition, there is a much higher prevalence of alcohol consumption among Irish nationals compared with non-Irish mothers living in Ireland.
Less than a quarter of Irish women (24 per cent) comply with all three of the major public health recommendations during pregnancy – to avoid tobacco and alcohol consumption and to start taking folic acid supplements at the right time.
More than half of the mothers (55 per cent) in the study did not comply with the recommendation to take a daily 400mg folic acid supplement three months before conception and during the first 12 weeks of pregnancy to guard against neural tube defects (NTDs) such as spina bifida as well as congenital malformations.
“This finding is of major clinical importance owing to evidence that increased peri-conceptional intakes of folic acid can significantly reduce the risk of first occurrence and recurrence of NTDs in up to 72 per cent of cases,” the authors comment.
“The fact that Irish NTD rates are among the highest in Europe, affecting 1-1.5 per 1,000 total births nationally, and that NTDs account for more national perinatal deaths than any other group of birth defects further increases the importance of strict compliance with daily peri-conceptional folic acid supplementation among women who could possibly conceive in Ireland.”
The study of maternal health behaviours during pregnancy was carried out by Dr Roslyn Tarrant, clinical research dietitian at Our Children’s Hospital, Crumlin, and Dr John Kearney, lecturer at the Dublin Institute of Technology.
It is the first Irish study to investigate compliance with all three public health recommendations during pregnancy and has just been published in the European Journal of Clinical Nutrition.
It involved the recruitment of 491 pregnant women from public and private clinics at the Coombe Women and Infants University Hospital, Dublin, with postpartum follow-up from June 2004 to October 2006.
In all, 35 per cent of mothers reported consuming alcohol and 21 per cent smoked during pregnancy. Some 44 per cent commenced taking folic acid at the recommended time.
Wine and beer/stout were the most frequently consumed alcoholic drinks followed by alcopops and spirits.
Mothers under 25 years of age were more likely not to have taken folic acid at the recommended time and to have smoked during pregnancy.
Being of Irish nationality was a positive predictor for both alcohol consumption and smoking during pregnancy.
Smoking was more common in mothers from lower socio-economic groups, but there was no association between alcohol consumption and social class.
“The fact that 6 per cent of mothers did not comply with any of these recommendations highlights the potential health disparities and increased likelihood for a compromised pregnancy outcome within our sample of mothers,” Dr Tarrant said.
To decrease health inequalities, the authors suggest that lower socio-economic groups and younger women should be specifically targeted in smoking cessation and folic acid promotion campaigns.