Question 8592 — health

Summary

Reducing the incidence of neural tube defects requires improving folate status in women before and at the start of pregnancy. A systematic prescription of folate, in a daily dose of 400 micrograms until the 12th week of amenorrhea is recommended (HAS, 2009), as soon as the woman wishes to become pregnant, for example, during a pre-pregnancy consultation. In France, according to data from the ESTEBAN study carried out by Public Health France, the prevalence of the risk of serum folate deficiency was almost zero among adolescent girls (15-17 years), but it has almost doubled over the last 10 years among adult women of childbearing age (18-49 years, non-menopausal) going from 7% in 2006 to 13% in 2015. This increase affects all age groups and is more particularly marked among women the least qualified. The results of the 2016 national perinatal survey carried out by the National Institute of Health and Medical Research and the Directorate of Research, Studies, Evaluation and Statistics show that the proportion of women who started taking folic acid before pregnancy increased between 2010 and 2016, from 14.8% to 23.2% but remains limited. Improve folate status women of childbearing age has been one of the key objectives of the national nutrition and health program (PNNS) since 2001. The PNNS has notably implemented information and education strategies. Specific tools for women before and during pregnancy have been developed. A leaflet intended for women, “Do you have a pregnancy plan? Think about vitamin B9” developed by Public Health France has been distributed since 2013 in more than 400,000 copies. A poster was distributed to health professionals in 2013 in more than 130,000 copies in order to encourage women to speak to doctors about the desire to become pregnant. A document intended for health professionals: “Folates and desire for pregnancy: inform and prescribe at the right time” (Coll. Les Essentiels de l’INPES) was the subject of a media communication in 2013 in a selection of press titles medical. These tools are available on the Public Health France website and on www.mangerbouger.fr. A diet consistent with the PNNS benchmarks, particularly sufficiently rich in fruits and vegetables, could be sufficient to cover needs. However, these recommendations are not followed by the entire population. The National Agency for Food, Environmental and Occupational Health Safety has published its opinion on updating the dietary benchmarks for pregnant and breastfeeding women in June 2019. The opinion of the High Council of Public Health is expected in June 2020. These opinions will allow Public Health France to update the existing PNNS benchmarks for pregnant women. Furthermore, the PNNS 4 launched on September 20, 2019 by the Ministry of Health, plans to redeploy communication and information strategies on the promotion of health by 2023. this folic acid supplementation in women seeking pregnancy aimed at health professionals (in particular general practitioners, pharmacists, midwives, obstetrician-gynecologists) as well as among women.

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