{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:37:32Z","timestamp":1793572652651,"version":"4.5.0"},"reference-count":57,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T00:00:00Z","timestamp":1569974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001797","name":"Curtin University of Technology","doi-asserted-by":"publisher","award":["HDR Research Support Fund"],"award-info":[{"award-number":["HDR Research Support Fund"]}],"id":[{"id":"10.13039\/501100001797","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Periconceptional folic acid (FA) supplementation is recommended to prevent neural tube defects (NTDs), but little information is known about its use in Vietnam. It is important that FA supplements start to be taken when planning a pregnancy and continued through the first trimester to prevent NTDs, as the neural tube closes in the first month of pregnancy. However, FA supplementation in Vietnam is usually recommended to commence from the first antenatal visit, which is usually at 16 weeks, and very few women take FA before their first visit. This multicenter study aimed to determine the prevalence of FA supplement use and associated maternal characteristics in Vietnam. FA supplementation was assessed in 2030 singleton pregnant women between 2015 and 2016. In total, 654 (32.2%) women reported taking either supplements containing FA alone or multivitamins containing FA, and 505 (24.9%) reported correctly taking supplements containing FA alone. Women who were aged 30 years or over, had low education levels, had formal employment, and whose current pregnancy was first or unplanned were less likely to supplement with FA. Education programs are needed to encourage FA supplementation when contemplating pregnancy.<\/jats:p>","DOI":"10.3390\/nu11102347","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T03:41:27Z","timestamp":1570074087000},"page":"2347","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Low Prevalence of Folic Acid Supplementation during Pregnancy: A Multicenter Study in Vietnam"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9495-9292","authenticated-orcid":false,"given":"Anh Vo Van","family":"Ha","sequence":"first","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"},{"name":"Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6220-3933","authenticated-orcid":false,"given":"Colin W.","family":"Binns","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4138-6427","authenticated-orcid":false,"given":"Ngoc Minh","family":"Pham","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"},{"name":"Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong Luat","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"},{"name":"National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8590-7637","authenticated-orcid":false,"given":"Phung Thi Hoang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"},{"name":"Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tan Khac","family":"Chu","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"},{"name":"Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy H.","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Public Health, Curtin University, Perth WA 6845, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0083-6729(08)00404-4","article-title":"Chapter 4 Molecular Mechanisms of Adaptation to Folate Deficiency","volume":"Volume 79","author":"Ifergan","year":"2008","journal-title":"Vitamins & Hormones"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bailey, L.B. (2009). Folate in Health and Disease, Taylor & Francis. [2nd ed.].","DOI":"10.1201\/9781420071252"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1017\/S1368980008003595","article-title":"Dietary intake and nutritional adequacy prior to conception and during pregnancy: A follow-up study in the north of Portugal","volume":"12","author":"Pinto","year":"2009","journal-title":"Public Health Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Nguyen, C.L., Van Hoang, D., Nguyen, P.T.H., Van Ha, A.V., Chu, T.K., Pham, N.M., Lee, A.H., Van Duong, D., and Binns, C.W. (2018). Low Dietary Intakes of Essential Nutrients during Pregnancy in Vietnam. Nutrients, 10.","DOI":"10.3390\/nu10081025"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Looman, M., Berg, C.V.D., Geelen, A., Samlal, R.A.K., Heijligenberg, R., Gunnewiek, J.M.T.K., Balvers, M.G.J., Leendertz-Eggen, C.L., Wijnberger, L.D.E., and Feskens, E.J.M. (2018). Supplement Use and Dietary Sources of Folate, Vitamin D, and n-3 Fatty Acids during Preconception: The GLIMP2 Study. Nutrients, 10.","DOI":"10.3390\/nu10080962"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mousa, A., Naqash, A., and Lim, S. (2019). Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence. Nutrients, 11.","DOI":"10.3390\/nu11020443"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S1474-4422(13)70110-8","article-title":"Neural tube defects: Recent advances, unsolved questions, and controversies","volume":"12","author":"Copp","year":"2013","journal-title":"Lancet Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/bdrc.20100","article-title":"Folate-mediated one-carbon metabolism and neural tube defects: Balancing genome synthesis and gene expression","volume":"81","author":"Beaudin","year":"2007","journal-title":"Birth Defects Res. Part C Embryo Today Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/nyas.13579","article-title":"A public health approach for preventing neural tube defects: Folic acid fortification and beyond","volume":"1414","author":"Garrett","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1017\/S1368980012003576","article-title":"Impact of folic acid fortification of flour on neural tube defects: A systematic review\u2014Corrigendum","volume":"16","author":"Uauy","year":"2013","journal-title":"Public Health Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"De-Regil, L.M., Pe\u00f1a-Rosas, J.P., Fern\u00e1ndez-Gaxiola, A.C., and Rayco-Solon, P. (2015). Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database Syst. Rev., CD007950.","DOI":"10.1002\/14651858.CD007950.pub3"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mao, B., Qiu, J., Zhao, N., Shao, Y., Dai, W., He, X., Cui, H., Lin, X., Lv, L., and Tang, Z. (2017). Maternal folic acid supplementation and dietary folate intake and congenital heart defects. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0187996"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1161\/CIRCULATIONAHA.116.022126","article-title":"Effect of Folic Acid Food Fortification in Canada on Congenital Heart Disease Subtypes","volume":"134","author":"Liu","year":"2016","journal-title":"Circulation"},{"key":"ref_14","unstructured":"World Health Organisation (2019). Periconceptional Folic Acid Supplementation to Preven Neural Tube Defects, e-Library of Evidence for Nutrition Actions (eLENA)."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"U. S. Preventive Services Task Force (2017). Folic acid supplementation for the prevention of neural tube defects: Us preventive services task force recommendation statement. JAMA, 317, 183\u2013189.","DOI":"10.1001\/jama.2016.19438"},{"key":"ref_16","unstructured":"Ministry of Health (2003). Improving Folate Intake in New Zealand: Policy Implications."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/cga.12238","article-title":"Preconceptional folic acid supplementation in Japan","volume":"57","author":"Hirahara","year":"2017","journal-title":"Congenit. Anom."},{"key":"ref_18","unstructured":"Vietnam Ministry of Health (2017). National Guideline on Nutrition for Pregnant and Lactating Women."},{"key":"ref_19","unstructured":"General Statistics Office and UNICEF (2015). Vietnam Multiple Indicator Cluster Survey 2014, General Statistics Office and UNICEF."},{"key":"ref_20","unstructured":"WHO (2018). Maternal Child Epidemiology Estimation (MCEE). Child Causes of Death, 2000\u20132017, WHO."},{"key":"ref_21","first-page":"1","article-title":"Updated Estimates of Neural Tube Defects Prevented by Mandatory Folic Acid Fortification\u2014United States, 1995\u20132011","volume":"64","author":"Williams","year":"2015","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Zaganjor, I., Sekkarie, A., Tsang, B.L., Williams, J., Razzaghi, H., Mulinare, J., Sniezek, J.E., Cannon, M.J., and Rosenthal, J. (2016). Describing the Prevalence of Neural Tube Defects Worldwide: A Systematic Literature Review. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151586"},{"key":"ref_23","unstructured":"Institute for Health Metrics and Evaluation (2017). Neural Tube Defects: Both Sexes, All Ages, 2007\u20132017, Prevalence, Rate per 100,000, Institute for Health Metrics and Evaluation."},{"key":"ref_24","unstructured":"Kurukulasuriya, S., Nguyen, P., Phan, H., and Tran, M.G. (2017). Situation Analysis of Children in Ho Chi Minh City, Vietnam 2017, UNICEF. Ho Chi Minh City People\u2019s Committee."},{"key":"ref_25","unstructured":"Shanks, E., BuonKrong, T.N., Duong, Q.H., Vu, V.D., and Pham, N.H. (2014). An Analysis of the Situation of Children and Women in Kon Tum Province, UNICEF. People\u2019s Committee of Kon Tum Province."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gonzalez-Casanova, I., Nguyen, P.H., Young, M.F., Harding, K.B., Reinhart, G., Nguyen, H., Nechitillo, M., Truong, T.V., Pham, H., and Nguyen, S. (2017). Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4379-4"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1177\/0379572116647830","article-title":"A Qualitative Study of Factors Influencing Initiation and Adherence to Micronutrient Supplementation among Women of Reproductive Age in Vietnam","volume":"37","author":"Nechitilo","year":"2016","journal-title":"Food Nutr. Bull."},{"key":"ref_28","unstructured":"Ministry of Health (2012). National Nutrition Strategy for 2011\u20132020, with a Vision toward 2030."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.puhe.2018.04.009","article-title":"Folate supplementation to prevent birth abnormalities: Evaluating a community-based participatory action plan for refugees and migrant workers on the Thailand-Myanmar border","volume":"161","author":"Stevens","year":"2018","journal-title":"Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1017\/S1368980008002115","article-title":"Factors associated with a positive intake of folic acid in the periconceptional period among Korean women","volume":"12","author":"Kim","year":"2009","journal-title":"Public Health Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e12435","DOI":"10.1111\/mcn.12435","article-title":"Consumption of dietary supplements by Chinese women during pregnancy and postpartum: A prospective cohort study","volume":"13","author":"Tang","year":"2017","journal-title":"Matern. Child Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1017\/S1368980017003172","article-title":"Awareness, use and information sources of folic acid supplementation to prevent neural tube defects in pregnant Japanese women","volume":"21","author":"Yamamoto","year":"2018","journal-title":"Public Health Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e016794","DOI":"10.1136\/bmjopen-2017-016794","article-title":"Cohort profile: Maternal lifestyle and diet in relation to pregnancy, postpartum and infant health outcomes in Vietnam: A multicentre prospective cohort study","volume":"7","author":"Nguyen","year":"2017","journal-title":"BMJ Open"},{"key":"ref_34","first-page":"55","article-title":"Validity and Reliability of a Food Frequency Questionnaire to Assess Habitual Dietary Intake in Northern Vietnam","volume":"1","author":"Nguyen","year":"2013","journal-title":"Vietnam J. Public Health"},{"key":"ref_35","unstructured":"Ministry of Health (2014). Regulations on Dietary Supplement Management."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Nguyen, P.H., Lowe, A.E., Martorell, R., Nguyen, H., Pham, H., Nguyen, S., Harding, K.B., Neufeld, L.M., Reinhart, G.A., and Ramakrishnan, U. (2012). Rationale, design, methodology and sample characteristics for the Vietnam pre-conceptual micronutrient supplementation trial (PRECONCEPT): A randomized controlled study. BMC Public Health, 12.","DOI":"10.1186\/1471-2458-12-898"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1038\/sj.ejcn.1602812","article-title":"Prenatal iron supplementation in rural Vietnam","volume":"62","author":"Aikawa","year":"2007","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"World Health Organization (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363, 157\u2013163.","DOI":"10.1016\/S0140-6736(03)15268-3"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1111\/j.1471-0528.2006.01096.x","article-title":"Folic acid knowledge and use in a multi-ethnic pregnancy cohort: The role of language proficiency","volume":"113","author":"Bonsel","year":"2006","journal-title":"BJOG"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kinnunen, T.I., Sletner, L., Sommer, C., Post, M.C., and Jenum, A.K. (2017). Ethnic differences in folic acid supplement use in a population-based cohort of pregnant women in Norway. BMC Pregnancy Childbirth, 17.","DOI":"10.1186\/s12884-017-1292-x"},{"key":"ref_41","first-page":"335","article-title":"Which mothers take folic acid and folate containing foods?","volume":"15","author":"Binns","year":"2006","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1017\/S1368980018000836","article-title":"Determinants of folic acid supplement use outside national recommendations for pregnant women: Results from the Growing Up in New Zealand cohort study","volume":"21","author":"Teixeira","year":"2018","journal-title":"Public Health Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"McKenna, E., Hure, A., Perkins, A., and Gresham, E. (2017). Dietary Supplement Use during Preconception: The Australian Longitudinal Study on Women\u2019s Health. Nutrients, 9.","DOI":"10.3390\/nu9101119"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.midw.2011.04.002","article-title":"Periconceptional folic acid supplementation among women attending antenatal clinic in Anhui, China: Data from a population-based cohort study","volume":"28","author":"Xing","year":"2012","journal-title":"Midwifery"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Lang, A.Y., Harrison, C.L., and Boyle, J.A. (2019). Preconception Lifestyle and Weight-Related Behaviors by Maternal Body Mass Index: A Cross-Sectional Study of Pregnant Women. Nutrients, 11.","DOI":"10.3390\/nu11040759"},{"key":"ref_46","unstructured":"StataCorp (2017). Stata Statistical Software: Release 15, StataCorp LLC."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1111\/aogs.12656","article-title":"Maternal folic acid supplementation trends 2009\u20132013","volume":"94","author":"McKeating","year":"2015","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1111\/1471-0528.12414","article-title":"Maternal and health care determinants of preconceptional use of folic acid supplementation in France: Results from the 2010 National Perinatal Survey","volume":"120","author":"Tort","year":"2013","journal-title":"BJOG"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ypmed.2018.05.023","article-title":"Folic acid supplementation during the preconception period: A systematic review and meta-analysis","volume":"114","author":"Toivonen","year":"2018","journal-title":"Prev. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/1471-0528.12634","article-title":"Education and severe maternal outcomes in developing countries: A multicountry cross-sectional survey","volume":"121","author":"Souza","year":"2014","journal-title":"BJOG"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1017\/S1368980013002656","article-title":"Factors associated with not using folic acid supplements preconceptionally","volume":"17","author":"Cornel","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/07399338509515683","article-title":"The Vietnamese woman: Health\/illness attitudes and behaviors","volume":"6","author":"Calhoun","year":"1985","journal-title":"Health Care Women Int."},{"key":"ref_53","unstructured":"The World Bank Group (2017). Fertility Rate, Total (Births per Woman). In 1960\u20132017, The World Bank Group."},{"key":"ref_54","unstructured":"UNFPA, and Ministry of Health (2017). Viet Nam Midwifery Report 2016."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1093\/ajcn\/nqy212","article-title":"Periconceptional intake of folic acid among low-risk women in Canada: Summary of a workshop aiming to align prenatal folic acid supplement composition with current expert guidelines","volume":"108","author":"Lamers","year":"2018","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Hoang, T., Nguyen, D.T., Nguyen, P.V.N., Tran, D.A., Gillerot, Y., Reding, R., and Robert, A. (2013). External birth defects in southern Vietnam: A population-based study at the grassroots level of health care in Binh Thuan province. BMC Pediatr., 13.","DOI":"10.1186\/1471-2431-13-67"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/nyas.13548","article-title":"Estimates of global and regional prevalence of neural tube defects for 2015: A systematic analysis","volume":"1414","author":"Blencowe","year":"2018","journal-title":"Ann. N. Y. Acad. 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