[Characterization of folate supplementation in pregnancy, based on a combination of health information systems]

Gac Sanit. Nov-Dec 2012;26(6):512-8. doi: 10.1016/j.gaceta.2011.10.022. Epub 2012 Mar 28.
[Article in Spanish]


Objectives: To explore the utility of combining health information systems from the Valencia Health Agency to characterize folate supplementation in pregnant women in the autonomous region of Valencia (Spain).

Methods: The cohort comprised women who gave birth during 2009 in hospitals within the Valencian Health Agency. These women were retrospectively followed-up using ABUCASIS electronic medical records and the GAIA electronic prescription system to identify folate consumption in the 3 months before and after conception.

Results: In 2009, there were 38,069 births in hospitals of the Valencian Health Agency, of which 37,040 (97.3%) were included for analysis. In 34% of women, at least one folate dispensation was registered with an official prescription form within the periconceptional period (6.6% in the 3 months prior to conception). Dispensation with an official prescription form was associated with older women, free pharmaceutical prescriptions, birth in Spain, antiepileptic medications, and a diagnosis of diabetes. Eight percent of women (23.6% of the folate-treated women) received folates at high doses.

Conclusions: Folate consumption during pregnancy is systematically under-registered by healthcare information systems because health professionals do not use the official prescription form for prescription and dispensation. Database linkage is an inadequate approach to assess folic acid supplementation during pregnancy.

Publication types

  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced
  • Abortion, Spontaneous / epidemiology
  • Adult
  • Age Factors
  • Anticonvulsants / therapeutic use
  • Cohort Studies
  • Diabetes, Gestational / epidemiology
  • Dietary Supplements*
  • Drug Prescriptions / economics
  • Drug Prescriptions / statistics & numerical data*
  • Drug Utilization / statistics & numerical data
  • Electronic Prescribing / statistics & numerical data*
  • Emigrants and Immigrants / statistics & numerical data
  • Epilepsy / drug therapy
  • Epilepsy / epidemiology
  • Female
  • Folic Acid / administration & dosage*
  • Folic Acid / economics
  • Follow-Up Studies
  • Forms and Records Control
  • Health Information Systems*
  • Humans
  • Insurance, Pharmaceutical Services / statistics & numerical data
  • Neural Tube Defects / prevention & control
  • Perinatal Care / statistics & numerical data
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / epidemiology
  • Pregnancy in Diabetics / epidemiology
  • Pregnancy*
  • Retrospective Studies
  • Spain
  • Young Adult


  • Anticonvulsants
  • Folic Acid