962: Comparative use and knowledge of preconceptional folic acid among obstetrics patients in Phoenix, Arizona- 2017

Abstract

We sought to determine use and knowledge of folic acid, and assess whether educational efforts within our community have led to an improvement in awareness regarding the benefits of folic acid, as a prior study (2001) found critical knowledge deficits. Following determination of IRB-exempt status, a survey similar to that given to participants in the original 2001 study was administered to willing participants presenting for prenatal care. Those who answered affirmative to the question “Taking vitamins helps prevent birth defects” were given part II of the survey, which asked more in depth questions about this topic. Results were analyzed to assess vitamin use and awareness of the benefits of preconceptional folic acid. Demographic variables were analyzed to determine if differences in knowledge existed within the study population. Half of patients surveyed had not consumed a multivitamin preconceptionally. Women with at least a high school degree (p < 0.001), Caucasian race (p < 0.001), and those identifying the pregnancy as “planned” (p<0.001) were more likely to take a vitamin before pregnancy. By ethnicity, 86%, 76%, 71%, 67%, 50%, and 43% of Caucasian, Hispanic, African American, Asian, Native American, and Other ethnicities, respectively, were aware of nonspecific benefits of vitamin intake and prevention of congenital malformations. Even among participants who indicated general awareness of vitamins preventing birth defects, 71.5% could not identify neural tube defects (NTDs) as the malformation prevented, and 52.3% were unable to identify folic acid as the correct vitamin. Only 16.3% of total survey participants were aware of the association between folic acid intake and the prevention of NTDs, and they were more likely to have completed high school (P=0.007) and identify as Caucasian (P=0.03). There has been a modest improvement in knowledge regarding folic acid use. Patients are more likely to take a multivitamin prior to pregnancy, even if they don’t understand the potential benefit. However, there appears to have been little improvement in those who correctly identify folic acid as the vitamin that prevents NTDs. Given the well known benefits of NTD prevention, educational efforts should be intensified, and particularly targeted towards ethnic minority women with lesser degrees of education.