Abstract
Objective: The aim of this study was to measure the knowledge level of physicians working in family health centers about the conditions leading to neural tube defect (NTD) and preventive measures. Material and Methods: In this cross-sectional study, 406 general practitioners and family medicine specialists made a survey consisted of 13 questions. Chi-square, Fisher’s Exact test and Pearson chi-square analysis were applied as statistical methods. Results: A total of 406 physicians (family medicine specialists: 110, general practitioners: 296) participated in the study. 81.53% of the participants were working in a city and 18.47% were working in the countryside. The number of referral to general practitioners before pregnancy was significantly higher than that of family medicine specialists. (p<0.05). 36.95% of the respondents knew that the neural tube was closed in the first month of embryological life. Folic acid initiation rate was 99.26% for patients planning pregnancy. Initiation of vit B12 with folic acid was 28.33% in patients planning pregnancy. The rate of knowing that vitamin B12 deficiency causes NTD was 39.41% (family medicine specialists: 50%, general practitioners: 35.47%), and FMSs were statistically significant (p<0.05). Discussion: While the number of pregnant women who received folic acid only was sufficient, the number of pregnant women who took vitamin B12 with folic acid was very low. Family medicine specialists and general practitioners had insufficient knowledge that using vitamin B12 in combination with folic acid prevented NTD development. By preparing and implementing algorithms that can prevent NTDs, many life-long complications can be prevented.
Highlights
Neural tube defects (NTD) develop on the first 28th day of embryological life when the neural tube that needs to be closed remains open [1]
A total of 406 physicians participated in the study. 81.53% of the participants were working in a city and 18.47% were working in the countryside
The number of referral to general practitioners before pregnancy was significantly higher than that of family medicine specialists. (p
Summary
Neural tube defects (NTD) develop on the first 28th day of embryological life when the neural tube that needs to be closed remains open [1]. There are various mutations among genetic factors, it is not clearly proven; maternal age lower than 19 years and older than 40 years considered as a risk factor [3,4] Among environmental factors; low folic acid, vitamin B 2-6-12, choline, betaine, n-3 polyunsaturated fatty acids, zinc and vitamin D levels and high homocysteine levels are seen in neural tube defects [2,5,6]. It is very important to take necessary precautions before and during pregnancy in order to prevent NTDs due to mortality and serious morbidities. Because of this serious effects, Republic of Turkey Ministry of Health started a support program for folic acid intake during pregnancy, since 1999 [8]
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