Comparative use and knowledge of preconceptional folic acid among Spanish- and English-speaking patient populations in Phoenix and Yuma, Arizona

Abstract

Objective: The goal of the study was to compare levels of use and knowledge regarding the importance of periconceptional folic acid intake among Spanish- and English-speaking patient populations. Study Design: A survey was distributed to 315 pregnant patients seeking care at Phoenix Perinatal Associates. English (n = 183) and Spanish (n = 132) language surveys were completed by patients over a 6-month period. Results were analyzed to determine the level of use and understanding in relation to the importance of periconceptional folic acid in the prevention of neural tube defects by primary language and educational level. Results: Fewer than 1 in 12 patients surveyed (7.9%) were aware of a specific association between folic acid intake and the prevention of neural tube defects. Thirty-five percent of Spanish-speaking patients and 56.3% of English-speaking patients (difference, P <.001) were aware of nonspecific benefits of vitamin intake and the prevention of congenital malformations. A mere 1.2% of women with <4 years of high school education were consuming a multivitamin supplement preconceptionally compared with 46% of those with any education beyond high school (P <.0001). Spanish-speaking patients were significantly less likely to be consuming a vitamin supplement preconceptionally when compared with English-speaking patients (3.7% vs 22.4%; P <.0001). Among the 25 patients who demonstrated a specific knowledge of the ability of folic acid intake to prevent neural tube defects, 92% were English speaking compared with 8% who were Spanish speaking (P <.0001). Conclusions: There is a critical lack of use and understanding regarding the importance of periconceptional folic acid intake to prevent neural tube defects. Our Spanish-speaking population and those with less formal education appear particularly vulnerable to not benefiting from the advantages of periconceptional folic acid. Educational efforts at promoting knowledge and use of folic acid need to incorporate strategies addressing the Spanish-speaking population. (Am J Obstet Gynecol 2001;184:1263-6.)