Abstract
IntroductionPregnancies affected with neural tube defects (NTDs) are mostly associated to maternal deficiency of folic acid (FA). Although supplementation is recommended for all women of childbearing age, the incidence of NTDs in Puerto Rico has not shown a significant decrease.ObjectiveThe goal of this study was to assess the awareness and level of knowledge of FA supplementation among women attending prenatal clinics, and correlate this knowledge with the source ofinformation and the actual use of FA. A secondary objective was to corroborate or abrogatethe association of the lack of FA supplementation with the occurrence of unplanned pregnancies.MethodsThis descriptive study was conducted at the High-Risk Prenatal Care Clinicsof the Adults University Hospital from August 2015 to November 2015. The answers to a non-validated self-administered questionnaire were assessed and then analyzed with Epi Info 7.ResultsFrom a total of 200 Hispanic female participants, 87.0% were Puerto Rican, most (69.0%) had an education above high school level and 54.5% had a low-income status. Overall, 66.5% were taking FA at the time of the interview, 77% understood that the best time to start FA supplementation was prior to conception, but only 23% of the participants actually began preconceptional FA intake. Unplanned pregnancies were reported in 70.5%. Most referred to have received information about FA benefits from a healthcare professional, yet many could not identify all of FA benefits.ConclusionAlthough most participants were aware of the best time to begin FA supplementation, the majority began intake once pregnancy was discovered; timing related to the 70.5% unplanned pregnancies. Information received is not sufficient sincemost women are not entirely clear about the benefits of FA supplementation, despite their source of information. In caring for women of childbearing age, further investigation is required to optimize educational strategies and methodologies.
Highlights
Pregnancies affected with neural tube defects (NTDs) are mostly associated to maternal deficiency of folic acid (FA)
Conclusion— most participants were aware of the best time to begin FA supplementation, the majority began intake once pregnancy was discovered; timing related to the 70.5% unplanned pregnancies
As to pregnant women correctly identifying the main benefits of FA supplementation, this study found that most could identify the prevention of spina bifida in particular, NTDs in general, and less frequently cleft lip and/or palate
Summary
Pregnancies affected with neural tube defects (NTDs) are mostly associated to maternal deficiency of folic acid (FA). According to Pregnancy Risk Assessment Monitoring System (PRAMS), FA consumption in women was highest among other race/ethnicity (33.0%), followed by Whites (32.4%), Blacks (19.5%) and Hispanics (10.9%) [11] This is of great importance considering the incidence rates of NTDs are known to vary by race and Hispanics have the highest rates [12]. The annual decline in the prevalence of NTDs in Puerto Rico is merely 3.5% [14] The reasons for this minimal reduction include: the lack of awareness of the benefits of FA supplementation in Puerto Rican women of childbearing age, the high rate of unplanned pregnancies (64.9%) and, correspondingly, the lack of early prenatal care [1,15].
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