Knowledge and Use of Folic Acid by Women of Childbearing Age—United States, 1995 and 1998

Abstract

In the United States, approximately 4000 pregnancies are affected by neural tube defects each year; 50%‐70% of these developmental defects could be prevented with daily intake of 400 μg of the B vitamin folic acid throughout the periconceptional period (1 ). In 1992, the Public Health Service recommended that all women capable of becoming pregnant consume 400 μg of folic acid daily throughout their childbearing years to reduce their risk for having a pregnancy affected by neural tube defects (2 ). In 1998, the Institute of Medicine recommended that all women of childbearing potential consume 400 μg of synthetic folic acid per day from fortified foods and/or a supplement in addition to food folate from a varied diet (3 ). This report summarizes the findings of a survey conducted during July‐August 1998 to assess folic acid knowledge and practices among women of childbearing age in the United States (4 ) and compares these results with those from a similar survey conducted in 1995. The findings indicate that 7% of women know folic acid should be taken before pregnancy to reduce the risk for neural tube defects. In 1998, the March of Dimes Birth Defects Foundation contracted with the Gallup Organization to conduct a random-digit‐dialed telephone survey of a stratified national sample of 2115 women aged 18‐45 years. The response rate was 52%. The margin of error for estimates based on the total sample size was ±3%; for comparisons involving subsets of the sample, the margin of error was greater. Statistical estimates were weighted to reflect the total population of women aged 18‐45 years in the contiguous United States who resided in households with telephones. The 1998 survey included many of the same questions asked in 1995, and the methods employed were essentially the same (4 ). Overall, 68% of women reported having ever heard of or having ever read about folic acid, a 31% increase from 52% in 1995. Awareness of folic acid was lowest among women aged 18‐24 years (50%) and women who had less than a high school education (40%). Of all women surveyed, 13% knew that folic acid helps prevent birth defects, and 7% knew that folic acid should be taken before pregnancy (Table 1), compared with 5% and 2%, respectively, in 1995. In 1998, 32% of women reported taking a vitamin supplement containing folic acid on a daily basis, compared with 28% in 1995. Among women who reported being not pregnant at the time of the survey, 29% reported taking a vitamin supplement