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

Abstract

Each year in the United States, approximately 4000 pregnancies are affected by spina bifida and anencephaly. Babies born with spina bifida usually survive, often with serious disability, but anencephaly is invariably fatal. The B vitamin folic acid can reduce the occurrence of spina bifida and anencephaly by at least 50% when consumed daily before conception and during early pregnancy. In 1992, the Public Health Service (PHS) recommended that all women of childbearing age who are capable of becoming pregnant consume 400 μg of folic acid daily (1 ). Folic acid can be obtained from multivitamins or certain other supplements and from some fortified breakfast cereals. It is found naturally in orange juice, green leafy vegetables, and beans; however, it is difficult to obtain the recommended 400 μg daily through diet alone. This report summarizes findings from a survey conducted during January and February 1997 that indicate modest increases since 1995 in knowledge about and consumption of folic acid among U.S. women aged 18‐45 years and highlights the need for additional public health efforts to take full advantage of this prevention opportunity. In 1997, the March of Dimes contracted The Gallup Organization to conduct a random-digit‐dialed telephone survey of a proportionate, stratified national sample of 2001 women aged 18‐45 years to assess knowledge about folic acid and use of vitamin supplements. The participation rate was 50%. Statistical estimates were weighted to reflect the total population of women aged 18‐45 years in the contiguous United States residing in households with telephones. The margin of error for estimates based on the total sample size is plus or minus two percentage points. The questionnaire and methods used in 1997 were identical to those used in a 1995 survey (2 ). Overall, 30% of nonpregnant women (i.e., women who were not pregnant at the time of the survey) reported taking daily a multivitamin supplement containing folic acid; 19% of nonpregnant women aged <25 years reported taking vitamin supplements daily, compared with 33% of nonpregnant women aged ≥25 years. Among women who had had a pregnancy during the 2 years preceding the 1997 survey, 23% reported taking a daily vitamin containing folic acid before pregnancy. A total of 66% of respondents said “yes” to the question “Have you ever heard or read anything about folic acid?”; 22% said they had heard of the PHS recommendation about folic acid. Of the survey respondents who knew about folic acid, 36% reported magazines and newspapers as the source of their knowledge about folic acid,