Multivitamins, Folic Acid and Birth Defects

Abstract

Background: Consumption of folic acid prior to conception can prevent up to 70% of neural tube defect (NTD)- affected pregnancies. In 1992, the U.S. Public Health Service (USPHS) issued a recommendation that all women of childbearing age capable of becoming pregnant consume 400 μg of folic acid daily to reduce their risk for a NTD-affected pregnancy. A 26% decrease in the overall NTD rate in the United States was observed between 1995 and 2000, after the fortification of cereal grain products. However, the NTD prevalence for Hispanics remains almost twice that of the general population, both nationally and in North Carolina. Purpose: To measure the baseline knowledge, beliefs and behaviors about multivitamins, folic acid and birth defects of Spanish-speaking Hispanic women ages 18-35 in North Carolina. Methods: Face-to-face oral interviews with Spanish-speaking Hispanic women were conducted by native Spanish-speaking data collectors using a culturally appropriate survey instrument in 12 North Carolina counties. Results: Thirty-three percent of the total respondents (n = 896) reported taking a daily multivitamin. Of those who reported currently planning a pregnancy or trying to become pregnant (n = 134), 22% reported taking a daily multivitamin. Knowledge was highest about birth defects (79%), followed by multivitamins (64%), and then folic acid (54%). Ninety-nine percent of respondents who did not take a daily multivitamin reported they would do so upon the recommendation of their health care provider. Discussion: Multivitamin consumption is low among this group at increased risk, and even lower among those actively attempting or contemplating pregnancy. Health care professionals play a critical role in increasing the knowledge and influencing the behaviors of this population. Translation to Health Education Practice: Folic acid education in all preconception encounters with Hispanic women is critical to address this health disparity and help prevent NTD-affected pregnancies.