Knowledge and clinical practice regarding folic acid among obstetrician-gynecologists

Objective: To assess obstetrician-gynecologists' knowledge of and clinical practice concerning folate. Methods: We mailed surveys on nutrition during pregnancy to the 230 ACOG Fe llows who are members of the collaborative Ambulatory Research Network and to a random sample of 800 Fellows who are not members of the Network. Our r esults focus on questions concerning folate. Results: We analyzed 488 surveys (a 47.4% response rate). Approximately two thirds of respondents screen their pregnant patients for folate intake. Fe wer (53%) screen their nonpregnant patients of childbearing age. Those who screened their patients for folate intake were more likely to counsel pregn ant patients about diet. They also were more likely to believe that nutriti onal counseling would improve pregnancy outcomes (70.0% versus 56.5%) and o verall patient health (77.5% versus 66.5%). Most Fellows were aware that ma crocytic anemia was a manifestation of folate deficiency (90.4%) and that f olic acid supplementation during preconception and the early prenatal perio d helps protect against neural tube defects (96.5%). They were aware that a lcoholics (91.4%), smokers (61.3%), and lactating women (53.5%) are at incr eased risk of folate deficiency. They were less aware of other consequences of: low folate intake, such as increased serum homocysteine (20.3%). Respo ndents who screen their pregnant patients for folate intake correctly answe red more of the knowledge questions about folate than physicians who do not screen. Conclusion: Obstetrician-gynecologists are generally aware of the link betw een folate intake and neural tube defects, but are less aware of other aspe cts of folate metabolism. (Obstet Gynecol 2000;95:895-8. (C) 2000 by The Am erican College of Obstetricians and Gynecologists).