Knowledge and use of folic acid supplementation: a study of Colorado womenwhose pregnancies were affected by a fetal neural tube defect

Objectives: To determine whether women who have ha da pregnancy in which th e fetus is affected by a neural tube defect (NTD) know of current folic aci d recommendations; whether the recommendations are followed before or durin g the pregnancy associated with an NTD and subsequent pregnancies; and to i nsure that women who have had an NTD-affected pregnancy have access to prop er information about NTDs and folic acid recommendations. Methods: Women living in Colorado who had a pregnancy in 1996 or 1997 in wh ich the fetus had an NTD were interviewed in 1998 about their knowledge and use of folic acid supplementation. Results: Twenty-one of 42 eligible women were interviewed. AU women first l earned of the folic acid recommendations either during or after their affec ted pregnancy. Only 23.8% of the women took vitamins containing folic acid during the 1 to 3 months before becoming pregnant. None who had a subsequen t pregnancy followed the recommendation to consume 4.0 mg/d of folic acid, beginning at least 1 month before conception. Women who had subsequent preg nancies became pregnant on average of 9 months after their affected pregnan cy ended. Conclusions: Most women who have an NTD-affected pregnancy are unaware of t he national folic acid recommendations and do not follow these recommendati ons for subsequent pregnancies. However, such women are receptive to inform ation about folic acid supplementation. Health care providers and public he alth officials should consider their role in assuring that education is pro vided in an effective and timely manner to women with NTD-affected pregnanc ies.