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

OBJECTIVES To determine whether women who have ha da pregnancy in which the fetus is affected by a neural tube defect (NTD) know of current folic acid recommendations; whether the recommendations are followed before or during the pregnancy associated with an NTD and subsequent pregnancies; and to insure that women who have had an NTD-affected pregnancy have access to proper information about NTDs and folic acid recommendations. METHODS Women living in Colorado who had a pregnancy in 1996 or 1997 in which 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. All women first learned of the folic acid recommendations either during or after their affected 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 subsequent pregnancy followed the recommendation to consume 4.0 mg/d of folic acid, beginning at least 1 month before conception. Women who had subsequent pregnancies became pregnant on average of 9 months after their affected pregnancy ended. CONCLUSIONS Most women who have an NTD-affected pregnancy are unaware of the national folic acid recommendations and do not follow these recommendations for subsequent pregnancies. However, such women are receptive to information about folic acid supplementation. Health care providers and public health officials should consider their role in assuring that education is provided in an effective and timely manner to women with NTD-affected pregnancies.