Predictors of early postpartum vitamin use among women of Mexican origin: implications for healthcare provider recommendations.

OBJECTIVE High parity and short birth intervals among Hispanic women may deplete their folic-acid levels and place them at risk for neural tube defects (NTDs). The purposes of this study were to evaluate factors associated with multivitamin supplementation rates during the early (one to six weeks) postpartum period among Mexican-origin women and present their implications in preventing NTDs in subsequent pregnancies. DESIGN A cross-sectional study was conducted among Hispanic mothers attending women, infant, and children (WIC) clinics in El Paso, Texas. Information was ascertained via interview on regular multivitamin use, and independent variables including sociodemographic characteristics, multivitamin knowledge, obstetric and health history, and birth control and infant feeding methods. RESULTS Only 66% of 329 mothers took postpartum multivitamins. Multivitamin consumption declined by 29% for each postpartum week (P=.0003). Adjusted odds ratios indicated positive associations between multivitamin supplementation and prenatal care exclusively in the United States (P=.007), breastfeeding (P=.071), preconceptional (P=.005) and prenatal multivitamin use (P=.0002), and multivitamin recommendation from a healthcare provider (P < or = .0001). The majority of 247 women with multivitamin counsel (59%) were told to finish prenatal vitamins or to continue use while breastfeeding. Smokers were less likely to take multivitamins than nonsmokers (P=.007). CONCLUSIONS A provider recommendation highly motivates early postpartum women to consume multivitamins. Since most women have more than one child, this period likely represents an interpregnancy interval and is an opportune time to educate and encourage women to take multivitamins. This simple and inexpensive measure could prevent birth defects in future pregnancies.