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. 1999 Jul;45:1717–1722.

Preventing neural tube defects. Survey of preconceptional use of folic acid.

I M Neimanis, J M Paterson, E Bain
PMCID: PMC2328376  PMID: 10424271

Abstract

OBJECTIVE: To determine the proportion of women who take daily folic acid supplements in the month before conception and to identify factors associated with supplement use. DESIGN: Cross-sectional survey by self-administered questionnaire. SETTING: Tertiary care teaching hospital in Hamilton, Ont. PARTICIPANTS: Four hundred eighty-four (43%) of 1132 women who delivered normal babies between November 1997 and March 1998. MAIN OUTCOME MEASURES: Reports of daily vitamin supplement use in the month before pregnancy and after pregnancy, and having heard or read about the need to take folic acid before pregnancy; sources of information about folic acid; factors associated with preconceptional vitamin use. RESULTS: Thirty-four percent of respondents reported taking vitamins before conception (use ranged from 21% for those with unplanned pregnancies to 40% for those with planned pregnancies); 80% after conception. Of all respondents, 63% were aware of the need for preconceptional folic acid. Key information sources were family doctors and the mass media: the media were more important before conception, doctors after. Being older (30 years or more), having post-secondary education, and having a planned pregnancy were associated with knowing about the benefits of folic acid; knowledge, regular exercise, perceived good health, and planned pregnancy were associated with preconceptional use of vitamins. CONCLUSIONS: Even in this sample of well educated, English-speaking women, only one third took vitamin supplements before conception, which indicates that current educational efforts do not reach most women early enough. A coordinated, multi-pronged strategy that targets and involves physicians and capitalizes on opportunities to work with schools, public health outlets, and the media is needed.

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Selected References

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  1. Block G., Cox C., Madans J., Schreiber G. B., Licitra L., Melia N. Vitamin supplement use, by demographic characteristics. Am J Epidemiol. 1988 Feb;127(2):297–309. doi: 10.1093/oxfordjournals.aje.a114805. [DOI] [PubMed] [Google Scholar]
  2. Carroll J. C., Reid A. J., Woodward C. A., Permaul-Woods J. A., Domb S., Ryan G., Arbitman S., Fallis B., Kilthei J. Ontario Maternal Serum Screening Program: practices, knowledge and opinions of health care providers. CMAJ. 1997 Mar 15;156(6):775–784. [PMC free article] [PubMed] [Google Scholar]
  3. Coles C. D. Impact of prenatal alcohol exposure on the newborn and the child. Clin Obstet Gynecol. 1993 Jun;36(2):255–266. doi: 10.1097/00003081-199306000-00007. [DOI] [PubMed] [Google Scholar]
  4. Czeizel A. E. Prevention of congenital abnormalities by periconceptional multivitamin supplementation. BMJ. 1993 Jun 19;306(6893):1645–1648. doi: 10.1136/bmj.306.6893.1645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dallaire L., Michaud J., Melancon S. B., Potier M., Lambert M., Mitchell G., Boisvert J. Prenatal diagnosis of fetal anomalies during the second trimester of pregnancy: their characterization and delineation of defects in pregnancies at risk. Prenat Diagn. 1991 Aug;11(8):629–635. doi: 10.1002/pd.1970110821. [DOI] [PubMed] [Google Scholar]
  6. Forman R., Singal N., Perelman V., Chou S., Hoffman L., Parkin P., Koren G. Folic acid and prevention of neural tube defects: a study of Canadian mothers of infants with spina bifida. Clin Invest Med. 1996 Jun;19(3):195–201. [PubMed] [Google Scholar]
  7. Fraser F. C. Folic acid and neural tube defects. CMAJ. 1995 May 1;152(9):1380–1381. [PMC free article] [PubMed] [Google Scholar]
  8. Grimes D. A. Unplanned pregnancies in the United States. Obstet Gynecol. 1986 Mar;67(3):438–442. [PubMed] [Google Scholar]
  9. Hunter A. G. Neural tube defects in Eastern Ontario and Western Quebec: demography and family data. Am J Med Genet. 1984 Sep;19(1):45–63. doi: 10.1002/ajmg.1320190108. [DOI] [PubMed] [Google Scholar]
  10. McGovern E., Moss H., Grewal G., Taylor A., Bjornsson S., Pell J. Factors affecting the use of folic acid supplements in pregnant women in Glasgow. Br J Gen Pract. 1997 Oct;47(423):635–637. [PMC free article] [PubMed] [Google Scholar]
  11. Quinby P. M., Graham A. V. Substance abuse among women. Prim Care. 1993 Mar;20(1):131–140. [PubMed] [Google Scholar]
  12. Sayers G., Scallan E., McDonnell R., Johnson Z. Knowledge and use of peri-conceptional folic acid among antenatal patients. Ir Med J. 1997 Oct;90(6):236–238. [PubMed] [Google Scholar]
  13. Turner L. A., McCourt C. Folic acid fortification: what does it mean for patients and physicians? CMAJ. 1998 Mar 24;158(6):773–776. [PMC free article] [PubMed] [Google Scholar]
  14. Wild J., Sutcliffe M., Schorah C. J., Levene M. I. Prevention of neural-tube defects. Lancet. 1997 Jul 5;350(9070):30–31. doi: 10.1016/S0140-6736(05)66239-3. [DOI] [PubMed] [Google Scholar]

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