Folic Acid and Pregnancy

1. Folic Acid and Pregnancy Data from the Pregnancy Risk Assessment Monitoring System (PRAMS)

2. Background • More than 4,000 babies in the United States are born each year with Neural Tube Defects (NTDs). • Taking Folic Acid at least one month before and during the first month of pregnancy can help prevent NTDs. • Folic Acid is found in many foods and multivitamins.

3. Background • Women of child bearing age need to take Folic Acid supplements and eat foods rich in folate. • Women of child bearing age with no history of NTDs should take 400 mcg (micrograms) of Folic Acid daily. • Women of child bearing age with a personal history or family history of NTDs should take 4,000 mcg of Folic Acid prescribed by their doctor.

4. Methods • Florida PRAMS data from 1996 and 2001 were weighted to reflect Florida’s total population of women giving birth to live born infants. • Sample size:1,986 PRAMS respondents in 1996 and2,006 in 2001. • 205,800 live births in Florida in 2001.

5. Methods • PRAMS is a federally-funded (CDC) state-wide project conducted by Florida Department of Health. • Mail survey questionnaire with telephone follow-up of non-responders. • Population-based random stratified selection of Florida residents that gave birth to live-born infants 3-6 months ago.

6. Results • Overall, 61% of new mothers did not take a multivitamin containing Folic Acid before pregnancy (2001). • The prevalence of not taking a multivitamin containing Folic Acid before pregnancy was higher among women who were on Medicaid (76%) than among women who were not on Medicaid (49%).

7. Results • 80% of new mothers were aware that Folic Acid can prevent Neural Tube Defects (2001). • More women (70%) heard about Folic Acid from their health care providers than from other sources (2001).

8. Questionnaire Component • Phase 3 (1996-1999) and Phase 4 (2000-2003) questionnaires had the question: “Have you ever heard or read that taking the vitamin folic acid can help prevent some birth defects?”

9. Figure 1. No Awareness of Folic Acid Benefits by Race/Ethnicity

10. Figure 2. No Awareness of Folic Acid Benefits by MedicaidStatus

11. Questionnaire Component • Phase 4 (2000-2003) questionnaire has the question:“Have you ever heard about folic acid from any of the following sources?”Magazine or newspaper article Radio or television Doctor, nurse, or other health care Book Family or friends

12. Figure 3. Source of Awareness of Folic Acid Benefits (2001) non-Hispanic whitenon-Hispanic blackHispanic

13. Questionnaire Component • Phase 4 (2000-2003) questionnaire has the question: “In the month before you got pregnant with your new baby, how many times a week did you take a multivitamin?”

14. Figure 4. – Multivitamin Containing Folic Acid by Age (2001)

15. Conclusions Women of child bearing age who are least likely to take a multivitamin containing Folic Acid: • Women under the age of 20 years • Women with less than 12 years education • Women with low incomes • Hispanic women • Women on Medicaid

16. Conclusions Meeting the needs of women of child bearing age: • Making doctors more aware of their patients needs • More media attention about the benefits of Folic Acid • Certain medications taken during pregnancy may reduce the effects of Folic Acid • All women need to take multivitamins containing Folic Acid and eat a diet of folate-rich foods

17. Thank You! • For more information about Florida PRAMS contact:Helen_Marshall@doh.state.fl.us • To view PRAMS reports go to DOH website:http://www.doh.state.fl.us/disease_control/epi/prams/prams.htm