Knowledge, use, and education regarding folic acid supplementation: continuation study of women in Colorado who had a pregnancy affected by a neural tube defect.

Background: This study was conducted to: (1) determine whether women who have had a neural tube defect (NTD) affected pregnancy know about recommendations for NTD recurrence prevention; (2) educate them about the recommendations; and (3) ensure that they have access to folic acid prior to another pregnancy.

Methods: Colorado women who had an NTD affected pregnancy in 1999 or later were interviewed about their knowledge and use of folic acid, provided with verbal information about folic acid and NTD prevention, and offered written information and a voucher for free folic acid.

Results: Thirty-two of 68 women who had an NTD affected pregnancy were interviewed. Of these, 22 (69%) were aware of the 0.4 mg. folic acid recommendation for women of child bearing age who have not had an NTD affected pregnancy (MMWR, '91). Only 15 (47%) of the women knew about the U.S. Public Health Service recommendation (MMWR, '92) to consume 4.0 mg of folic acid prior to another pregnancy for NTD recurrence prevention. Twenty-five (78%) of the women reported taking a multivitamin or folic acid daily.

Conclusions: Nine years after national folic acid recommendations, a majority of interviewed women (53%) with NTD affected pregnancies did not know about the recommendation to consume 4.0 mg of folic acid for NTD recurrence prevention. This sample of women are receptive to information about folic acid. Health care providers and public health officials should ensure that education about folic acid is provided in an effective and timely manner to women with NTD-affected pregnancies.