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Oregon PRAMS: Presentations

Prevention of Birth Defects: Periconceptional Multivitamins with Folic Acid (MVF)

Jill M. Moore, Kenneth D. Rosenberg, MD, MPH, Alfredo S. Sandoval, MS, MBA
Oregon Health Division, Portland, Oregon

Introduction. Periconceptional use of multivitamins with folic acid (MVF) can prevent many birth defects, including at least 50% of neural tube defects.

Methods. Oregon PRAMS surveys a stratified random sample of women approximately 3 months after a live birth. In 1998-99 we interviewed 1867 women (65.4% response rate). Women were asked whether they took folic acid most days in the month before becoming pregnant. Responses were analyzed using SPSS and SUDAAN.

Results. 29.7% of women had taken MVF. The multivariate significant predictors of taking MVF were: 1. knowledge that taking folic acid can prevent birth defects; 2. pregnancy intended; 3. any health insurance; and 4. family income $$30,000/year. Hispanic women (15.8%) and African American women (19.7%) were less likely to be taking MVF than non-Hispanic white women (35.9%).

Discussion. 77.1% of women said that they knew that taking folic acid can prevent birth defects. This knowledge was the most powerful predictor of taking MVF. But only 38.5% of the women who knew were taking MVF. Programs need to 1. increase knowledge and 2. increase the taking of daily MVF among knowledgeable women. These can be accomplished by media campaigns and counseling (in physicians' offices, family planning programs and among postpartum WIC clients). Advice from providers is particularly effective in encouraging use of MVFs. Hispanic women should be a major focus of programmatic activity, since their risk of NTDs is twice as high as white women's. See (pdf) (36K)

American Public Health Association 129th annual meeting, October 24, 2001