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Folic Acid Use by Women Receiving Routine Gynecologic Care

From the Arkansas Center for Birth Defects Research and Prevention, Departments of Pediatrics and Obstetrics and Gynecology, College of Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas.

Address reprint requests to: Mario A. Cleves, PhD, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Slot 512–40, Little Rock, AR 72202-3591; e-mail: clevesmarioa{at}uams.edu.

OBJECTIVE: Many health professional groups recommend folic acid supplementation for all women able to become pregnant. In this study, we document folic acid supplement use among a sample of women receiving routine gynecologic care.

METHODS: A short questionnaire was administered to 322 women aged 18–45 years who were seeking routine gynecologic care at participating clinics in Little Rock, Arkansas. Questions covered knowledge and use of folic acid supplements, pregnancy intention, and demographic and socioeconomic characteristics. Primary study outcomes were self-reported folic acid awareness, daily or weekly use of folic acid supplements, and intention to begin taking folic acid. Factors affecting study outcomes were examined individually by computing crude odd ratios and adjusted for other covariates using unconditional logistic regression.

RESULTS: Although 61.8% of women reported awareness of the association between folic acid and birth defects prevention, only 27.1% of these women, and 22.7% of all study participants, reported daily use of a folic acid supplement. Substantially more women (39.8%) were taking a folic acid supplement at least once per week. Age, race, educational level, folic acid awareness, marital status, pregnancy intent, and other preventive health behaviors were the most important predictors of compliance.

CONCLUSION: The results indicate a need for targeted interventions directed toward minority women, young women, and those of lower socioeconomic and educational status. The routine gynecologic visit is an ideal opportunity to counsel women of reproductive age to take folic acid daily.

LEVEL OF EVIDENCE: III

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