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Doctors Miss Chance to Advise Women of Vitamin That Prevents Birth Defects, Survey Finds
WHITE PLAINS, N.Y., SEPT. 5 – Doctors and other healthcare providers are losing a key birth defects prevention opportunity by failing to tell their female patients to take a multivitamin every day, according to a national survey released today by the March of Dimes.
Fewer than one-third of American women of childbearing age not currently pregnant take a daily multivitamin containing folic acid. However, 20 percent of women who don’t take the vitamin said unprompted that they would be more likely to do so if their physician or other health care provider recommended it. It also found that most women (76 percent) say their doctor did not discuss the benefits of folic acid with them.
The survey also found that fewer Hispanic women, 23 percent in 2001, down from 36 percent in 2000, take a vitamin containing folic acid. According to a recent Centers for Disease Control and Prevention (CDC) focus group finding, "vitamins" are still perceived negatively by many Hispanic women, who are also less likely to have entered the health system for any type of care, to have been admitted to a hospital, or to have used preventive care.
"Reaching Hispanic women of childbearing age is particularly urgent, because research has shown that Hispanic women are 40 to 50 percent more likely to have babies with birth defects of the brain and spine than non-Hispanic white women," said Dr. Jennifer L. Howse, president of the March of Dimes. "Latinas are more likely to be affected by this problem that may be addressed by taking the B vitamin folic acid, which has been shown to reduce the risks of birth defects of the brain and spine, also known as neural tube defects, by as much as 70 percent."
"Women look to their doctors for advice on how to do everything possible to have a healthy baby," added Dr. Howse. "And it takes very little time for a doctor to say, ‘You need to take a multivitamin containing folic acid every day before you get pregnant.’ Our survey found that many women would be more likely to take the vitamin if they heard these simple words. Folic acid can prevent some very serious and tragic birth defects of the brain and spine. We believe doctors should consider every office visit with a woman of childbearing age as an opportunity to prevent birth defects that shouldn’t be missed. Right now, only 22 percent of women say they learn about folic acid from their physician."
Dr. Howse said the survey found that folic acid education campaigns run by the March of Dimes and CDC over the past six years have successfully raised the profile of the vitamin in the United States. There has been a steady increase in awareness over these years, reaching a high of 79 percent in 2001. However, most women who have heard of folic acid still do not understand that it must be consumed beginning prior to pregnancy in order to prevent neural tube defects (NTDs), she said.
Dr. Howse noted that the 2000 National Health and Nutrition Examination Survey from the CDC found that average blood levels of folic acid in women of childbearing age have increased since 1998 (see Morbidity and Mortality Weekly Report, Oct. 27, 2000). An article in the June 20, 2001 issue of the Journal of the American Medical Association indicated that NTDs in newborns are down 19 percent.
"These data show that we’re moving in the right direction," Dr. Howse said. "But we could prevent many more NTDs if we increased multivitamin use."
Neural tube defects are among the most serious birth defects in the United States. Each year, an estimated 2,500 babies are born with these defects, and many additional affected pregnancies result in miscarriage or stillbirth. The most common NTD is spina bifida, a leading cause of childhood paralysis. Another NTD is anencephaly, a fatal condition in which a baby is born with a severely underdeveloped brain and skull.
To help prevent NTDs, all women capable of having a baby should consume a multivitamin containing 400 micrograms of folic acid every day, beginning before conception and continuing into the early months of pregnancy, as part of a healthy diet including foods containing folic acid, such as leafy green vegetables, orange juice, peanuts, beans, and fortified grains.
Today's survey follows up four previous March of Dimes polls of women's knowledge and behavior on issues related to healthy pregnancy. It was conducted for the March of Dimes by The Gallup Organization under a grant from the CDC.
The survey results are based on telephone interviews with a national sample of 2,001 women age 18 to 45 conducted from April 14 to May 22, 2001. For results based on samples of this size, one can say with 95 percent confidence that the error attributable to sampling and other random effects could be plus or minus three percentage points. For comparisons involving the full subset of 164 Hispanic women, the margin of error could be plus or minutes nine percentage points.
Copies of the March of Dimes survey, "Folic Acid and the Prevention of Birth Defects: A National Survey of Pre-Pregnancy Awareness and Behavior Among Women of Childbearing Age, 1995-2001," item #31-1596-01, can be obtained by calling toll-free 1-800-367-6630.
The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects and infant mortality. Founded in 1938, the March of Dimes funds programs of research, community services, education, and advocacy to save babies. For more information, call 1-888-MODIMES.
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