"Frankly, we're surprised at this increase, but it's good news," says Dr. Jennifer L. Howse, president of the March of Dimes. "The increase is especially important because we've been very worried about the effects on mothers and babies of popular low-carbohydrate diets that drastically reduce grain foods enriched with folic acid, such as bread and pasta. However, our survey finds that 49 percent of women who have been on low-carb diets in the past six months said they actually took a daily multivitamin containing folic acid. So perhaps these women are taking their vitamins because they realize they're missing out on important food groups."
However, Dr. Howse said, low-carb and other diets could not be the only reason behind the increase because rates of folic acid use were also higher than expected for women not dieting (39 percent). She also said the March of Dimes urges all women to eat a varied, healthy diet before and during pregnancy.
Of women who were not pregnant at the time of the 2004 survey, 37 percent reported taking a vitamin containing folic acid daily, up from 30 percent in 2003.
Daily consumption of the B vitamin folic acid beginning before pregnancy is crucial because serious birth defects of the brain and spine known as neural tube defects (NTDs) occur in the early weeks following conception, often before a woman knows she is pregnant.
The survey was conducted for the March of Dimes by The Gallup Organization under a grant from the U.S. Centers for Disease Control and Prevention.
Dr. Howse said the March of Dimes survey found that more women seem to understand the importance of folic acid to the health of babies. A comparison of the eight previous surveys shows that 12 percent of women know that, to be effective, folic acid must be consumed before pregnancy -- up from only 2 percent in 1995. Those who know that folic acid helps prevent birth defects increased to 24 percent in 2004, up from only 4 percent in 1995.
"Although folic acid now has a higher profile in this country, we can't be complacent in our efforts to prevent disabling or fatal NTDs from occurring," said Dr. Howse. "We urge health care professionals and pharmacists to remember to use every contact they have with women capable of having a baby to advise them to take a multivitamin with at least 400 micrograms of folic acid daily."
NTDs are among the most serious birth defects in the United States. Each year, an estimated 2,200 babies are born with these defects, and additional affected pregnancies result in miscarriage or stillbirth.
To help prevent NTDs, the March of Dimes says, all women capable of becoming pregnant should consume a multivitamin containing at least 400 micrograms of folic acid every day beginning before pregnancy, as part of a healthy diet containing foods fortified with folic acid and foods that naturally contain folic acid, such as leafy green vegetables, and beans.
The March of Dimes 2004 survey results are based on telephone interviews with a national sample of 2,012 women age 18 to 45 conducted from April 19 to May 20, 2004. 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.
"Use of Vitamins Containing Folic Acid Among Women of Childbearing Age -- United States, 2004," by Heather K. Carter, M.P.H., Association for Teachers of Preventive Medicine; Lisa L. Massi Lindsey, Ph.D., CDC Foundation; Joann R. Petrini, Ph.D., March of Dimes; Christine Prue, Ph.D., and Joseph Mulinare, M.D., NCBDDD, CDC, was published in MMWR, September 17, Volume 53, No. 36.
Copies of the March of Dimes survey, item #31-1897-04, can be obtained by calling toll-free 1-800-367-6630. For detailed data and trends, visit www.marchofdimes.com/peristats.
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 and in 2003 launched a five-year campaign to address the increasing rate of premature birth. For more information, visit the March of Dimes Web site at marchofdimes.com or its Spanish Web site at nacersano.org.
More information on folic acid can be found at the Centers for Disease Control and Prevention Web site at www.cdc.gov/ncbddd/folicacid.
Journal
MMWR Morbidity and Mortality Weekly Report