Health-Care Providers Could Do More to Prevent Birth Defects -- Most Women Don't Know They Should Ta

Health-Care Providers Could Do More to Prevent Birth Defects -- Most Women Don't Know They Should Take Folic Acid Before They Become Pregnant

SEATTLE, July 25, 2003 -- Health-care providers are routinely passing up opportunities to help female patients prevent common birth defects in their future children, according to research sponsored by March of Dimes and conducted by a team at Swedish Medical Center.

The Pregnancy Foresight Project aims to improve preconception and prenatal health education about the B vitamin folic acid, smoking, alcohol and other factors that can affect a developing fetus. According to a survey conducted as part of the project, 74 percent of the women recalled their provider discussing folic acid during a pregnancy visit. However, only 35 percent of women recalled having such a discussion during a non-pregnancy visit. The survey was conducted in obstetric and family health clinics in Eastern and Western Washington between June 2001 and October 2002.

"We'd like to get the word out that obstetricians aren't the only health-care providers whose patients can benefit from discussions about folic acid," said Robert G. Resta, M.S., C.G.C., a genetic counselor at Swedish and principal investigator for Pregnancy Foresight. "A key finding of the survey so far is that physicians tell a lot of patients about folic acid, but they are not doing a good job of getting that message to the most important audience - women who are not yet pregnant."

Folic-acid supplementation has been shown to prevent up to 70 percent of birth defects of the brain and spine (neural tube defects, or NTDs), the best known of which is spina bifida. But folic acid works to prevent NTDs only if taken before conception and in the first weeks of pregnancy. Since the brain and spine of a fetus develop in the first few weeks of pregnancy - before many women realize they are pregnant - a woman must have adequate amounts of folic acid in her system before conception and during pregnancy.

Even though some foods like leafy vegetables and fortified cereals are good sources of folic acid, it is extremely difficult to consume a sufficient amount of folic acid through diet alone. Therefore, the March of Dimes and Centers for Disease Control recommend that all women of childbearing years take a daily multivitamin containing folic acid, whether or not they intend to become pregnant.

In the United States, about half of all pregnancies are unplanned and half of those pregnancies involved a failed attempt at birth control. Folic-acid supplements are inexpensive and widely available at supermarkets and drugstores.

Gallup surveys conducted for March of Dimes indicate that nationally, physicians are the leading source of information about folic acid for women who are pregnant or actively trying to become pregnant. But in Washington state, more respondents of the Pregnancy Foresight Project survey reported learning about folic acid through broadcast media than from physicians.

However, "women are much more likely to take advice from a trusted source like their health-care provider than they are to respond to ad campaigns with the same message," said Resta. "That's why it's so important for our state's medical-care providers to deliver this vital health message to all women who could become pregnant."

"Non-pregnancy-related visits are also a good opportunity to discuss the effects smoking, alcohol use, and other behaviors could have on future children," Resta said.

The Pregnancy Foresight Project maintains a Web site for more information, including resources for health-care practitioners. The Web site can be found by clicking here. Additional information for women and health-care providers can be found on the Washington State Folic Acid Council Web site at www.folicacidcouncil.org.

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