title: Knowledge and clinical practice regarding folic acid among obstetrician-gynecologists.
abstract: OBJECTIVE
  To assess obstetrician-gynecologists' knowledge of and clinical practice concerning folate.
  
  
  METHODS
  We mailed surveys on nutrition during pregnancy to the 230 ACOG Fellows who are members of the Collaborative Ambulatory Research Network and to a random sample of 800 Fellows who are not members of the Network. Our results focus on questions concerning folate.
  
  
  RESULTS
  We analyzed 488 surveys (a 47.4% response rate). Approximately two thirds of respondents screen their pregnant patients for folate intake. Fewer (53%) screen their nonpregnant patients of childbearing age. Those who screened their patients for folate intake were more likely to counsel pregnant patients about diet. They also were more likely to believe that nutritional counseling would improve pregnancy outcomes (70.0% versus 56.5%) and overall patient health (77.5% versus 66.5%). Most Fellows were aware that macrocytic anemia was a manifestation of folate deficiency (90.4%) and that folic acid supplementation during preconception and the early prenatal period helps protect against neural tube defects (96.5%). They were aware that alcoholics (91.4%), smokers (61.3%), and lactating women (53.5%) are at increased risk of folate deficiency. They were less aware of other consequences of low folate intake, such as increased serum homocysteine (20.3%). Respondents who screen their pregnant patients for folate intake correctly answered more of the knowledge questions about folate than physicians who do not screen.
  
  
  CONCLUSIONS
  Obstetrician-gynecologists are generally aware of the link between folate intake and neural tube defects, but are less aware of other aspects of folate metabolism.
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC, USA. mpower@acog.org
authors.forename: M L
authors.initials: ML
authors.lastname: Power
authors.forename: G B
authors.initials: GB
authors.lastname: Holzman
authors.forename: J
authors.initials: J
authors.lastname: Schulkin
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D005260:Female; D005494:Folic Acid Deficiency / Q000150:complications; D006176:Gynecology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009436:Neural Tube Defects / Q000209:etiology / Q000517:prevention & control; D009774:Obstetrics; D010818:Practice Patterns, Physicians'