Prevention of neural tube defects: effect of an intervention aimed at implementing the official recommendations.
OBJECTIVE
The periconceptional intake of 0.4 mg folic acid is recommended in many countries to prevent neural tube defects. This paper describes the poor implementation of corresponding guidelines in Germany, the effectiveness of an intervention-based on providing adequate information and the problems associated with the implementation.


METHODS
Two cross sectional studies investigated knowledge, attitude, and behaviour of randomly sampled gynaecologists (n = 24/27), pharmacists (n = 21/21), and women in childbed (n = 131/118) before and after the information campaign.


RESULTS
Before the intervention, 3.8% of the women implemented folic-acid-prophylaxis compared with 9.3% afterwards (p = n.s.). The awareness of the prophylaxis before pregnancy correlated with socio-economic status and rose from 28% (before) to 42% after intervention (p < 0.05). Before the intervention, 38% of the gynaecologists and 38% of the pharmacists recommended the prophylaxis compared with 74% (p < 0.05) and 43% (p = n.s.) afterwards.


CONCLUSIONS
The effect of the intervention was small. To improve the situation, fortification of specially selected and labelled food should be considered. An accompanying nationwide information campaign should focus on women with lower socio-economic status.
Egen
Veronika
V
Institute for Medical Informatics, Biometry and Epidemiology (IBE), University of Munich. egen@ibe.med.uni-muenchen.de
Hasford
Joerg
J
D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005858:Germany; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006176:Gynecology / Q000706:statistics & numerical data; D006266:Health Education / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006284:Health Plan Implementation / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D009436:Neural Tube Defects / Q000517:prevention & control*; D010595:Pharmacists / Q000706:statistics & numerical data; D016742:Preconception Care / Q000706:statistics & numerical data; D011247:Pregnancy
D005492:Folic Acid