title: Supplement use and other characteristics among pregnant women with a previous pregnancy affected by a neural tube defect - United States, 1997-2009.
abstract: Neural tube defects (NTDs) include anomalies of the brain (anencephaly and encephalocele) and spine (spina bifida). Even with ongoing mandatory folic acid fortification of enriched cereal grain products, the U.S. Preventive Services Task Force recommends that women of childbearing potential consume a daily supplement containing 400 µg-800 µg of folic acid. Women with a prior NTD-affected pregnancy have an increased risk for having another NTD-affected pregnancy, and if they are planning another pregnancy, the recommendation is that they consume high-dosage folic acid supplements (4.0 mg/day) beginning ≥4 weeks before conception and continuing through the first 12 weeks of pregnancy. To learn whether folic acid supplementation (from multivitamins or single- ingredient supplements) was commonly used during pregnancy by women with a previous NTD-affected pregnancy, supplement use was assessed among a convenience sample of women with a previous NTD-affected pregnancy who participated in the National Birth Defects Prevention Study (NBDPS), a case-control study of major birth defects in the United States. Characteristics of women who previously had an NTD-affected pregnancy and whose index pregnancy (pregnancy included in NBDPS) was either affected by an NTD (N = 17) (i.e., recurrence-cases) or resulted in a live-born infant without a major birth defect (N = 10) (i.e., recurrence-controls) were assessed. Taking a supplement that included folic acid was more common among recurrence-control mothers (80%) than recurrence-case mothers (35%). The recommendation that women should take folic acid supplements just before and during early pregnancy is not being followed by many women and offers an opportunity for NTD prevention, especially among women who are at a higher risk because they have had a previous pregnancy affected by an NTD.
authors.forename: Annelise
authors.initials: A
authors.lastname: Arth
authors.forename: Sarah
authors.initials: S
authors.lastname: Tinker
authors.forename: Cynthia
authors.initials: C
authors.lastname: Moore
authors.forename: Mark
authors.initials: M
authors.lastname: Canfield
authors.forename: Aj
authors.initials: A
authors.lastname: Agopian
authors.forename: Jennita
authors.initials: J
authors.lastname: Reefhuis
mesh_terms: D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D016022:Case-Control Studies; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology / Q000517:prevention & control*; D009765:Obesity / Q000453:epidemiology; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology / Q000523:psychology*; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D005492:Folic Acid