Periconceptional folic acid use among Hispanic women in Oregon

Background: Although Hispanic women are at an increased risk to have an infant with a neural tube defect, they are less likely to be taking folic acid than women of other race/ethnicies. Study Question: Among Hispanic women, what are the risk factors for not taking periconceptional folic acid (PFA)? Methods: To better understand PFA use by Hispanic women in Oregon, data were analyzed from the Oregon 1998-1999 Pregnancy Risk Assessment Monitoring System (PRAMS). Oregon PRAMS asked women whether they had taken the vitamin folic acid in the month prior to pregnancy. Results: Of the 443 Hispanic women surveyed by 1998-1999 PRAMS in Oregon, only 15.7% (weighted) reported taking the vitamin folic acid in the month before pregnancy compared to 35% of non-Hispanic women. Among Hispanic women who had recently given birth, in multivariate analysis, knowledge of folic acid (OR 8.71, 95% CI 3.00-24.53), intended pregnancy (OR 2.87, 95% CI 1.39-5.94) and mother's age 30 or older (OR 2.03, 95% CI 1.00-4.09) were significant predictors of PFA use. Conclusion: Knowledge of the benefits of folic acid remains the most important predictor of PFA vitamin use for Hispanic women. Public Health Implications: Public health agencies should develop more culturally sensitive programs to educate Hispanic women about the importance of taking multivitamins containing folic acid. Decreasing unintended pregnancy, by decreasing barriers to family planning and emergency contraception, may also increase the proportion of Hispanic women taking PFA and therefore decrease the proportion of their infants with birth defects.