Racial and ethnic disparities in preconceptional folic acid knowledge and use: Findings from the Los Angeles Mommy and Baby (LAMB) Survey

Objective: To assess preconceptional folic acid knowledge and intake behavior in a population-based sample of women who recently gave birth in Los Angeles County. Methods: We used data from the 2007 LAMB survey, a population-based, mail sample survey with telephone follow-up for non-respondents based on multistage clustered design. Analyses were based on unweighted responses of 4,426 women with live births. Self-report of folic acid intake was measured by asking respondents how many times per week they took a vitamin pill with folic acid or a multivitamin during the month before getting pregnant. Knowledge of folic acid was measured by assessing if the respondent correctly identified the statement that folic acid prevents birth defects. Relationships between race-ethnicity, folic acid intake, and folic acid knowledge were examined using Pearson's Chi-square tests. Results: Fifty-two percent of women surveyed reported not having taken folic acid the month before getting pregnant. Hispanic and African American women were significantly less likely to have taken folic acid compared to White and Asian/Pacific Islander (API) women (p-value <0.01). More than 40% of women surveyed did not know that folic acid prevents birth defects. Hispanic and African American women were significantly less likely to know that folic acid prevents birth defects compared to women of other race-ethnicities (p-value< 0.01). Discussion: Our findings suggest a lack of knowledge and intake of folic acid prior to pregnancy, particularly among Hispanic and African American women. Further public health messaging is needed to close these racial-ethnic gaps.