According to a recent survey by the Centers for Disease Control and Prevention (CDC), despite widespread educational efforts, some women still lack an understanding of the importance of taking folic acid prior to getting pregnant to reduce the risk of birth defects.

The survey was conducted in the state of Oklahoma because it is the only state with a detailed question on preconception health, “Before you became pregnant with your new baby, did any of these things happen? a) You heard or read that taking vitamins with folic acid could help prevent some birth defects; and b) you received advice or counseling from a health-care provider to prepare for becoming pregnant.”

Results indicate that among Oklahoma women who gave birth to a live infant between 2000 and 2003, 21.5 percent were unaware of the benefits of folic acid prior to pregnancy, 74 percent did not take a daily multivitamin at least four times a week, and 85 percent did not receive preconception counseling from a health care provider. So while the awareness of folic acid benefits was high, the consumption of multivitamins containing folic acid was low, as was the receipt of preconception counseling.

Data show that lack of awareness of folic acid benefits before pregnancy was greatest among women who were less than 20 years of age, black, or enrolled in Medicaid, further highlighting the need for outreach to targeted populations.

The survey results are limited by several factors, 1) the data are self-reported and subject to recall bias, 2) assessment of multivitamin intake may not reflect folic acid intake, 3) the findings are generalizable only to mothers in Oklahoma who have recently given birth to live infants, and 4) the cross-sectional design allows only for presumptions regarding association not causation.

Kudos to Oklahoma for recognizing the importance of being good to babies before they’re conceived!