CAROL DAGOSTIN: Thank you. It’s great to be here. This presentation is going to look at folic acid and the multi-vitamin usage of mothers in Alabama. Let me get my bearings here. Okay. This is where I want to be. Okay. Research has shown that inadequate intake of folic acid before conception may reduce the risk of neural tube defects by as much as 70% that’s been mentioned several times already during our conference today. In Alabama, Alabama PRAMS showed that almost 80%, 79.5% of women had knowledge of folic acid and it’s importance in healthy babies. So, Alabama PRAMS seeks to show if the knowledge of folic acid by these women was translated into a positive pattern of regular multi-vitamin usage before a pregnancy occurred.
Okay, so when we started to do our study, we wanted to target certain populations. Limin, the same question that she mentioned was one that we wanted to use. We wanted to look at the mothers who stated that they were trying to become pregnant, because we felt like this would be the group that would be most consciences about themselves and taking care of themselves before their pregnancies. So we were looking at that group of mothers, the ones that were trying to become pregnant, and then of course their multi-vitamin usage. The usage we broke down in the question as--excuse me let me get on the right page--“Did not take any, took one to three times per week.” The third time was from four to six times a week, and of course, the last time would be seven days a week. Then the other groups that we wanted to look, the predictors, were the mothers ages, the mothers race, the mothers education, and then the source of the payment whether their deliveries were paid by Medicaid or by some other insurance.
Okay, this slide is one of PRAMS that went back from 1966--I’m sorry, 1996--to 1999, and we changed our question in 2000 to the multi-vitamin usage. So, I wanted to give you this slide so that you could see from 1996 we had a gradual increase in knowledge by the mothers in Alabama, and then in 1999 you can see that 79.5% said that they did have knowledge of folic acid. Okay now this slide is just a comparison between the percent of all mothers versus the percent of mothers trying to become pregnant and their vitamin usage before pregnancy. You can see the pink is the “all mothers” and then the kind of taupe color is the “mothers trying to become pregnant.” The mothers trying to become pregnant, only 37% were taking a vitamin seven days a week. Okay this slide, again, it’s show the percent of women trying to become pregnant and their vitamin usage and it’s showing the mother’s age. We looked at the group of the teenage, the 10 to 19 year olds, the 20 to 29 year olds, and then the 30 and plus mother groups, and as far as “did not take any” as you probably would expect, the teenagers were less likely to take any vitamins whatsoever. And the ones--if you look at the seven days a week group, then even the 30 and plus year old group of women were only 43.9% that took a vitamin everyday.
Okay, this is by the mother’s race. It’s still the same questions. We’re still talking about mothers trying to become pregnant and their multi-vitamin usage. We have the white race that’s in the pink color and in the black another race and in the taupe. The black and other group were more likely not to take any whatsoever and then for the seven days a week, we had 40.5% of the white race that took one everyday and 22.3% of the black and other race that only took everyday. Okay, this one is by the mother’s education. We broke it out into zero to 11 years of education, then 12 years, and then the 13 and higher number of years of education for taking a vitamin seven days a week. The more educated group were more likely to take more vitamins but still it’s below 50%, was only 44.2%. Through 12 years was only 27%, and of course the zero to 11 was the lowest group, 26% only took seven days a week. Okay, this is by source of payment. Seven days a week, the Medicare mothers that were on Medicaid only 19.8% took seven days a week. The other coverage type insurances, that group registered 42.5%, still below even 50%. So clearly, Medicaid had no, you know, affect whatsoever apparently in this question. Okay, so as I mentioned before where as almost 80% of women had knowledge of folic acid in 1999, by looking at all of these different groups, you know, the knowledge did not translate into a healthy lifestyle or a healthy preparation for a future pregnancy.
So we conclude for this that just constant reinforcement by all public health organizations is needed to, you know, educate these young women or women of child bearing age to the benefits of taking folic acid, you know, that it’s critical and that any public health organization should play a part if they certainly can in educating. And I had chance to talk with our perinatal director in Alabama and they’re pushing real hard to come up with a educational program in the schools now that’s targeting not only girls, but guys to educate them how important folic acid, because of, you know, some recent discoveries in the health benefits of folic acid that they’re trying to make this an issue early in adolescents and even in the school programs to educate to be sure that folic acid is there when the pregnancy occurs. That’s all I had. Thank you.