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CDC COMMUNITY GUIDE: Prevention of Birth Defects: Community-Wide Campaigns to Promote the Use of Folic Acid Supplements

CDC

An Evidence-Based Practice

Description

If a woman has enough folic acid in her body before she is pregnant, it can reduce the risk of a pregnancy affected by neural tube birth defects (NTD). Community-wide campaigns to promote the use of folic acid supplements are designed to disseminate information to women of childbearing age or intending to become pregnant, regarding the use of supplements containing folic acid. These campaigns involve the dissemination of coordinated educational and motivational messages and materials within the community. Educational content can be delivered through:
• Mass media messages and articles
• Community activities and promotions
• Distribution of small media (posters, flyers, brochures, etc.)

The U.S. Public Health Service recommends that all women of childbearing age consume 400 micrograms (0.4 milligrams) of folic acid each day in order to reduce the risk of a pregnancy affected by a neural tube birth defect (CDC) . The U.S. Preventive Services Task Force recommends that women of childbearing age take a daily supplement containing 400-800 micrograms (0.4-0.8 milligrams) of folic acid.

The Community Preventive Services Task Force recommends community-wide education campaigns to promote the use of folic acid supplements among women of childbearing age on the basis of sufficient evidence that these approaches are effective in increasing the number of these women who consume folic acid supplements.

Impact

The Community Preventive Services Task Force has found that community-level education campaigns that promote the use of folic acid among women of child-bearing age can increase the number of these women who take folic acid supplements.

Results / Accomplishments

Results of the Systematic Review:
The twenty-four studies that qualified for the review assessed several outcomes.

Folic acid consumption among women of childbearing age:
• Median increase of 5.9% (interquartile interval [IQI] 2.5% to 20.5%; 16 studies)
• Studies with lowest baseline consumption rates generally reported the largest effect size.

Prevalence rates of neural tube defects (NTD):
• Median reduction of 4% (IQI: -33.9% to 8.5%; 8 studies)
• The two studies that showed the greatest reduction were potentially confounded by ongoing national fortification programs and by additional NTD recurrence prevention programs focused on increasing the use of folic acid before and during pregnancy.
• Findings from individual studies were inconsistent and the effect measured across studies does not indicate substantial changes in NTD rates.

• The overall body of evidence represents women of childbearing age (18-45) with varying levels of education and social economic status.
• The intervention was delivered in urban, rural, and suburban settings in various international communities with high-income economies.

About this Promising Practice

Primary Contact
1600 Clifton Rd, NE
MS E69
Atlanta, GA 30329
404-498-1827
communityguide@cdc.gov
http://www.thecommunityguide.org/index.html
Topics
Health / Maternal, Fetal & Infant Health
Source
Community Guide Branch Epidemiology and Analysis Program Office, Centers for Disease Control and Prevention
Location
USA
For more details
Target Audience
Children, Women