García-Fragoso Lourdes, García-García Inés, Rivera Cynthia E
University of Puerto Rico School of Medicine, Department of Pediatrics, Neonatology Section, San Juan, Puerto Rico, USA.
Ethn Dis. 2008 Spring;18(2 Suppl 2):S2-168-71.
The occurrence of neural tube defects (NTDs) varies by race/ethnicity, and the highest rates are among women of Hispanic ethnicity. Women of reproductive age are advised to use folic acid to prevent NTDs and other birth defects. Since 1994, Puerto Rico has had a campaign to promote the use of folic acid, and since 1998, enriched grain products have been fortified with folic acid. After fortification, the incidence of NTDs in the island decreased. The objective of this study was to assess the use of folic acid by women of reproductive age in Puerto Rico and determine factors associated with its use.
A self-administered questionnaire was answered by 964 women around the island.
Folic acid consumption was reported by 30% of the participants, 21% reported consuming it at least 4 times per week, and only 14% consumed it the day before the survey. Knowledge about the recommendation for women to consume folic acid was reported by 97% of the participants. The use of folic acid was lower among women of lower education and lower social class. Women with higher education were 8.3 times more likely to consume folic acid.
The folic acid campaign has improved women's knowledge about the recommendation for folic acid supplementation. Nevertheless, its use is lower than is needed to continue reducing the incidence of birth defects in Puerto Rico. Education and social class continue to be barriers to eliminating the disparities in the preconception health of our population.
神经管缺陷（NTDs）的发生率因种族/族裔而异，西班牙裔女性的发生率最高。建议育龄妇女使用叶酸以预防神经管缺陷和其他出生缺陷。自1994年以来，波多黎各开展了一项推广使用叶酸的运动，自1998年以来，强化谷物产品中添加了叶酸。强化后，该岛神经管缺陷的发生率有所下降。本研究的目的是评估波多黎各育龄妇女叶酸的使用情况，并确定与其使用相关的因素。
该岛各地的964名妇女回答了一份自填式问卷。
30%的参与者报告服用过叶酸，21%的人报告每周至少服用4次，只有14%的人在调查前一天服用过。97%的参与者表示了解关于女性服用叶酸的建议。受教育程度较低和社会阶层较低的女性叶酸使用率较低。受过高等教育的女性服用叶酸的可能性高出8.3倍。
叶酸运动提高了女性对补充叶酸建议的认识。然而，其使用率低于继续降低波多黎各出生缺陷发生率所需的水平。教育和社会阶层仍然是消除我国人群孕前健康差异的障碍。
