The Association of Reproductive Health Professionals (ARHP) is sponsoring Hot Topics in Preconception Care: Folate and Beyond, an education program for health care providers. The purpose of this program is to increase clinicians' ability to promote healthy nutrition, including adequate folate intake among all women of reproductive age, particularly among women who are sexually active, practicing contraception, and not currently planning a pregnancy.
For more information about the program, please contact Camille Harris at charris@arhp.org or (202) 466-3825.
Background
Recognizing the importance of folate (and its synthetic form: folic acid) for preventing neural tube defects (NTDs), the Institute of Medicine, Centers for Disease Control and Prevention (CDC), and the American College of Obstetricians and Gynecologists, among others, recommend that women of reproductive age consume at least 0.4 mg of this B vitamin daily.1-3 Although folate is found naturally in some foods, such as green leafy vegetables and legumes, and in fortified cereals and other bread products, most women do not consume enough of this important vitamin.4
It is well-accepted that adequate folate intake prior to and immediately following conception can prevent up to 70 percent of NTD-affected pregnancies.5 Neural tube defects (NTDs) such as spina bifida and anencephaly occur within the first four weeks after conception and affect as many as 3,000 pregnancies in the United States in a given year, resulting in significant morbidity and mortality.6 Since NTDs occur before most women know they are pregnant-and nearly half of all pregnancies in the US are unintended-clinicians should be prepared to offer evidence-based information, motivation, options, and support to all women of reproductive age for ensuring adequate folate intake.
Program Design and Educational Activities
Provider Education Activities
- Power point slide set with talking points, case studies and learning activities
- 4 live sessions
- Integration of content into CORE, ARHP's on-line, open-access collection of peer-reviewed, evidence-based teaching materials
- Provider education fact sheet
Patient Education
Dr. Rodriguez is a practicing ob/gyn at the Women and Infants Hospital of Rhode Island and the associate chief of ob/gyn and a clinical associate professor at Brown University's Warren Alpert Medical School. (recorded December 22, 2009)
Curriculum Learning Objectives
At the conclusion of this course, clinicians should be able to:
- Demonstrate effective preconception counseling skills and provide appropriate care
- Effectively counsel patients using accurate and practical information about folic acid to prevent neural tube defects
- Explain why all women of reproductive age should receive folic acid supplementation
- Translate the current recommendations and latest research findings regarding the risks associated with alcohol ingestion during pregnancy in order to counsel patients appropriately
- Accurately and consistently counsel patients on decreasing exposure to chemical contaminants commonly found in consumer products, food, and drinking water based on currently available scientific evidence
Intended Audience and Accreditation
The target audience is professionals that provide reproductive health services and education, including physicians, nurse practitioners, nurse-midwives, physician assistants, pharmacists, and educators, in obstetrics/gynecology, family medicine, primary care, and related fields. This broad group of health care professionals is often involved in women's primary care and they play a crucial role in counseling and educating women about proper nutrition and folate intake.
The live sessions associated with this program are accredited for continuing medical education, nursing contact hours, pharmacology, and pharmacist credits.
Funding
This project is funded through an educational grant from Bayer Healthcare Pharmaceuticals.
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- Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press; 1998.
- Johnson K, Posner SF, Biermann J, et al. Recommendations to improve preconception health and health care-United States. MMWR. 2006 Apr 21; 55(RR06):1-23.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins. ACOG practice bulletin no. 44: Neural tube defects. Obstet Gynecol. 2003 Jul; 102(1):203-13.
- Centers for Disease Control and Prevention (CDC). Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR. 1992 Sep 11; 41(RR-14):1-7.
- Yang Q-H, Carter HK, Mulinare J, et al. Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: Findings from the National Health and Nutrition Examination Survey, 2001-2002. Am J Clin Nutr. 2007 May; 85(5):1409-16.
- Hochberg L, Stone J. Prevention of neural tube defects. 2008 Jan 10. Available at www.uptodate.com. Accessed February 26, 2008
