Kathleen M O'Rourke, PhD, MPH¹, Mary Roddy, PhD, MPH¹, Darryl Williams, MD², and Kristina D. Mena, MSPH, PhD³. (1) Biometry and Epidemiology, Medical University of South Carolina, 135 Cannon St, Suite 302K, PO Box 250835, Charleston, SC 29425, 843-876-1118, orourkek@musc.edu, (2) Office of Border Health, Texas Tech University Health Sciences Center at El Paso, 4800 Alberta Ave, El Paso, TX 79905, (3) School of Public Health, UT Houston SPH, 1100 N. Stanton, Suite 110, El Paso, TX 79902

Background: Hispanic women have low rates of folic acid use compared with white women, which may be due to language, economic, and cultural barriers. Methods: This study compared preconceptual, pregnancy, and postpartum supplementation among 329 Hispanic women living on the US/Mexico border from 1-6 weeks postpartum. Interviews obtained data on current, pregnancy, and preconceptional vitamin use. Multivariate logistic regression models obtained odds ratios (OR) and 95% confidence intervals (CI) for the association of socio-demographic factors, maternal behavior, folic acid knowledge, and obstetric history with vitamin use throughout the reproductive cycle. Results: Less than 20% of the mothers used vitamins pre-conceptually, 89% during pregnancy, and 66% postpartum. Increasing maternal age (OR=1.11, 95%CI: 1.1, 1.2), folic acid knowledge (OR=1.9, 95%CI: 1.0, 3.6), not smoking (OR=0.52, 95%CI: 0.3, 1.0) and English language preference (OR=0.46, 95%CI: 0.2, 0.9) were associated with preconceptual vitamin use. Only knowledge of folic acid was related to pregnancy supplementation. Preconceptual use (OR=3.4, 95%CI: 1.5, 7.8), pregnancy use (OR=4.7, 95%CI: 2.8, 10.7), prenatal care exclusively in the US (OR=3.0, 95%CI: 1.3, 6.6), a medical recommendation for vitamin use (OR=7.3, 95%CI: 3.9, 13.7), and breastfeeding (OR= 1.7, 95%CI: 1.0, 3.2) were associated with postpartum use. For each postpartum week the likelihood of vitamin use decreased by 29% (OR = 0.71, 95%CI: 0.6, 0.9). Conclusion: The lowest rate of vitamin use occurs preconceptually, the highest occurs during pregnancy, and use declines postpartum. The drop in use for each postpartum week shows postpartum women are not continuing supplementation, and could be at risk if an additional pregnancy occurs. Clinicians should reinforce adherence to multivitamins to prevent future birth defects in postpartum women.

Learning Objectives:

• Learning Objectives. At the conclusion of the session, the attendee will be able to
• 1. Identify factors associated with vitamin use during the preconceptional period, during pregnancy, and postpartum
• 2. Articulate the importance of supporting postpartum use of vitamin supplements.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.