Documented folic acid supplementation among pregnant hispanic patients in an Omaha, Nebraska healthcare system: Patterns and implications for prenatal care
Meghan Fries, Lauren Seger, Eleanor Richardson, Danielle B. Dilsaver, Meaghan ShanahanBackground
Folic acid supplementation reduces the risk of neural tube defects; however, disparities in supplementation practices may limit the preventive benefit. Infants born to Hispanic patients in the US experience higher rates of neural tube defects, suggesting potential differences in utilization of folic acid supplementation. This study examined folic acid supplementation among pregnant Hispanic patients receiving prenatal care in Omaha, Nebraska.
Methods
A retrospective chart review from 2014 to 2024 identified pregnant patients who received prenatal care within the CHI Healthcare system in Omaha, Nebraska. The primary outcome was documented folic acid supplementation, both prescribed and over-the-counter. Patient descriptives were stratified by folic acid supplementation and compared via chi-square tests and the Mann-Whitney U-test. To assess whether the odds of folic acid supplementation varied by ethnicity, a multivariable logistic regression model was estimated to control for maternal age, insurance status, parity, gravidity, and language preference.
Results
Overall, 66.03% of patients had documented folic acid supplementation. Hispanic patients were associated with significantly lower odds of folic acid supplementation compared to non-Hispanic patients (56.41% vs 67.65%,
Conclusions
Pregnant Hispanic patients were associated with lower odds of folic acid supplementation after adjusting for demographic and obstetric factors. These findings highlight gaps in counseling, documentation, and preconception care, suggesting a need for targeted, system-level interventions to improve consistency of supplementation and reduce disparities.