Use of family history information for neural tube defect prevention - integration into state-based recurrence prevention programs

Oct 15, 2026

A family history of neural tube defects (NTDs) increases the likelihood that a pregnancy will be affected, and periconceptional folic acid use reduces that risk. This study evaluated whether second-degree relatives of children with NTDs differed from the general population in folic acid use, and delivered targeted folic acid education. Michigan and Colorado health workers contacted eligible families, surveyed relatives, and analyzed supplement use, risk perceptions, and reproductive planning outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Purpose

Methods

Results

Discussion

Translation to Health Education Practice

Research Article use of family History information for neural Tube defect Prevention: integration into state-based recurrence Prevention Programs Ridgely Fisk Green, Joan Ehrhardt, Margaret F. Ruttenber, and Richard S. Olney ABSTRACT Background: A family history of neural tube defects (NTDs) can increase the risk of a pregnancy affected by an NTD. Periconceptional folic acid use decreases this risk. Purpose: Our objective was to determine whether seconddegree relatives of NTD-affected children showed differences in folic acid use compared with the general population and to provide them with folic acid education. Methods: Michigan and Colorado health workers contacted families with a previous pregnancy or child affected by an NTD, identified through NTD recurrence prevention programs. Families were interviewed to identify the number of second-degree relatives of child-bearing age. Families mailed surveys to these relatives, who returned them to the state health departments. The survey assessed folic acid use, viewson having an affected child, and reproductive planning. Folic acid education materials were sent to relatives who provided contact information. Results: Folic acid supplement use among relatives was similar to that of the general population, despite elevated risk perceptions. Discussion: Both state health departments plan to increase efforts to contact affected families and their relatives through partnerships with family support groups. Translation to Health Education Practice: Including outreach to second-degree relatives in NTD recurrence prevention programs could increase the impact of these programs. Green RF, Ehrhardt J, Ruttenber MF, Olney RS. Use of family history information for neural tube defect prevention: integration into statebased recurrence prevention programs. Am J Health Educ. 2011; 43(5):296-308. This paper was submitted to the Journal on February 9, 2011, revised and accepted for publication on June 25, 2011. bACkGround Spina bifida and other neural tube defects (nTDs) are serious birth defects, with spina bifida affecting approximately 3.5 per 10,000 live births in the U.S.1 In the general population, folic acid supplementation has been shown to reduce the risk of nTDs.2 ThenTD risk is higher in certain individuals with a family history of nTDs, with a 2-5% recurrence risk in siblings with a single affected child and a risk in other close relatives that is increased above that of the general popula- tion.3-7 For women with a previous affected pregnancy, 4 mg of folic acid supplementation daily, 10 times the dosage recommended Ridgely Fisk Green is a pediatric genetics researcher at Carter Consulting, Inc. and National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333; E-mail: grf1@ [cdc.gov. Joan Ehrhardt](cdc.gov. Joan Ehrhardt) is the Birth Defects program coordinator at the Michigan Department of Community Health, Bureau of Epidemiology, for the general population, is recommended to reduce risk of recurrence in siblings,8 and folic acid supplement use has been shown to Lansing, MI 48913. Margaret F. Ruttenber is the program director at Colorado Responds to Children with Special Needs, Colorado Department of Public Health and Environment, Denver CO 80246. Richard S. Olney is a medical officer at the National Center on Birth Defects and Developmental Disabilities; Centers for Disease Control and Prevention, Atlanta, GA 30333. 296 American Journal of Health Education—September/October 2011, Volume 42, No. 5 Ridgely Fisk Green, Joan Ehrhardt, Margaret F. Ruttenber, and Richard S. Olney result in an 87% reduction in recurrence in siblings.5 Despite public health campaigns to increase folic acid supplement use in the general population, only about 40% of women of childbearing age report consuming the recommended daily level of supplemental folic acid.9 Even among those women with an affected child, a s

FAQs

Why does family history of neural tube defects matter for pregnancy risk?

A family history of neural tube defects (NTDs) increases the risk that a pregnancy will be affected by an NTD.

What was the purpose of the study regarding folic acid?

The study assessed whether second-degree relatives of NTD-affected children used folic acid differently from the general population and provided them with folic acid education.

How did the researchers collect information from relatives?

Health workers contacted families through NTD recurrence prevention programs, interviewed families to identify second-degree relatives of childbearing age, mailed surveys to those relatives, and sent education materials to relatives who provided contact information.

Oct 15, 2026

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