To define the frequency of Sicilian pregnant women taking folic acid during the periconceptional period (three months before and two months after conception) and how many are familiar with the preventive effects of folic acid on NTD.
987 pregnant women from eastern Sicily, mainly with low incomes and low levels of education, most with secondary school certificates, underwent biochemical screening for Down's syndrome and NTD in the second trimester of pregnancy.
An anencephalous fetus was diagnosed (frequency 0.1%) in a non-risk couple who had not taken folic acid during the periconceptional period: 4.1% (41 cases) of pregnant women reported having taken folic acid before pregnancy and 12.3% (122) during the first two months of pregnancy: five (0.5%) took folic acid during the periconceptional period (three months before conception and two months after). None of the 5 patients with a positive family history of NTD had taken folic acid. In all 122 cases the intake of folic acid supplements during pregnancy started after the positive results of the pregnancy test or echographic evidence of pregnancy, namely between the fifth and eighth week of pregnancy. Only the 5 pregnant women (0.5%) who took folic acid during the periconceptional period were aware of the possibility of preventing NTD through supplements of this vitamin.
Greater efforts must be made to increase periconceptional use of folic acid for the prevention of NTD in pregnant women in Sicily.