Differences in folic acid use, prenatal care, smoking, and drinking in early pregnancy by occupation

Prev Med. 2012 Oct;55(4):341-345. doi: 10.1016/j.ypmed.2012.07.015. Epub 2012 Jul 27.


Objective: To describe differences in four high risk periconceptional behaviors (lack of folic acid supplementation, lack of early prenatal care, smoking, and drinking) by maternal occupation.

Methods: Analyses were conducted among women in the National Birth Defects Prevention Study who delivered liveborn infants without birth defects. Periconceptional occupational data were collected using a computer-assisted telephone interview and occupational coding was performed using the 2000 Standard Occupational Classification System. Logistic regression analyses were conducted to determine whether prevalence of behaviors differed between occupational groups.

Results: Subjects included 5153 women employed during early pregnancy from 1997 to 2007. Compared to women in management, business, science, and arts occupations, women in other occupations (e.g., service occupations) were significantly more likely to engage in all four high risk behaviors. Specifically, women in food preparation/serving-related occupations were significantly more likely to engage in all four behaviors compared to women in all other occupational groups (odds ratios: 1.8-3.0), while women in education/training/library occupations were significantly less likely to do so (odds ratios: 0.2-0.5).

Conclusion: We identified several occupational groups with an increased prevalence of high-risk maternal behaviors during pregnancy. Our findings could aid in developing interventions targeted towards women in these occupational groups.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Dietary Supplements / statistics & numerical data
  • Female
  • Folic Acid / therapeutic use*
  • Humans
  • Logistic Models
  • Occupations*
  • Pregnancy
  • Pregnancy Trimester, First*
  • Pregnant Women / psychology
  • Prenatal Care
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Socioeconomic Factors


  • Folic Acid