BACKGROUND: Birth defects can cause significant morbidity and mortality. We examined the prevalence of maternal characteristics and risk factors associated with birth defects and examined their associations with prepregnancy multivitamin/folic acid (MVF) intake and diabetes. METHODS: Data from 22 jurisdictions participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2017-2022) of women with recent live births were used. Distributions were calculated for: prepregnancy health factors (MVF intake, diabetes status, obesity, smoking, alcohol use) and for participant characteristics (age, race/ethnicity, educational attainment, pregnancy intention, federal poverty level). Log-binomial regression was used to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for the associations between selected characteristics and MVF intake and diabetes. Associations between pregnancy intention and MVF intake stratified by selected characteristics were also examined. Finally, differences in longitudinal MVF intake across jurisdictions were assessed. RESULTS: Almost half (48.2%) of women reported no prepregnancy MVF intake; before pregnancy, 52.0% were overweight or had obesity, 57.9% used alcohol, 15.2% smoked, and 3.1% had diabetes. Prepregnancy MVF intake was associated with increased age (≥ 30 years vs. 25-29: aPRs > 1.10), higher educational attainment (graduate degree vs. ≤ high school: aPR = 1.32, 95% CI: 1.17, 1.49), and intended pregnancies (aPR: 1.50, 95% CI: 1.42, 1.58). Diabetes status was not associated with MVF intake or pregnancy intention. CONCLUSIONS: Prevalence of risk factors for birth defects was high, and differences exist across groups of women. Findings from this study can help inform public health interventions on risk factors that may help improve birth outcomes.
Wong et al. (2026) studied this question.