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Clinicians on the front line: Focus on preconception folate counseling

September 2009 · Vol. , No.

Release date: September 1, 2009
Expiration date: September 1, 2010
Estimated Time to Complete Activity: 1.0 hour


Statement of Need

Neural tube defects (NTDs)—failure of the fetal neural tube to close properly—can result in anencephaly (inevitably fatal) or spina bifida (associated with varying degrees of disability). NTDs, however, are among the few birth defects for which primary prevention is possible, via adequate folate intake or supplementation with folic acid—its synthetic form—before conception and up to the first 25 days of pregnancy. Because half of all pregnancies in the United States are unintended, and because even women with planned pregnancies typically do not present for prenatal care until after neural tube closure has occurred, NTD risk-reduction strategies must include all women capable of conceiving.

Target Audience

Obstetrician/gynecologists and other clinicians who provide health care for women

Learning Objectives

After completing this educational activity, participants should be able to:
• Describe population-wide strategies to reduce the risk for neural tube defects
• Identify women who require counseling about folate/folic acid intake
• List 3 demographic characteristics of women who may be less likely to adhere to recommended levels of folate/folic acid intake
• Translate broad-based recommendations about folate/folic acid intake into individualized recommendations for each patient
• Develop strategies to ensure that their reproductive-aged patients receive appropriate counseling about reducing risk for neural tube defects

Accreditation Statement

Boston University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Boston University School of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure Statement

Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve any apparent conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of a pharmaceutical or device is being discussed.

FACULTY DISCLOSURES

Lynn Borgatta, MD, MPH, receives grant/research support from Bayer HealthCare Pharmaceuticals and Roche Pharmaceuticals. Dr Borgatta also serves on the speakers bureau for Schering-Plough.

Andrew M. Kaunitz, MD, is participating in or has participated in clinical trials for Barr (Teva), Bayer HealthCare Pharmaceuticals, Ortho (Johnson & Johnson), Medical Diagnostic Laboratories, Organon (Schering-Plough), and Procter & Gamble. He is also a speaker and/or consultant for Barr (Teva), Bayer HealthCare Pharmaceuticals, Ortho (Johnson & Johnson), Merck & Co., Inc., Organon (Schering-Plough), and Procter & Gamble. Dr Kaunitz is also a stockholder of Becton, Dickinson and Company and sanofi-aventis.

Lee P. Shulman, MD, receives grant/research support from Bayer HealthCare Pharmaceuticals. He is a consultant for and is on the speakers bureaus of Bayer HealthCare Pharmaceuticals, Ortho-McNeil Pharmaceutical, Inc., Barr Laboratories/Duramed, and Schering-Plough.

Anna Maria Siega-Riz, PhD, RD, is a consultant for Nestlé and Shoulder to Shoulder.

The planning committee (Elizabeth Gifford and Elizabeth Stier, MD, Boston University, Fay Nham and Jill Rovitzky Black, Haymarket Medical Education) has no significant financial relationships to disclose.

Boston University School of Medicine advises the audience that one or more articles in this continuing medical education activity may contain reference(s) to unlabeled or unapproved uses of drugs or devices.

Dr Kaunitz will reference unlabeled/investigational uses of a commercial product.

Dr Shulman and Dr Siega-Riz will not reference unlabeled/investigational uses of a commercial product.

To receive AMA PRA Category 1 Credit™

Via Mail or Fax: Please submit the answer sheet to Boston University School of Medicine, Continuing Medical Education, E.FOLACOGHAY09, 72 East Concord St., A305, Boston, MA 02118, FAX: 617-638-4905. Your certificate will be mailed to you within 4-6 weeks.

Online: Receive your certificate instantly at www.bucmetest.com. After registering, enter “E.FOLACOGHAY09” in the Test Code Search field. Please do not mail the original if you submit online.

DISCLAIMER
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR THE PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKE NO WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL THE TRUSTEES OF BOSTON UNIVERSITY BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.

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