References

Abdullahi H, Gasim GI, Saeed A Antenatal iron and folic acid supplementation use by pregnant women in Khartoum, Sudan. BMC Res Notes. 2014; 7 https://doi.org/https://doi.org/10.1186/1756-0500-7-498

Almeida LC, Cardoso MA. Recommendations for folate intake in women: implications for public health strategies. Cad Saude Publica. 26:(11)2011-26

Al-Hakeem MMMK Impact of education on knowledge and use of folic acid among Saudi women. Pak J Med Sci. 2012; 28:(4)686-90

Anzaku AS Assessing folic acid awareness and its usage for the prevention of neural tube defects among pregnant women in Jos, Nigeria. Journal of Basic and Clinical Reproductive Sciences. 2013; 2:(1)13-17 https://doi.org/https://doi.org/10.4103/2278-960X.112574

Auriel E, Biderman A, Belmaker I Knowledge, attitude and practice among women and doctors concerning the use of folic acid. ISRN Obstet Gynecol. 2011; 2011 https://doi.org/https://doi.org/10.5402/2011/946041

Barbour RS, Macleod M, Mires G, Anderson AS Uptake of folic acid supplements before and during pregnancy: focus group analysis of women's views and experiences. J Hum Nutr Diet. 2012; 25:(2)140-7 https://doi.org/https://doi.org/10.1111/j.1365-277X.2011.01216.x

Copp AJ, Greene ND Genetics and development of neural tube defects. J Pathol. 2010; 220:217-30

Deepti K, Anila H, Arup C, Vinohar B Determinants of knowledge regarding folic acid in periconceptional use among pregnant mothers in Southern India. IOSR Journal of Dental and Medical Sciences. 2013; 4:(3)25-9

Herrman W, Obeid R The mandatory fortification of staple foods with folic acid: a current controversy in Germany. Dtsch Arztebl Int. 2011; 108:(15)249-54 https://doi.org/https://doi.org/10.3238/arztebl.2011.0249

Hisam A, Rahman MU, Mashhadi SF Knowledge, attitude and practice regarding folic acid deficiency: a hidden hunger. Pak J Med Sci. 2014; 30:(3)583-8 https://doi.org/https://doi.org/10.12669/pjms.303.4716

Jou H, Hsu I, Liu C Awareness and use of folic acid among pregnant women in Taipei. Taiwan J Obstet Gynecol. 2010; 49:(3)306-10

Lauria L, Adinolfi G, Bartolomeo F Women's knowledge and periconceptional use of folic acid: data from three birth centers in Italy. Rare Diseases And Orphan Drugs. 2014; 1:(3)

Lawal TA, Adeleye AO Determinants of folic acid intake during periconception and in early pregnancy by mothers in Ibadan, Nigeria. Pan Afr J Med. 2014; 1:(19) https://doi.org/https://doi.org/10.11604/pamj.2014.19.113.4448

Liang H, Ma D, Zhou S, Li X Knowledge and use of folic acid for birth defect prevention among women of childbearing age in Shanghai, China: a prospective cross-sectional study. Med Sci Monit. 2011; 17:(12)87-92

Naithani M, Saxena V, Mirza AA Assessment of folic acid supplementation I pregnant women by estimation of serum levels of tetrahydrofolic acid, dihydrofolate reductase and homocysteine. Scientifica (Cairo). 2016; 2016 https://doi.org/http://doi.org/10.1155/2016/1520685

Ogundipe O, Hoyo C, Ostbye T Factors associated with antenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital based study. BMC Public Health. 2012; 12

Ren A, Zhang L, Li Z, Li Z Awareness and use of folic acid, and blood folate concentrations among pregnant women in northern China—an area with a high prevalence of neural tube defects. Reprod Toxicol. 2006; 22:(3)431-6 https://doi.org/https://doi.org/10.1016/j.reprotox.2006.02.003

Riazi H, Bashirian S, Amini L Awareness of pregnant women about folic acid supplementation in Iran. Journal of Family and Reproductive Health. 2012; 6:(4)159-63

Taye B, Abeje G, Mekonen A Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: a cross-sectional study. Pan Afr Med J. 2015; 20

World Health Organization. Guideline: Daily iron and folic acid supplementation in pregnant women. 2012. http://tinyurl.com/zlm3qqr (accessed 10 March 2017)

Yin Z, Xu W, Xu C A population-based case-control study of risk factors for neural tube defects in Shenyang, China. Childs Nerv Syst. 2011; 27:(1)149-54

Knowledge and uptake of folic acid among pregnant women attending a secondary health facility in Nigeria

02 June 2017
Volume 25 · Issue 6

Abstract

Background

Folate deficiency is associated with poor pregnancy outcomes and is one of the most common vitamin deficiencies in women, especially those of reproductive age.

Aims

This study aimed to determine the level of knowledge and uptake of folic acid among a sample of pregnant women.

Method

A descriptive cross-sectional study, using a structured questionnaire, was carried out among 300 pregnant women attending antenatal clinics in one hospital in Oluyoro, Ibadan, Nigeria.

Findings

All participants claimed to have heard of folic acid and major source of information was health workers (77.3%). Only 11.8% knew that folic acid can prevent birth defects and just 22.7% knew the best time to start using folic acid. Almost all the women (98.3%) reported using folic acid in the current pregnancy, of whom 54.2% used it as prescribed. Education (P=0.002), marital status (P=0.001), plan of pregnancy (P=0.022), and maternal age (P=0.046) were significantly associated with knowledge of folic acid. Employment status was significantly associated with uptake of folic acid (P=0.004).

Conclusions

In this study, knowledge and uptake of folic acid was low among young, single and low education status women. Campaigns promoting periconceptional use of folic acid will be very useful in reaching women of child-bearing age particularly those pregnant and not registered for antenatal care.

Folate is an essential micronutrient that cannot be biosynthesised by human body and must be obtained either from diet or from supplements; it is required for fetal body metabolism, growth, and development in pregnant women (Naithani et al, 2016).

The relationship between serious birth defects and their prevention by folic acid is well established. Several studies, including randomised control trials and observational studies, have shown that maternal intake of folic acid supplements before and early in pregnancy reduces the risk of neural tube defects in infants. Children with severe birth defects have a 15-fold increased risk of death during the first year of life, and studies have estimated that approximately 9–10% of such children die during this period (Copp and Greene, 2010).

Women who could become pregnant are advised to eat foods fortified with folic acid or to take supplements in addition to eating folate-rich foods. Taking 400 mg of synthetic folic acid supplementation daily has been suggested by the World Health Organization (WHO) (2012). Despite WHO recommendation, the use of iron and folic acid supplementation is still low in many countries, especially those with low resources (Ogundipe et al, 2012).

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