Awareness of the benefits of folic acid and prevalence of the use of folic acid supplements to prevent neural tube defects among Thai women

From Awareness to Action: Addressing Folic Acid Supplementation in Western India Among Women of Reproductive Age

Background Folate, a vitamin B9, can be sourced naturally in the diet or the form of supplements. Studies highlight the prevention of neural tube abnormalities in women of reproductive age. To prevent these, low daily doses of FA (400-800 μg) are recommended for all women planning pregnancy, with higher doses for those with previous NTD-affected pregnancies. Folic acid supplementation lowers the risk of NTDs, other birth defects, and obstetrical complications. Methods The study explored awareness of and knowledge of folic acid supplements among women of childbearing age in Pune City, western Maharashtra, India. The cross-sectional survey was carried out at Symbiosis University Hospital and Research Centre (SUHRC), involving 300 female participants aged 16-44 years. The study utilized a structured questionnaire to evaluate participants' knowledge of folic acid supplements, their benefits, and usage patterns. Results Use as well as awareness of folic acid supplements was strongly associated with educational attainment. The awareness was low or none in participants who never attended school, and highest among the university graduates. The study included 300 women aged 16-45. About 43% of the study participants were between the ages of 23 and 29 years old; 57.7% were single, and 59.3% among them were university graduates. 59.7% of the study participants knew about folic acid supplements, but only 20% took them regularly. Knowledge about ideal timing and benefits was limited among them. 38% correctly identified prepregnancy as the ideal time to start. Only 18% knew it prevents neural tube defects, and 27% knew it could be obtained naturally. Conclusion The study highlights a lack of detailed knowledge about folic acid supplements among the study participants. Recommendations to enhance the supplement's intake include public health campaigns, enhanced healthcare provider education, easy-to-read informational materials, and strengthening government supplement programs to improve awareness and food fortification. Further research on consumption barriers for the supplement needs to be carried out.

Peri-conception folic acid supplementation knowledge and associated factors among women visiting Maternal and Child Health clinics in Addis Ababa, Ethiopia

Back ground

Peri-conception care plays an essential and vital role for the health of the mother, her child and her family. Taking folic acid orally prior to conception and during the early stages of pregnancy plays a significant role in preventing Neural Tube Defects and has been associated with preventing other folic acid sensitive congenital anomalies. There exists problem in different parts of the globe on women's understanding of the importance of folic acid making them not to take this supplement in peri-conception period.

Objective

This study aimed at assessing the knowledge of peri-conception folic acid supplementation among women visiting Maternal and Child Health clinics of public health facilities in Addis Ababa, Ethiopia.

Methods

Institution based cross-sectional study was conducted from May 15 to June 20/2020 among 226 women visiting Maternal and Child Health clinics of health centers in Addis Ababa. Consecutive sampling technique was used to select study participants. Data were collected through interviewer administered structured questionnaire and analyzed using Statistical Package for Social Sciences version 24. Tables, charts and graphs were used for data presentation. Multivariable logistic regression analysis was done to identify the independent predictors of women's knowledge of folic acid at p-value ≤ 0.05.

Results

More than two-third of the study participants, 156 (69.0%) had good knowledge on peri-conception folic acid supplementation and its health benefits. Participants with age 25–30 years were 2.14 times more likely to have good knowledge compared to those aged less than 25 years while women with age greater than 30 years were 5.20 times more likely to have good knowledge compared to those with age less than 25 years. Women who had attended high school were 2.93 times more likely to have good knowledge compared to those with no formal education. Likewise, women who had attended college and above were 4.18 times at odd of having good knowledge on periconception folic acid supplementation compared to those with no formal education. Women who had information on prenatal care were 1.48 times more likely to have good knowledge compared to those who never had no information.

Conclusion

Folic acid supplementation knowledge in more than two third of the study participants was good. Participants' age, educational status and information on prenatal care were the independent predictors of knowledge on folic acid supplementation. The Ministry of health, Addis Ababa city health bureau, the study facilities’ management as well as Non-Governmental Organizations working on health in the city should focus on means to increase knowledge of peri-conception folic acid health benefits for women with poor knowledge on the same.

A survey on women's awareness of iron and folic acid intake during preconception period and its associated factors in Manna District, Oromia region, Southwest Ethiopia

Aim

This study aimed to assess pregnant women's awareness of iron and folic acid intake during the preconception period and associated factors.

Design

A cross‐sectional study.

Methods

This study was conducted on 636 pregnant women in Manna District, Oromia region, Southwest Ethiopia. Women's awareness of iron and folic acid intake during the preconception period was measured using a pre‐tested structured questionnaire. Descriptive, binary and multivariable logistic regression analyses were carried out.

Results

Of the total of 623 participants, 6.7% of them had an awareness of iron and folic acid intake during preconception period. Women's husband who had formal education, women who had ≥four ANC visits and women who were at distance of <30 min from the nearest health facility were significant predictors of pregnant women's awareness iron and folic acid intake during the preconception period.

Conclusions

Women's awareness of iron and folic acid intake during the preconception period was very low. Husband educational status, frequency of ANC visits and distance from health facility were predictors of women's awareness of iron and folic acid intake during the preconception period.

Registry-Based Study of Prevalence of Cleft Lip/Palate in Thailand from 2012 to 2015

OBJECTIVE

Two main objectives were established. First objective was to determine the prevalence of the cleft lip and/or cleft palate (CL/P) in Thailand from 2012 to 2015 using the orofacial clefts (OFCs) registry and civil registration. Second objective was to conduct a quality control of this OFC registry especially for the Birth Defects Registration (BDR).

DESIGN

Registry-based survey.

SETTING

Analyzing data from the Thailand National Health Security Office.

PARTICIPANTS

Registered patients with CL/P in Thailand from 2012 to 2015.

INTERVENTION

None.

MAIN OUTCOME MEASURE

Duplicated records were verified using National Identity Number (Thai ID#) and date of birth. The prevalence of CL/P and specific phenotypes was then calculated. From this prevalence estimate method, quality assurance of the OFCs registry was possible.

RESULTS

For the main outcome, the population-weighted pool prevalence of CL/P was 2.14 per 1000 live births (95% confidence interval of 2.08-2.20). Thai ID# and expense reimbursement systems were the main factors driving this cases capturing. However, this OFCs registration still requires active case finding with clinical verification, improvement of staff training and databases networking.

CONCLUSIONS

This study reported a very high CL/P prevalence of Thailand. Strengths and limitations of these OFCs registry and BDR were described.

Awareness, knowledge, and use of folic acid among non-pregnant Korean women of childbearing age

BACKGROUND/OBJECTIVES

Folic acid supplementation before pregnancy is known to reduce the risk of neural tube defects. The purposes of this study were to investigate the awareness, knowledge, and use of folic acid supplements along with their associated factors among non-pregnant Korean women of childbearing age.

SUBJECTS/METHODS

From August 2012 to March 2013, 704 women aged 19-45 years completed a self-administered questionnaire regarding their awareness, knowledge, and use of folic acid as well as questions to identify risk of inadequate folate intake.

RESULTS

Approximately 67% of women reported that they had heard of folic acid, and 23.7% had knowledge of both the role of folic acid in preventing birth defects and appropriate time for taking folic acid supplements to prevent birth defects. However, only 9.4% of women took folic acid supplements at the time of the survey. Women aged 19-24 years, unmarried women, and women who had never been pregnant were less likely to be aware and knowledgeable of folic acid or take folic acid supplements. In addition, women at high risk of inadequate folate intake were less likely to take folic acid supplements. In a multivariate analysis, women aged 19-24 years, women with a high school diploma or lower education level, and unmarried women were less likely to be aware and have knowledge of folic acid. The percentage of women taking folic acid supplements was significantly higher among knowledgeable women than among unknowledgeable women.

CONCLUSIONS

These results support our hypothesis that women with knowledge of folic acid are more likely to take folic acid supplements. Therefore, educational programs or campaigns to improve knowledge regarding the importance of folic acid and to promote consumption of folic acid supplements as well as folate-rich foods are needed to target young, less educated, and unmarried women.

Preconceptional use of folic acid and knowledge about folic acid among low-income pregnant women in Korea

BACKGROUND/OBJECTIVES

Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea.

SUBJECTS/METHODS

A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers.

RESULTS

Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%).

CONCLUSIONS

Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.

A Mixed-Method Study to Determine the Benefits of Periconceptional Folic Acid Supplementation and Effects of Folic Acid Deficiency in Mothers on Birth Outcomes

BACKGROUND

Evidence from high income countries shows mothers who are supplemented with folic acid in their periconceptional period and early pregnancy have significantly reduced adverse outcomes like birth defects. However, in India there is a paucity of data on association of birth defects and folic acid supplementation. We identified a few important questions to be answered using separate scientific methods and then planned to triangulate the information.

OBJECTIVE

In this paper, we describe the protocol of our study that aims to determine the association of folic acid and pregnancy outcomes like neural tube defects (NTDs) and orofacial clefts (OFCs). We decided to fill the gaps in knowledge from India to determine public health consequences of folic acid deficiency and factors influencing dietary and periconceptional consumption of folic acid.

METHODS

The proposed study will be carried out in five stages and will examine the questions related to folic acid deficiency across selected locations in South and North India. The study will be carried out over a period of 4 years through the hierarchical evidence-based approach. At first a systematic review was conducted to pool the current birth prevalence of NTDs and orofacial clefts OFCs in India. To investigate the population prevalence, we plan to use the key informant method to determine prevalence of NTDs and OFCs. To determine the normal serum estimates of folic acid, iron, and vitamin B12 among Indian women (15-35 years), we will conduct a population-based, cross-sectional study. We will further strengthen the evidence of association between OFCs and folic acid by conducting a hospital-based, case-control study across three locations of India. Lastly, using qualitative methods we will understand community and health workers perspective on factors that decide the intake of folic acid supplements.

RESULTS

This study will provide evidence on the community prevalence of birth defects and prevalence folic acid and vitamin B12 deficiency in the community. The case-control study will help understand the association of folic acid deficiency with OFCs.

CONCLUSIONS

The results from this study are intended to strengthen the evidence base in childhood disability for planning and policy initiatives.

Awareness of preconception care among women and men: A study from Jordan

The objective of this study was to examine awareness of Jordanian married women and men of preconception care. A total of 763 (537 women and 226 men) Jordanians who attended maternal and child healthcare centres in a city, in the centre of Jordan, were included in the current study. The Health before Pregnancy Questionnaire was used to collect the data from participants, while they waited to be seen by the healthcare provider in the health centres. Family history of chronic disorders, 1st-degree consanguineous marriages and planning pregnancy were associated with awareness of preconception care. Around 50% of participants were aware of the serious impact that a woman's and man's family history can have on the health of their babies. The majority of participants were aware of changes that should be made prior to conception.

Preconception care: nutritional risks and interventions

INTRODUCTION

There is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy.

METHODS

A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.

RESULTS

Maternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight.

CONCLUSION

All women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition-sensitive strategies (such as food fortification; integration of nutrition initiatives with other maternal and child health interventions; and community based platforms) is necessary among adolescent girls and women of reproductive age. The effectiveness of interventions will need to be simultaneously monitored, and form the basis for the development of improved delivery strategies and new nutritional interventions.

Supplement Use Among Pregnant Women in Ethiopia: Prevalence and Predictors

Purpose The purpose of this article was to assess the pattern of supplement use and associated factors among pregnant women in Ethiopia. Methods A facility-based cross-sectional study was conducted. A total of 339 pregnant women were included in the study, 63 (18.3%) and 23 (6.8%) of whom used at least 1 supplement during pregnancy and 2 to 4 weeks prior to pregnancy, respectively. Only 3 women were prescribed folic acid during pregnancy. The pregnant women were interviewed to collect supplements use and pregnancy-related information through a pretested semistructured questionnaire. Subsequent charts of prescribed supplements were reviewed using a pretested data collection format. Results The majority (76.4%) of the women claimed no awareness about the benefits of early supplementation. Supplement use was about 8 times higher among women with > 3 children (adjusted odds ratio, 7.85; 95% confidence interval, 1.69-36.28; P = .008) than among nulliparous women, and about 6 times higher among women in their second trimester (adjusted odds ratio, 6.26; 95% confidence interval, 1.91-20.55; P = .03) of pregnancy compared to those women in their first trimester. Conclusion Overall supplement use, particularly folic acid intake, was found to be negligible during the prenatal as well as antenatal periods. The majority of the women in the study lacked awareness about the benefits of supplementation and potential risks associated with the absence of folic acid during pregnancy. Information by the media and health care personnel given to childbearing women about the need to take folic acid to prevent neural tube defects seems to improve the intake of folic acid during the protective period.

Prevention of oro-facial clefts in developing world

Oro-facial cleft (OFC) remains a prominent health issue in developed and developing countries alike. It is the commonest craniofacial birth defect in humans. Mounting evidence suggest a polygenic, multifactorial and a list of epigenetic events. Primary prevention of OFC is based on recognition of the etiologic and risk factors. While a number of preventive strategies are in place for OFC in most developed countries of the world, the majority of developing countries are distant from achieving this goal for a number of reasons. Notable among these are a huge knowledge and practice gap in the field of genetics and dearth of accurate data. In addition, improper coordination and absenteeism from antenatal care contributed greatly to this set back. With ongoing efforts aimed at determining the genetics of nonsyndromic OFC in developing countries, researches directed at identifying environmental factors should equally be in place. Pending the outcome of these, implicated environmental and attitudinal risk factors in other populations could serve as preventive template in health education and interventions. Since risk factors vary between populations, definitive and effective preventive strategies and models would vary from place to place and from time to time. Frantic effort directed at identifying specific implicated risk factors in developing countries should include developing and keeping comprehensive national perinatal database and centralization of antenatal care protocol. Additionally, active health education at every level and a focus on developing manpower in the field of genetics should be in place. These would be designed and tailored toward identified, proven, and emerging risk factors.

Awareness of periconceptional folic acid supplementation among Nepalese women of childbearing age: a cross-sectional study

OBJECTIVE

Maternal folate deficiency is associated with neural tube defects (NTDs), the most common congenital birth defect at Maternity Hospital, Kathmandu, Nepal. NTDs can be prevented with periconceptional folic acid supplementation (FAS). This study was performed to assess the awareness of FAS among women of reproductive age in Kathmandu.

METHODS

A semi-structured questionnaire was administered to 400 randomly selected patients aged 15 to 45 years visiting Kathmandu Model Hospital from May to July 2011, seeking any awareness of FAS, knowledge of its impact on fetal development and knowledge of the appropriate time of supplementation.

RESULTS

Forty percent (95% CI 35.1-45.0) of women had heard about FAS, 16.3% (95% CI 12.8-20.2) knew that folate affects fetal health and 5.0% (95% CI 3.1-7.6) knew that it should be taken pre-pregnancy. Level of education was strongly associated with awareness (multivariate Odds Ratio for lowest vs. highest level of education: 0.29, 95% CI 0.15-0.56).

CONCLUSIONS

Knowledge of FAS is very low among women of childbearing age in Kathmandu. Inclusion of FAS information in health awareness programs is recommended.

Awareness and intake of folic acid for the prevention of neural tube defects among Lebanese women of childbearing age

Since the early 1990s, international recommendations have promoted folic acid supplementation during the periconception period as an effective way of preventing neural tube defects (NTDs). However, the adoption of this recommendation remains insufficient. To assess the awareness and actual intake of folic acid among married Lebanese women aged 18-45 years, a cross-sectional study was conducted among 600 women selected from all five administrative districts in Lebanon, using a multistage cluster sampling procedure. An anonymous questionnaire was completed which covered measures of knowledge and use of folate supplements, as well as demographic, socioeconomic and obstetrical factors. Sixty percent of surveyed women (60%; n = 360) had heard about folic acid. Doctors were the most frequent source of information (61.1%) but only 24.7% of women have been told of the correct period during which folic acid supplementation was useful. Overall, only 6.2% had taken folic acid tablets during the adequate period. Younger age, higher education level and stability/sufficiency of income appeared to be significant predictors of awareness among Lebanese women. Actual folic acid intake was significantly associated with younger age, higher number of pregnancies, planning the last pregnancy and having had that last one after 1990. In Lebanon, the level of folic acid awareness and adequate intake remain relatively low. Several approaches should be used to promote folic acid intake including awareness campaigns, and routine counseling by primary health care physicians on folic acid during preconception visits.

Folic acid awareness and intake among women in areas with high prevalence of neural tube defects in China: a cross-sectional study

Objective

To measure folic acid awareness and intake rates among women of childbearing age in certain areas of China with a high prevalence of neural tube defects (NTD).

Design

A cross-sectional survey was carried out utilising a nineteen-item questionnaire enquiring into individual women's knowledge of, attitude towards and practice of folic acid supplementation.

Setting

A total of 293 low-income counties in six provinces of China.

Subjects

Women aged 19–44 years from six provinces with a high prevalence of NTD recruited from June to August 2008.

Results

Among 33 025 participants, 57 % had heard of folic acid but only 15 % knew all of the core information. The intake rate was 12 %; only 8 % took the recommended dose and only 4 % of non-pregnant women took folic acid. Some women did not take folic acid because they did not know that they should take it (49 %) or they had misconceptions about it (24 %). According to logistic regression analysis, rural residence was a risk factor for folic acid awareness. Ethnicity, educational level, average annual income per person and pregnancy were the influencing factors of folic acid awareness and folic acid intake.

Conclusions

Although more than half of the respondents had heard of folic acid, the intake rate was still very low in areas with a high prevalence of NTD. Thus, more efforts are needed to increase folic acid awareness and intake among women of reproductive age in these areas.

Awareness, knowledge, and use of folic acid among women: a study from Turkey

PURPOSE

To investigate the awareness, knowledge, and behaviors relevant to folic acid intake in women aged 15-49 years.

MATERIALS AND METHODS

A questionnaire designed by the researchers was administered to 1,083 women who attended to family health care centers for any reason, between 1 and 15 of December 2009.

RESULTS

Half of the women (53.7%) surveyed did not hear or read about folic acid. Women older than 35 and less-educated women were more unaware of folic acid. Out of 171 pregnant women, 81.3% (139 women) were taking/took vitamin/folic acid supplementation but only 12.2% of the users started to take supplements at least 1 month before conception. Out of 912 non-pregnant women 81 (8.9%) said they are taking any vitamin or mineral supplement. Out of the women who are not pregnant, not using a modern contraceptive method and planning to have a child at the time of the survey, only 9 (10%) were taking vitamin/folic acid. The most common information sources on folic acid were the doctors.

CONCLUSION

In order to improve the intake of folic acid during the recommended period, preconceptional counseling by the family doctors to inform women of childbearing age about the need to take folic acid to prevent NTDs seems to be important.

Omega-3 supplements in pregnancy: are we too late to identify the possible benefits?

OBJECTIVE

Postpartum depression (PPD) is a common and recurring illness. Most women who experience PPD do not seek professional help; for those who do, the available treatment options are not supported by extensive research evidence. Several lines of research have linked omega-3 fatty acids (omega-3) supplementation with a reduced risk of PPD. Although it has been suggested that women in the perinatal period consume sufficient omega-3 to potentially prevent PPD, there is a lack of definitive research evidence. This pilot study surveyed pregnant women's current use of omega-3, multivitamin, and other supplements, as well as their attitudes toward omega-3 research during pregnancy, to assess the feasibility of pregnant women's participation in a large randomized controlled trial evaluating omega-3 supplementation.

METHODS

Women attending prenatal clinics over a three-week period were invited to participate in a survey. The survey contained an information letter that was followed by a brief questionnaire assessing the use of nutritional supplements and opinions regarding the likelihood of participating in a clinical trial during pregnancy.

RESULTS

Of the 176 women who completed the survey, six women were in the first trimester of pregnancy, 82 were in the second trimester, and 87 were in the third trimester. One hundred fifty-nine respondents (90.3%) reported taking a multivitamin supplement but none were taking a supplement that contained omega-3; only 20 (11.4%) were taking omega-3. Seventy-eight women (44.4%) responded that they would participate in a clinical study evaluating the effects of fish oil on their health.

CONCLUSION

The results of our study indicate that many pregnant women take prenatal multivitamins and nutritional supplements, that there are currently few pregnant women attending clinics at our hospitals who are supplementing with omega-3, and that pregnant women would be willing to participate in a clinical trial evaluating the effects of omega-3.

Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy

This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9%), iron (55.4%), and multivitamins (76.2%) as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95%CI: 1.58-3.29; iron, RR = 1.99; 95%CI: 1.57-2.52, multivitamins, RR = 1.97; 95%CI: 1.54-2.51). Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95%CI: 1.18-1.70), but not multivitamins (RR = 0.87; 95%CI: 0.77-0.98). Use of folic acid was less prevalent in single women (RR = 0.67; 95%CI: 0.48-0.95) and during unplanned pregnancies (RR = 0.81; 95%CI: 0.71-0.92). Adequacy of prenatal care is a major determinant of vitamin/mineral intake during pregnancy.

Preconceptional folic acid supplement use in Lebanon

OBJECTIVE

The objective of the present study was to assess the prevalence and determinants of preconceptional folic acid supplement use among pregnant women in Lebanon.

DESIGN/SETTING/SUBJECTS

The study was a descriptive epidemiological study. Analysis was performed on 5280 deliveries admitted to twelve member hospitals of the National Collaborative Perinatal Neonatal Network during the period September 2003-January 2005. Information on folic acid intake and maternal and neonatal characteristics were obtained from obstetric charts along with direct interviews performed by trained personnel. Logistic regression was performed to determine the predictors of preconceptional folic acid use.

RESULTS

The overall use of preconceptional folic acid supplementation was 14.0 % (18.6 % in urban hospitals v. 2.7 % in rural hospitals). Higher socio-economic status, lower parity and having a history of previous spontaneous abortions were significantly associated with preconceptional folic acid use.

CONCLUSION

Our study shows that Lebanon currently has a low rate of preconceptional folic acid supplement use. Intervention through the means of awareness campaigns needs to be implemented on a national level.