Study on Knowledge and Practice of Periconceptional Intake of Folic Acid among Antenatal Mothers at Saveetha Medical College Hospital, Tamil Nadu
Mangala Lakshmi Pritem
Citation Information :
Pritem ML. Study on Knowledge and Practice of Periconceptional Intake of Folic Acid among Antenatal Mothers at Saveetha Medical College Hospital, Tamil Nadu. Int J Infertil Fetal Med 2020; 11 (3):57-60.
Background: Neural tube defects (NTDs) are one of the common congenital malformations. Neural tube defects are preventable with folic acid (FA) supplementation periconceptionally. Knowledge about FA and its periconceptional intake among women of reproductive age, pregnant women, and healthcare providers is important for timely supplementation, thereby preventing NTDs.
Aim and objective: To assess the knowledge about FA and its benefits and their actual intake of FA periconceptionally among pregnant women at Saveetha Medical College and Hospital.
Study design: A cross-sectional descriptive study was conducted at Saveetha Medical College and Hospital in the year 2017.
Materials and methods: Two hundred pregnant women attending Antenatal Outpatient Department willing to participate in the study were interviewed with a structured questionnaire and responses were collected and analyzed.
Results: Among 200 pregnant women, 153 (76.5%) women had heard about FA and mostly from healthcare providers (94.7%). Sixty-one women (30.5%) and nine women (4.5%) were aware of the benefits of FA in neural development and anemia prevention, respectively. Nine (4.5%) were able to mention a diet rich in FA and 15 (7.5%) women knew the dose of FA. Only 32 women (16%) took FA periconceptionally, whereas 150 women (75%) took FA only after the diagnosis of pregnancy. Among them, 164 women took the tablets regularly. Eighteen women (9%) did not take FA during pregnancy. Out of 131 women (65.5%) who had planned pregnancy, only 48 women (36%) had taken periconceptional FA.
Conclusion: Awareness about FA and its importance of periconceptional intake is low among women in this population. The practice of periconceptional intake of FA is less which may be due to a lack of knowledge about the benefits of FA. Health education, awareness programs, planned pregnancy, and preiconceptional counseling can help in optimizing the periconceptional FA intake.
Rehan M, Mahmood N, Mazhar SB. Knowledge, attitude and practices regarding periconceptional folic acid supplementation in a tertiary care hospital. Ann Pak Inst Med Sci 2015;11(4):172–175.
Vitale K, Mujkić A, Todorović G, et al. Is level of knowledge, attitude and use of folic acid among pregnant women in Croatia a call for public health action? Periodicum Biologorum 2009;111(3):329–335.
Food and Nutrition Board 1998 Institute of Medicine. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin and choline: a report of the Standing Committee on the Scientific Evaluation of Dietary References Intakes and its Panel on Folate, other B Vitamins and Choline and Subcommittee on Upper Reference Levels for Nutrients. Washington (DC): National Academies Press; 1998. pp. 8–11.
Hernandez-Diaz S, Werler MM, Walker AM, et al. Folic antagonist during pregnancy and the risk of birth defects. New Eng J Med 2000;343(22):131–137. DOI: 10.1056/NEJM200011303432204.
Deepti K, Anila H, Arup C, et al. Determinants of knowledge regarding folic acid in periconceptional use among pregnant mothers in Southern India. IOSR J Dent Med Sci 2013;4(3):25–29. DOI: 10.9790/0853-0432529.
Ray JG, Singh G, Burrows RF. Evidence for suboptimal use of periconceptional folic acid supplements globally. BJOG 2004;111(5):399–408. DOI: 10.1111/j.1471-0528.2004.00115.x.
Gupta H, Gupta P. Neural tube defects and folic acid. Indian Pediatr 2004;41:577–586.
Hall JG, Sollehhdin F. Genetics of neural tube defects. Ment Retard Dev Disabil 1999;4(4):269–281. DOI: 10.1002/(SICI)1098-2779(1998)4:4<269::AID-MRDD6>3.0.CO;2-8.
Bhide P, Sagoo GS, Moorthie S, et al. Systematic review of birth prevalence of neural tube defects in India. Birth Defects Res A Clin Mol Teratol 2013;97(7):437–443. DOI: 10.1002/bdra.23153.
Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992;327(26):1832–1835. DOI: 10.1056/NEJM199212243272602.
Prevention of neural tube defects: results of the medical research council vitamin study. MRC vitamin study research group. Lancet 1991;338(8760):131–137. DOI: 10.1016/0140-6736(91)90133-A.
Smithells RW, Seller MJ, Harris R, et al. Further experience of vitamin supplementation for prevention of neural tube defect recurrences. Lancet 1983;1(8332):1027–1031. DOI: 10.1016/S0140-6736(83)92654-5.
Keshavarzi F, Ting CM, Yi WM, et al. Periconceptional folic acid usage pattern in Malaysian women. Int J Pharmaceut Clin Res 2016;8(8):1199–1204.
WHO Fact Sheet. Congenital Anomalies. Available from: http://www.who.int/mediacentre/factsheets/fs370/en/.
A Strategic Approach to Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) in India. Ministry of Health and Family Welfare, Government of India. 2013.
Wilson R, Davies G, Desilets V, et al. The use of folic acid for the prevention of neural tube defects and other congenital anomalies. J Obstet Gynaecol Can 2003;25(11):959–973. DOI: 10.1016/S1701-2163(16)30248-1.
Saxena V, Naithani M, Kumari R, et al. Peri-conceptional supplementation of folic acid-knowledge and practices of pregnant women and health providers. J Family Med Prim Care 2016;5(2):387–392. DOI: 10.4103/2249-4863.192374.
Lumley J, Watson L, Watson M, et al. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Cochrane Data Base Systema Reviews 2001. CD001056.
Ward M, Hutton J, Mc Donnell R, et al. Folic acid supplements to prevent neural tube defects: trends in East of Ireland 1996-2002. Irish Med J 2004;97(9):274–276.
Howell SR, Barnett AG, Underwood MR. The use of pre-conceptional folic acid as an indicator of uptake of a health message amongst white and Bangladeshi women in Tower Hamlets, east London. Fam Pract 2001;18(3):300–303. DOI: 10.1093/fampra/18.3.300.
Peake JN, Copp AJ, Shawe J. Knowledge and periconceptional use of folic acid for the prevention of neural tube defects in ethnic communities in the United Kingdom: systematic review and meta-analysis. Birth Defects Res A Clin Mol Teratol 2013;97(7):444–451. DOI: 10.1002/bdra.23154.
Eichholzer M, Tönz O, Zimmermann R. Folic acid: a public-health challenge. Lancet 2006;367(9519):1352–1361. DOI: 10.1016/S0140-6736(06)68582-6.
Botto LD, Lisi A, Robert-Gnansia E, et al. International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working? BMJ 2005;330(7491):571–573. DOI: 10.1136/bmj.38336.664352.82.
Gjergja R, Stipoljev F, Hafner T, et al. Knowledge and use of folic acid in Croatian pregnant women – a need for health care education initiative. Reprod Toxicol 2006;21(1):16–20. DOI: 10.1016/j.reprotox.2005.07.005.
Coll O, Pisa S, Palacio M, et al. Awareness of the use of folic acid to prevent neural tube defects in a Mediterranean area. Eur J Obstet Gynecol Reprod Biol 2004;115(2):173–177. DOI: 10.1016/j.ejogrb.2003.12.009.
Morin VI, Mondor M, Wilson RD. Knowledge on periconceptional use of folic acid in women of British Columbia. Fetal DiagnTher 2002;16(2):111–115. DOI: 10.1159/000053892.
Canfield MA, Przybyla SM, Case AP, et al. Folic acid awareness and supplementation among Texas women of childbearing age. Prev Med 2006;43(1):27–30. DOI: 10.1016/j.ypmed.2006.01.022.
Alozie Arole CN, Puder KS, Reznar M, et al. Folic acid awareness in Michigan, 1996-1999. Obstet Gynecol 2003;102(5 Part 1):1046–1050. DOI: 10.1097/00006250-200311000-00029.