Folic acid supplementation and neural tube defects: a cross-sectional study of knowledge and practice among pregnant mothers in Lira, Northern Uganda

Abstract

Background and aim: Folic acid requirements increase during pregnancy to meet the metabolic needs, DNA synthesis, and rapid cell division during fetal development. Low levels of folate before and during pregnancy augment the chances of poor pregnancy outcomes, like neural tube defects. Awareness of the importance of folic acid in the prevention of neural tube defects is low among women of childbearing age. This study intended to explore the level of knowledge and practices of pregnant mothers regarding folic acid supplementation in preventing neural tube defects in Lira, northern Uganda. Study design: This study employed a cross-sectional approach of data collection. A consecutive sampling technique was employed to recruit and interview 199 pregnant mothers attending antenatal care at Lira regional referral hospital. Descriptive statistics and chi-square tests were performed using SPSS V20 to determine the association between knowledge and practices of folic acid supplementation for prevention of neural tube defects. A p-value of ≤ 0.05 was statistically significant. Results: The knowledge level regarding folic acid was adequate. 88% had ever heard of it; 73.0% knew its benefits, but only 20.1% knew that it prevents neural tube defects; 83.9% were currently taking it, while only 18.0% took it before conception. In addition, the practice of folic acid supplementation was significantly associated with cues to action (p < 0.001), and perceived risk (p < 0.001) while knowledge was significantly associated with practice (p < 0.001). Conclusion: Pregnant mothers in Lira had limited knowledge of the role of folic acid in preventing neural tube defects. The pre-conception intake of folic acid was very low. Health education should include the role of folic acid in averting neural tube defects among women of childbearing age. Mothers should be encouraged to take folic acid pre- and post-conception, especially during the first trimester.