Folic acid knowledge and awareness in a sample of pregnant women in Erbil city
DOI:
https://doi.org/10.15218/zjms.2025.008Keywords:
Folic acid, Supplement, Knowledge, Pregnant WomenAbstract
Background and objective: Folic acid is one of the essential vitamins for women of childbearing ages, and its deficiency is the second leading cause of anemia worldwide after iron deficiency. The purpose of the study was to find out the factors associated with supplemental folic acid knowledge of pregnant women visiting primary health care centers in Erbil city.
Methods: A cross-sectional study was conducted and involved all the twenty-three primary health care centers in Erbil city. The data collection period was from 1st September 2021 to 1st March 2022. A convenience sample of 727 pregnant women visited primary health care centers in the Erbil city were collected through face-to face interviews by using a pre-designed questionnaire format.
Results: The study found that pregnant women had poor knowledge about using folic acid during pregnancy. There was a highly significant (P <0.001) positive association between the knowledge of pregnant women about folic acid and the increasing socio-economic class level, older age groups, a greater number of pregnancies, more birth spacing, and the absence of anemia, abortion and existence of congenital malformation during the previous pregnancies.
Conclusion: The majority of pregnant women have limited awareness about benefits of folic acid, especially among low socio-economic classes.
Metrics
References
Fite MB, Assefa N, Mengiste B. Prevalence and determinants of Anemia among pregnant women in sub-Saharan Africa: a systematic review and Meta-analysis. Arch Public Health. 2021; 79(1):219. doi: 10.1186/s13690-021-00711-3
Castellanos-Sinco HB, Ramos-Peñafiel CO, Santoyo-Sánchez A, Collazo-Jaloma J, Martínez-Murillo C, Montaño-Figueroa E, et al. Megaloblastic anaemia: Folic acid and vitamin B12 metabolism. Rev Med Hosp Gen Mex. 2015; 78(3):135–43. doi: 10.1016/j.hgmx.2015.07.001
Hisam A, Rahman MU, Mashhadi SF. Knowledge, attitude and practice regarding folic acid deficiency; A hidden hunger. Pak J Med Sci. 2014; (3):583–8. doi: 10.12669/pjms.303.4716
Pelletier JL, Reilly R, Bigornia S. Assessment of the Intake and Knowledge of Folate/Folic Acid Among UNH Students. 2017 [cited 2023]. Available from: https://www.semanticscholar.org/paper/Assessment-of-the-Intake-and-Knowledge-of-Acid-UNH-Pelletier-Reilly/1dfb915f25ae76bf11da17deec8c7d50f64005c1
Pence JC, Martin KR, Bloomer RJ. Beyond Nutrition Recommendations: What Healthcare Professionals Should Know About Dietary Supplements to Best Serve Their Patients. Health. 2021; 13(04):334. doi: 10.4236/health.2021.134027
Crider KS, Bailey LB, Berry RJ. Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions. Nutrients. 2011; 3(3):370–84. doi: 10.3390/nu3030370
Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW, et al. Folic Acid Supplementation for the Prevention of Neural Tube Defects: JAMA. 2017; 317(2):183–9. doi: 10.1001/jama.2016.19438
Radcliff E, Cassell CH, Tanner JP, Kirby RS, Watkins S, Correia J, et al. Hospital use, associated costs, and payer status for infants born with spina bifida. Birth Defects Res A Clin Mol Teratol. 2012; 94(12):1044–53. doi: 10.1002/bdra.23084
Saxena V, Naithani M, Kumari R, Singh R, Das P. Peri-conceptional supplementation of folic acid-knowledge and practices of pregnant women and health providers. J Family Med Prim Care. 2016; 5(2):387–92. doi: 10.4103/2249-4863.192374
Yahyaa BT. Study of Awareness and Practice of Folic Acid Intake among Iraqi Women. Al- Anbar Medical Journal [Internet] 2019 [cited 2023]; 15(1). Available from: https://www.iasj.net/iasj/article/168734
Gadgil M, Joshi K, Pandit A, Otiv S, Joshi R, Brenna JT, et al. Imbalance of folic acid and vitamin B12 is associated with birth outcome: an Indian pregnant women study. Eur J Clin Nutr. 2014; 68(6):726–9. doi: 10.1038/ejcn.2013.289
Schmidt RJ, Tancredi DJ, Ozonoff S, Hansen RL, Hartiala J, Allayee H, et al. Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE (CHildhood Autism Risks from Genetics and Environment) case-control study123. Am J Clin Nutr. 2012; 96(1):80–9. doi: 10.3945/ajcn.110.004416
Ozório Linhares A, Cesar J. Folic acid supplementation among pregnant women in southern Brazil: Prevalence and factors associated. Ciência & Saúde Coletiva. 2017; 22:535–42. doi: 10.1590/1413-81232017222.06302016
Ngethe HM, Mapesa DJ, Mugambi L. Relationship between compliance to Iron and Folic Acid Supplementation and Anaemia among Pregnant Women in Nyeri County, Kenya. IJSRP. 2020; 10(11):272. doi: 10.1590/1413-81232017222.06302016
Mohammed BK. The role of folic acid in preventing neural tube defects in Iraqi pregnant women: A cross sectional study. Prensa méd argent. 2019; 296–301. https://pesquisa.bvsalud.org/portal/resource/esSiqueira/prensamedica.com.
Hameed AL, Hanna NG, Mohammed Halmi FT, Zaki SM. The Association of BMI, smoking, caffeine consumption and folic acid supplementation with hemoglobin levels in third trimester pregnant women in Erbil city. MJN. 2021; 9(1):1–13. doi: 10.33899/mjn.2021.167591
Sadiq ZA, Hussein HK. Assessment of knowledge and attitudes among pregnant women’s towards folic acid intake during pregnancy in a sample of women attending primary health care centers in Babylon province. Medical Journal of Babylon. 2022; 19(2):142. doi: 10.4103/MJBL.MJBL_72_21
Kim J, Yon M, Kim Cl, Lee Y, Moon GI, Hong J, et al. Preconceptional use of folic acid and knowledge about folic acid among low-income pregnant women in Korea. Nutr Res Pract. 2017; 11(3):240–6. doi: 10.4162/nrp.2017.11.3.240
Yamamoto S, Wada Y. Awareness, use and information sources of folic acid supplementation to prevent neural tube defects in pregnant Japanese women. Public Health Nutr. 2018; 21(4):732–9. doi: 10.1017/S1368980017003172
AlDuraibi S, Al-Mutawa J. Knowledge and awareness of folic acid usage in Saudi pregnant women in Riyadh city from 2019-2020 J Family Med Prim Care. 2020; 9(10):5158–64. doi: 10.4103/jfmpc.jfmpc_638_20
Muhammed Ebrahim S, Jasim U, Kadhim Z, Ibrahim A. Knowledge and use of folic acid among pregnant women attending antenatal care units :a study from Basra city. 2021; 32:24736–43. https://www.researchgate.net/publication/355795971
Anzaku AS. Assessing Folic Acid Awareness and its Usage for the Prevention of Neural Tube Defects Among Pregnant Women in Jos, Nigeria. J Basic Clin Reprod Sci. 2013; 2(1):13–7. https://www.ajol.info/index.php/jbcrs/article/view/115382
Fekadu M, Ketema K, Mamo Y, Aferu T. Peri-conception folic acid supplementation knowledge and associated factors among women visiting Maternal and Child Health clinics in Addis Ababa, Ethiopia. Heliyon. 2022; 8(10): e11114. doi: 10.1016/j.heliyon.2022.e11114
Al-Zahrani A, Al-Marwani S, Al-Zahrani A, Al-Marwani S. The effectiveness of an educational session about folic acid on pregnant women’s knowledge in Yanbu City, Kingdom of Saudi Arabia. AIMSMEDS. 2022; 9(3):394–413. doi: 10.3934/medsci.2022019
B. Lyoba W, Mwakatoga JD, Festo C. Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania [Internet] 2019 [cited 2023]. Available from: https://www.hindawi.com/journals/ijrmed/2020/3127245/ https://www.hindawi.com/journals/ijrmed/2020/3127245/ (accessed 2.19.23).
Jou HJ, Hsu IP, Liu CY, Chung SH, Chen SM, Gau ML. Awareness and Use of Folic Acid Among Pregnant Women in Taipei. Taiwan J Obstet Gynecol. 2010; 49(3):306–10. doi: 10.1016/S1028-4559(10)60066-6
Riazi H, Bashirian S, Amini L. Awareness of Pregnant Women about Folic Acid Supplementation in Iran. J Family Reprod Health. 2012; 159–63. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/336
Alsammani MA, Kunna A, Adam EM. Factors associated with folic acid knowledge and intake among pregnant women in Sudan. East Mediterr Health J. 2017; 23(10):662–9. doi: 10.26719/2017.23.10.662
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Shawkat Ahmed Braim, Sherzad Abdulahad Shabu (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
