Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.