Knowledge, Attitude and Practices (KAP) of Preconceptional Folic Acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching hospital Abakaliki, Ebonyi State, Nigeria

Abstract

Background: Folate deficiency is associated with poor pregnancy outcomes and is one of the most common vitamin deficiencies in women, especially those of reproductive age. Folic acid intake prior to, and during, the first months of pregnancy significantly reduces the risk of fetal neural tube defects. Maternal folate status has been associated with other adverse pregnancy outcomes such as preeclampsia, malformations (orofacial clefts, Neural tube defects, anencephaly and encephalocele resulting from incomplete neural tube closure during early embryogenesis), spontaneous abortion, fetal death, fetal growth restriction and preterm delivery. Methods: The study embraced a cross-sectional study that assess Knowledge, Attitude and Practice of preconceptional folic acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State. 152 women attending antenatal clinics in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State were interviewed using structured questionnaire. Data collected were analyzed using SPSS version 21 for frequency and percentage at P < 0.05 significance level. Results: 98.7% of the participants had heard about folic acid, but an analysis of data shows that 26.6% of them knew that folic acid is a vitamin. In addition, very few (29.6%) knew that folic acid could prevent neural tube defects. The main source of information about folic acid supplementation among the surveyed women were through the health workers. Incidence of at least one episode of adverse pregnancy outcome was noted in about 35.5% of the population under study though a majority indicated the form for their loss were miscarriage and stillbirth. Finding showed that 37.5% of the respondent claimed to have used folic acid before pregnancy while 40.1% of the women in this study were aware of the right time to start using folic acid. 46% of the women took folic acid during Antenatal care and their reason were attributed to late presentation for antenatal care, delayed prescription of the folic acid for women during pregnancy, unplanned pregnancy while others claimed they are getting enough folate from food. Approximately 40.8% of the respondents had started supplementation on antenatal booking and from analysis of data on the preferred/normal booking time of the respondents it shows that a high percentage of them attended antenatal from the third month of pregnancy this shows that the majority of the respondents started supplementation too late which is inconsistent with the ideal time to start folic acid supplementation in prevention of neural tube defect. In this study it has been revealed that 48% of the respondents could identify green leafy vegetable as the only source of folate in local foods and 0.7% could identify other food sources like legumes and fruits as sources of folate. Conclusion: There is a low overall level of awareness of folic acid among pregnant women including lack of understanding of its natural sources, usefulness in preventing Neural Tube Defects and preconceptional intake recommendation. Health education regarding the preconceptional use of folic acid among women of reproductive age is recommended.