Background: Folic acid (vitamin B9) is one of the important vitamins required for embryonic growth and development, as well as preventing the occurrence of congenital malformations, which are a major health concern in developing countries and around the world because they have a direct impact on the affected babies, their families, and the community. Objectives: To assess the knowledge and attitudes of pregnant women toward folic acid intake throughout pregnancy in a sample of women in Babylon Governorate and to assess the association of knowledge, attitude of folic acid with certain sociodemographic and obstetric characteristics. Methods: A cross-sectional interview-based study targeting a convenient sample of 265 pregnant women who attended antenatal care unit of five PHCCs in Babylon Governorate/Iraq during a period of three months (from April 1 to July 1, 2021). The respondents were interviewed with a pretested questionnaire, that includes data related to sociodemographic and obstetric history, seven questions related to pregnants’ knowledge, and five questions related to pregnant attitudes toward the importance of folic acid intake during pregnancy. Data were analyzed by SPSS, version 26. Results: 265 pregnant women were enrolled in this study. The result found that the mean (±standard deviation) age was 26.5 (±5.7) years where 58.1% (154) of women were in the age group of 20–29 years and two-third of participants were a resident in urban areas. In addition, 54.5% (144) of women had college and postgraduate education, housewives consisted 51% (134) of the sample, and 45 were employed; only 26 (9.8%) pregnant women were not hearing about folic acid intake during pregnancy. The major source of hearing was doctors. 44.8% (107) of participants had fair level of knowledge; knowledge score was significantly associated with age, residency, and occupation of pregnant women (P ≤ 0.05); knowledge score had no significant association with educational level, parity, history of abortion and stillbirth, or having children with congenital anomalies. 75 (31.4%) mothers had negative attitude toward using folic acid during pregnancy. Pregnant attitude toward folic acid supplements had no association with sociodemographic and obstetrical history. There was a positive moderate linear correlation between the mother's knowledge and attitude (r = 0.36, P < 0.001). Conclusions: The study found that pregnant women had a fair and good knowledge about using folic acid during pregnancy. In addition, most pregnant women have a positive attitude.
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