Women’s knowledge and periconceptional use of folic acid: data from three birth centers in Italy.

Abstract

The Italian strategy to prevent neural tube defects is based on the periconceptional use of folic acid. This strategy implies a good capacity of control by women over their reproductive choices. Three sample surveys of delivering women were conducted in three birth centers in two Italian cities. Overall, 973 women were interviewed through a structured questionnaire. Information on women’s socio-demographic characteristics, knowledge and use of folic acid and on counselling received by health professional in anticipation of and during pregnancy were collected. Logistic regression models were used to explore factors associated with the outcome variables. The prevalence of periconceptional use of folic acid was 37.9%. Before or during pregnancy, about half of the women had received partial information on what folic acid is and its benefits but only half of them received information on the correct period of assumption. Internet is a primary source of information for women who have the ability to search for the information they need, and these are the more educated. Older women, better educated, and Italians  were more likely to plan a pregnancy, to know the correct period of folic acid assumption and to take it. Among multiparous women, those who received correct information during the previous pregnancy were more likely to use periconceptional folic acid in the present pregnancy OR=6.83 (95%CI:3.58-13.0). The provision of information on the correct period of assumption of folic acid is associated with better knowledge and with its increasing use. Investing on provision of information instead of the directive approach represented by the compulsory fortification of food, appears an appropriate action. The prevalence of periconceptional use of folic acid is an expression of the level of women’s empowerment which the public health services should always aim to improve.