Awareness of periconceptional folic acid supplementation among Nepalese women of childbearing age: a cross-sectional study

Paudel, Prakash; Wing, Kevin; Silpakar, S.K.

doi:10.1016/j.ypmed.2012.09.001

Cited by 12 publications

(17 citation statements)

References 18 publications

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“…These findings provide a snapshot of the level of folic acid fortified flour intake among WRA after initiation of a fortification program in Ifakara. Folic acid awareness was low, far less than awareness reported in other studies done in Nepal, Honduras, Europe, USA, and New Zealand where awareness ranged from 40 to 98% [10][11][12][13][14]. Furthermore, our study found that only five (10.1%) respondents who were aware of folic acid knew that folic acid can prevent some birth defects.…”

Section: Discussioncontrasting

confidence: 86%

Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study

Mwandelile

Mpembeni

Abade³

et al. 2019

BMC Nutr

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Background: Folic acid fortification of staple foods has been in place in many countries for over two decades. Studies have shown that folic acid fortification can significantly reduce incidence of neural tube defects. Tanzania adopted a mandatory fortification policy for commercially-produced wheat and maize flour in 2011. We determined factors influencing intake of folic acid-fortified flour among women of reproductive age (WRA). Methods: We conducted a cross-sectional study among WRA during March-April 2017 in Ifakara Town Council, Morogoro region. Multistage cluster sampling was used to select study participants. We used a questionnaire to capture information on demographics, awareness of folic acid, awareness of existence of folic acid fortified flour in community and intake of folic acid fortified flour. Intake was defined as reported consumption of folic acid fortified flour products at least once within 7 days before interview. Univariate, bivariate, and multivariable logistic analyses were done to evaluate factors associated with intake of folic acid fortified flour. Results: The median age of the 698 participating WRA was 30 years (range: 18-49). Awareness of folic acid and folic acid fortified flour was 6.9% (95% CI: 5.2-9.0%) and 7.5% (95% CI: 5.7-9.6%), respectively. Consumption of folic acid fortified flour was 63.3% (95% CI: 59.7-66.8%). Independent factors associated with intake included being employed (aOR = 1.91; 95% CI: 1.19-3.06), having no children (nulliparity) (aOR = 2.59; 95% CI: 1.36-4.95) or having 1-4 children (aOR = 1.98; 95% CI: 1.17-3.33) (vs. 5 or more children), and folic acid awareness (aOR = 2.53; 95% CI: 1.30-4.92). Conclusion: Folic acid fortified flour was used by most respondents in our study despite low awareness of existence of folic acid fortified flour in the community. Being employed, having fewer than five children, and folic acid awareness were independent factors associated with intake. We recommend scaling up of mandatory flour fortification program and doing further studies on blood folate level among women of reproductive age in Ifakara to assess fortification program effectiveness.

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Section: Discussioncontrasting

confidence: 86%

Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study

Mwandelile

Mpembeni

Abade³

et al. 2019

BMC Nutr

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“…A recent systematic review [ 41 ] demonstrated that even in high income countries, only half of all women use folic acid before conception, therefore protective levels cannot be achieved before the critical period of neural tube closure. Reasons for low prevalence of use are confirmed by other studies [ 220 - 228 ] and include low maternal education and socioeconomic status; young maternal age; lack of a partner; and unplanned pregnancy. It is necessary therefore to improve awareness and use of folic acid supplements among all women of reproductive age so that even women with unplanned pregnancies are protected.…”

Section: Discussionsupporting

confidence: 64%

Preconception care: nutritional risks and interventions

et al. 2014

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IntroductionThere is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy.MethodsA systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.ResultsMaternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight.ConclusionAll women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition-sensitive strategies (such as food fortification; integration of nutrition initiatives with other maternal and child health interventions; and community based platforms) is necessary among adolescent girls and women of reproductive age. The effectiveness of interventions will need to be simultaneously monitored, and form the basis for the development of improved delivery strategies and new nutritional interventions.

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“…Low awareness in action of folic acid is supported by study done in Kathmandu model hospital by Paudel, Wing & Silpakar that study result showed that awareness in folic acid supplementation is very low. 13 However other studies showed that slightly more awareness; there was 49.7% in study done in China by Liang, Ma, Zhou, & Li and 59% in study done by Delgado. 14,15 As regard the association between level of awareness and sex of respondents, the study findings revealed that there is no statistically significant relationship between awareness level and sex of the respondents.…”

Section: Discussionmentioning

confidence: 92%

Awareness regarding preconception care among bachelor level students, Banepa

Manandhar

Subedi

2018

J Chitwan Med Coll

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Background: Preconception care means care and counseling that is provided to future parents. The objective of the study was to identify the level of awareness regarding preconception care among bachelor level students. Methods: A descriptive cross sectional study was carried out with bachelor level students from 4 different colleges of Banepa. Samples were selected using cluster sampling. Data was collected through self-administered questionnaire. The data was analyzed using descriptive and inferential statistics. Results: In the study, 59.9% of the respondents had fair awareness and 20.2% had low awareness and only 18.9% had high awareness regarding preconception care. There is significant association between information acquired and level of awareness (p=0.026) and source of information and level awareness (p= 0.069). Conclusion: In overall, respondents had fair awareness with higher level in prevention of teratogenic exposure. There is significant association between information acquired and source of information and level of awareness.

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Awareness of periconceptional folic acid supplementation among Nepalese women of childbearing age: a cross-sectional study

Abstract: Knowledge of FAS is very low among women of childbearing age in Kathmandu. Inclusion of FAS information in health awareness programs is recommended.

Cited by 12 publications

References 18 publications

Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study

Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study

Preconception care: nutritional risks and interventions

Awareness regarding preconception care among bachelor level students, Banepa

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