Determinants of folic acid intake during preconception and in early pregnancy by mothers in Ibadan, Nigeria

Abstract

Introduction: In order to identify targets for primary preventive strategies, we explored possible  predictors of periconceptional folic acid (pFA) intake in a Nigerian population of reproductively active  women.

Methods: A cross sectional study of mothers attending immunization clinics at two hospitals was conducted between May and November 2012. Information obtained included sociodemographic and  obstetric details and periconceptional usage of FA. Independent variables were analysed as predictors of pFA intake using chi-square statistical test and multinomial logistic regression.

Results: The study involved 602 mothers aged 17 to 42 years; 23% had a university degree and 66%  were in the working class. Preconceptional usage was proven in only 15 (2.5%). Periconceptional usage was more likely among professionals (X2 = 41.194, p < 0.001), those with university degree (X2 = 53.089, p < 0.001),are primigravid (X2 = 18.415, p < 0.001) and early antenatal clinic attendees (X2 =  355.9, p < 0.001). Women were less likely to know that FA could prevent birth defects if in the working class (1.7% vs. 11.1%, X2 = 25.593, p < 0.001), less educated (0.5 vs. 10.9%, X2 = 38.083, p < 0.001) or booked late for antenatal care (2.0 vs. 5.9%, X2 = 5.767, p = 0.016). The determinants of late commencement of FA were low social class (OR = 4.29, 95% CI: 1.59, 11.31), lack of university  education (OR = 4.58, 95% CI: 3.06, 6.87) and late booking (OR = 104.27, 95% CI: 53.09, 204.76). 

Conclusion: In this population of reproductively active women, pFA intake and knowledge of its health benefits are poor amongst mothers - in working class, with limited education, and who present late for  antenatal care.

Key words: Periconceptional, folic acid, neural tube defects, prevention, determinants