Folic acid awareness and intake among women in areas with high prevalence of neural tube defects in China: a cross-sectional study

Objective: To measure folic acid awareness and intake rates among women of childbearing age in certain areas of China with a high prevalence of neural tube defects (NTD). Design: A cross-sectional survey was carried out utilising a nineteen-item questionnaire enquiring into individual women's knowledge of, attitude towards and practice of folic acid supplementation. Setting: A total of 293 low-income counties in six provinces of China. Subjects: Women aged 19-44 years from six provinces with a high prevalence of NTD recruited from June to August 2008. Results: Among 33 025 participants, 57% had heard of folic acid but only 15% knew all of the core information. The intake rate was 12%; only 8% took the recommended dose and only 4% of non-pregnant women took folic acid. Some women did not take folic acid because they did not know that they should take it (49 %) or they had misconceptions about it (24 %). According to logistic regression analysis, rural residence was a risk factor for folic acid awareness. Ethnicity, educational level, average annual income per person and pregnancy were the influencing factors of folic acid awareness and folic acid intake. Conclusions: Although more than half of the respondents had heard of folic acid, the intake rate was still very low in areas with a high prevalence of NTD. Thus, more efforts are needed to increase folic acid awareness and intake among women of reproductive age in these areas.