Knowledge of Neural Tube Defects and Prevention Through Folic Acid Use Among Women in Faisalabad, Punjab, Pakistan: A Cross-Sectional Survey

Abstract

Shazia Yasmin,1,2 Ayesha Siddiqa,3 Lauren Rockliffe,4 Jaleel Miyan2 1Department of Rural Sociology, Faculty of Social Sciences, University of Agriculture, Faisalabad, Pakistan; 2Faculty of Biology, Medicine & Health, School of Biological Sciences, The University of Manchester, Manchester, M13 9PT, UK; 3Department of Sociology and Criminology, University of Sargodha, Punjab, Pakistan; 4Manchester Centre for Health Psychology, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UKCorrespondence: Shazia Yasmin, School of Biological Sciences, The University of Manchester, 3.540 Stopford Building, Oxford Road, Manchester, M13 9PT, UK, Tel [phone], Email [email protected]; [email protected]: Neural tube defects (NTDs) are one of the most common congenital abnormalities of the central nervous system and are associated with significant mortality, morbidity, and major life-long disability. Periconceptional folic acid reduces the risk of NTDs by up to 70%; however, in Pakistan, no public information program exists concerning the risks of NTDs or promoting folic acid use. As such, the aim of this study was to assess levels of knowledge about NTDs and folic acid use among women attending the gynaecology department of DHQ Hospital, Faisalabad, Pakistan.Design: A cross-sectional survey.Setting: The gynaecology department of the District Head Quarter (DHQ) Hospital in Faisalabad, Pakistan.Participants: Three hundred and fifty-five married women.Primary and Secondary Outcome Measures: Primary outcome measures included knowledge of NTDs and knowledge of folic acid use.Results: About 85.4% of participants had no knowledge of neural tube defects and 76.7% reported no knowledge about folic acid use. The majority of participants (86.2%) were unaware that folic acid protects against NTDs. Lack of knowledge of NTDs was significantly associated with education (P = 0.001), husband’s education (P = 0.002), planned pregnancy (P = 0.002), sources of antenatal care (P = 0.003), knowledge of folic acid (P = 003), knowledge that folic acid protects against NTDs (P = 0.002), and health decision-making (P = 0.003). Knowledge of folic acid use was significantly associated with age (P = 0.000), education (P = 0.004), husband’s education (P = 0.002), monthly income (P = 0.003), planned pregnancy (P = 0.003), pregnancy trimester (P < 0.001), sources of antenatal care (P < 0.001), knowledge of NTDs (P = 0.002), knowledge that folic acid protects against NTDs (P < 0.001), use of folic acid (P < 0.001), sources of vitamin information (P < 0.001), and health decision-making (P = 0.002).Conclusion: These findings highlight extremely low levels of knowledge about NTDs and folic acid use of women in Pakistan. There is an urgent need to increase knowledge and awareness of the risks of NTDs and preventative approaches, through health education programs delivered by trusted health professionals.Keywords: neural tube defects, folic acid, knowledge, health education

Keywords

• neural tube defects
• folic acid
• knowledge
• health education