Prevalence of periconception folic acid therapyuse and associated factors among women attending antenatal care at Mbale regional referral hospital.

Abstract

Background: Folic acid supplementation in the periconception period prevents folic acid sensitive congenital anomalies. In Uganda, most women do not receive the recommended dose of folic acid in the periconception period. This study aimed at determining the prevalence and the factors associated with periconception use of folic acid among pregnant women at Mbale Regional Referral Hospital.

Methods: We used a cross sectional study design among pregnant women attending antenatal clinic at Mbale Regional Referral Hospital. A total of 464 women participated. We used consecutive sampling technique to select study participants using an interviewer administered questionnaire to capture information on prevalence of periconception folic acid therapy use and its associated factors. The prevalence of periconception folic acid therapy use was measured by counting the number of folic acid tablets consumed on average in a week/ month in the periconception period, women who took 4 or more tablets in a week were considered to have adhered to folic acid therapy. Data collected was coded and imported into STATA version 13 for analysis where bivariable and multivariable logistic regression was applied to determine the factors associated to periconception folic acid therapy use. Factors with a p value < 0.05 at bivariable analysis and plausible factors were included in the multivariate analysis. The strength of association was measured using odds ratio, and 95% confidence interval.

Results: The prevalence of preconception folic acid therapy use was 2/464 (0.4%) while the prevalence of folic acid therapy use during the first trimester was 56/464 (12.1%). At multivariable analysis women who had heard about folic acid were more likely to adhere to the recommended dose of periconception folic acid (aOR: 28.5, 95% CI: 5.1-157.9, p<0.001) than women who had not heard about folic acid use. Women who attended their antenatal care first visit at ≤12 weeks of gestation were more likely to adhere to periconception folic acid therapy (aOR: 0.05, 95%CI: 0.001-0.1, p<0.001).

Conclusion: The prevalence of periconception folic acid therapy use was very low. There was poor utilization of folic acid in the periconception period. This could have been because women lacked knowledge about the appropriate time to start folic acid supplementations and the duration of intake. Therefore, awareness campaigns are recommended to emphasize on counseling women about the timing and benefits of folic acid therapy use in the periconception period.

Key words: periconception period, folic acid therapy, women