Awareness, use and information sources of folic acid supplementation to prevent neural tube defects in pregnant Japanese women

Objective: Folic acid supplementation and folate-rich diets are recommended for women of childbearing age worldwide to prevent congenital anomalies. We aimed to determine the current status of folic acid supplementation among pregnant Japanese women and identify means to increase the intake of these supplements. Design: Cross-sectional study. Subjects: A total of 1862 pregnant women who consulted the perinatal centre from September 2014 to December 2015 completed a questionnaire concerning knowledge about folic acid, sources of information and the use of folic acid supplements. Setting: Osaka Medical Center and Research Institute for Maternal and Child Health (Japan). Results: In our study population, only 20.5% of pregnant women took folic acid supplements periconceptionally even though 70-4% knew about the protective effect of folic acid. A multivariate analysis demonstrated that age >= 35 years (OR = 2.80: 95% CI 1.24, 6.29) and knowledge of the benefits of folic acid (OR = 2.64: 95% CI 1.92. 3.62) were associated with periconceptional folic acid use, and mulriparity was negatively associated with such use. Compared with those who took folic acid supplements periconceptionally, women who did not take supplements received information through passive and less interactive media. Conclusions: Although folic acid awareness was relatively high among pregnant Japanese women, folic acid supplementation before conception was insufficient. To increase the intake of folic acid supplements in countries in which foods are not fortified with folic acid, an effective public health approach promoting behavioural change is necessary for women of reproductive age.