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Matern Child Health J. 2009 Nov;13(6):814-21. doi: 10.1007/s10995-008-0414-5. Epub 2008 Sep 23.

Assessing awareness, knowledge and use of folic acid in Kansas women between the ages of 18 and 44 years.

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  • 1Kansas City University of Medicine and Biosciences, 1750 Independence Ave., Kansas City, MO 64106, USA.


Taking folic acid daily, before and during early pregnancy, has been proven to reduce neural tube birth defects (NTD). Unfortunately, many women fail to take it daily as recommended.


To assess women's self-reported awareness, knowledge and use of folic acid. Methods Data were obtained by cross-sectional, random digit-dialing, computer-assisted telephone interviews with 250 women in Kansas. Associations were determined by chi-squared analysis.


Eighty-eight percent of childbearing age women in Kansas have a general awareness of folic acid, 20% have knowledge that it reduces birth defects, but only 25% report taking it daily. Awareness was associated with high school or greater education (P < .0001), incomes over $25,000 (P = 0.0003), being married (P = 0.0035), being white (P = 0.0135), having health insurance (P = 0.0152) and being capable of pregnancy (P = 0.0119). Knowledge that folic acid reduces birth defects was associated with being aware of the USPHS recommendation (P < .0001), being capable of pregnancy (P = 0.0043), being pregnant (P = 0.0061), and being aware of folic acid (P = 0.0379). Taking folic acid daily was associated with currently being pregnant (P = 0.0126).


Women less likely to take folic acid on a daily basis were young, non-Caucasians who reported less education, less income and no health insurance. Based upon these data, multi-level education campaigns that specifically target lower-SES women should be considered.

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