Public Health Nutrition

Monitoring and surveillance

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

Ziqian Zenga1a2, Ping Yuana1, Yanping Wanga2, Xi Maa3 and Jun Zhua2 c1

a1 Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China

a2 National Center for Birth Defects Monitoring of China, West China Women's and Children's Hospital, Sichuan University, no. 17, Section 3, South Ren Min Road, Chengdu 610041, People's Republic of China

a3 Shanxi Provincial Maternal and Child Hospital, People's Republic of China


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.

(Received July 29 2010)

(Accepted January 09 2011)

(Online publication February 16 2011)


c1 Corresponding author: Email