[Awareness and periconceptional use of folic acid among non-western and western women in the Netherlands following the 1995 publicity campaign].
OBJECTIVE
To investigate the influence of ethnicity on the awareness and use of folic acid by pregnant women.


METHODS
Secondary data analysis.


METHODS
Using the data on 1555 women, collected during a cross-sectional study conducted among pregnant women with good knowledge of the Dutch language in 1996, the authors determined what was known about the recommendation to use folic acid around the time of conception and what the actual use was. Women were defined as either 'western' or 'non-western' on the basis of the place of birth of the woman and her parents.


RESULTS
Of the 1555 pregnant women, 74 (5%) were non-western or of non-western descent. Non-western women more often had a lower educational level than western women (51% versus 34%; p = 0.002) and more often had an unintended pregnancy (24% versus 8%; p < 0.0001). 41% of the non-western women had heard of the recommendation to use folic acid before pregnancy, compared to 79% of the western women (p < 0.0001). However, the use of folic acid was not significantly different between non-western and western women (56% versus 69%) if they had been aware of the recommendation to use folic acid before pregnancy. Awareness of the recommendation to use folic acid was higher in older women (OR: 1.46; 95% CI: 1.13-1.89), women of western descent (0.27; 0.16-0.47), women with a higher level of education (0.35; 0.27-0.45) and in case of planned pregnancy (0.45; 0.31-0.67). The use of folic acid, restricted to women who were aware of the recommendation to use folic acid before their pregnancy, was higher in older women (1.37; 1.05-1.80) and lower in those with more previous pregnancies (0.57; 0.43-0.75) and in case of an unplanned pregnancy (0.55; 0.34-0.88).


CONCLUSIONS
Although non-western women had less knowledge of the recommendation to use folic acid than western women, the use of folic acid was not significantly different from that by western women if they had been aware of the recommendation to use folic acid before pregnancy. Continued education on folic acid targeting non-western and western women is important.
Bakker
M K
MK
Rijksuniversiteit Groningen, disciplinegroep Medische Genetica, EUROCAT Noord Nederland, Triadegebouw KZ00.10, Postbus 30.001, 9700 RB Groningen.
Cornel
M C
MC
de Walle
H E
HE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001364:Awareness; D003430:Cross-Sectional Studies; D004522:Educational Status; D005006:Ethnicity / Q000193:education / Q000706:statistics & numerical data*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005494:Folic Acid Deficiency / Q000517:prevention & control; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009426:Netherlands; D009436:Neural Tube Defects / Q000517:prevention & control*; D016742:Preconception Care; D011247:Pregnancy
D005492:Folic Acid