18. Prevalence and predictors of periconceptional folic acid use

The benefits of periconceptional folic acid supplementation in prevention of neural tube defects are well established. However, use of periconceptional folic acid remains disappointingly low despite clear evidence of benefit – typically less than one-third of women actually take periconceptional folic acid supplements. This chapter considers the many factors influencing the prevalence of periconceptional folic acid use – demographic, socioeconomic, lifestyle, gynaecological, previous pregnancies, current pregnancies, other medical conditions and access to folic acid supplements. The importance of underlying awareness and knowledge is discussed, including the various sources of information. The role that these factors may have in shaping future strategies to promote folic acid supplementation is also considered.