Changes in knowledge and attitudes of folate, and use of dietary supplements among women of reproductive age in Norway 1998-2000

AIMS: From March 1998, Norwegian nutrition authorities have recommended that women consume a folic acid supplement before and early in pregnancy to prevent neural tube defects. The authors wished to establish Norwegian data on knowledge of, use of, and attitudes to folic acid supplement and dietary supplements before and after implementing national information campaigns on folate and pregnancy. METHODS: Telephone surveys were carried out in late 1998 and in late 2000 among, respectively, 1,146 and 1,218 Norwegian women of reproductive age. RESULTS: Overall, 50% of the women in 1998 and 60% of the women in 2000 had heard about folate, 33% and 46% knew about its role in pregnancy, and 9.5% and 21% knew that it may prevent a congenital malformation. Only 4.0% and 8.5% of the women, respectively, knew that the critical period for folic acid supplement to reduce the risk of neural tube defect is before and early in pregnancy. Knowledge and increase in knowledge between the two surveys were highest among women close to pregnancy (woman planning pregnancy, pregnant women, or women who had given birth within the last 12 months), and among women with high education. Among the 54 women in 1998 and the 55 women in 2000 whose last birth was within the previous year, use of a folic acid supplement before or early in the last pregnancy was reported by 10% (95% confidence interval (CI) 5-21%) and by 47% (95% CI 35-60%), respectively. Among women close to pregnancy, 76% in 1998 and 87% in 2000 stated that they would use a folic acid supplement in a future pregnancy. CONCLUSIONS: Knowledge and use of folate among Norwegian women increased from 1998 to 2000. Future information strategies on folate and pregnancy should in particular aim at increasing women's knowledge on the critical period for folic acid supplementation, as well as reducing socio-demographic differences in use and knowledge of folate.