Three years after the Dutch folic acid campaign: Growing socioeconomic differences

Background. We investigated periconceptional awareness and the use of folic acid tablets 3 years after the 1995 campaign in the northern Netherlands. We studied whether the socioeconomic differences we found in 1996 with respect to awareness and use of folic acid remained in 1998. Methods. The present study took place in 1998. Pregnant women were asked to complete a questionnaire. Results. A total of 452 women completed the questionnaire in 1998. Sixty percent of the women with a lower level of education and 85% of the women with a higher level of education had heard of folic acid before pregnancy. Newspapers and magazines were the most often cited sources of information. Fifty percent of the women with a lower educational level used folic acid, while this figure was 80% for the group with higher education. Conclusion. Awareness and use of folic acid increased after the 1995 campaign. However, socioeconomic differences with respect to awareness of folic acid remained and even increased with respect to knowledge of the advised period. Use of folic acid is also associated with level of education more strongly than in 1996. Therefore, fortification of staple foods is an attractive option.