AWARENESS, TIMING, AND TYPE OF PERICONCEPTIONAL FOLATE SUPPLEMENTATION (FOLIC ACID VS L-METHYLFOLATE) AMONG PARENTS OF CHILDREN WITH SPINA BIFIDA: IDENTIFYING GAPS IN PREVENTION STRATEGIES

Abstract

Background: Periconceptional folate supplementation is an effective strategy for preventing neural tube defects, including spina bifida. However, awareness, correct timing, and knowledge regarding folic acid versus L-methylfolate remain limited in many low-resource settings.

Objective: To assess awareness, timing, and type of periconceptional folate supplementation among parents of children with spina bifida.

Methodology: This analytical cross-sectional study was conducted at Department of Paediatric Neurosurgery, The Children's Hospital Lahore from January 2024 to September 2024, including 137 parents of children with spina bifida. Data were collected using a structured questionnaire regarding awareness of folic acid and L-methylfolate, supplement use, timing, source of information, and barriers. Data were analyzed using SPSS version 26.0.

Results: The mean age of participants was 30.8 ± 5.9 years. Awareness of folic acid was reported by 83 (60.6%) parents, while only 18 (13.1%) had heard of L-methylfolate. Folate supplementation during pregnancy was used by 72 (52.6%) participants, but only 21 (29.2%) started before conception. Folic acid was the most commonly used preparation 58 (80.6%), while L-methylfolate use was reported by only 4 (5.6%). Doctors were the most common source of information 52 (38.0%). Lack of awareness 59 (43.1%) and unplanned pregnancy 42 (30.7%) were the main barriers.

Conclusion: Awareness and timely use of periconceptional folate supplementation were inadequate among parents of children with spina bifida. Preconception counseling and public health education should be strengthened to improve prevention of neural tube defects.