Late Initiation and Overuse of Folic Acid Supplements: A Public Health Challenge in Maternal Nutrition

Abdulkareem Selim A.1, Hameed I. A.1, Mosimabale M.M.1,  Enwerem Deborah Ekpenyobhiele1, Akinola O. O.1, Orji Ijeoma G.1, Babalola Abibat Oluwakemi1 

1 Department of Nutrition & Dietetics, Federal Polytechnic Ede, Osun State, Nigeria


DOI: 


Keywords: Folic acid; Maternal nutrition; Applied public health; Neural tube defects; Nigeria 



Abstract

Folic acid supplementation prevents neural tube defects (NTDs), but late initiation and overuse remain challenges in low-resource settings. This study aimed to understand supplementation patterns to inform public health solutions. A cross-sectional survey was conducted among 381 pregnant women attending antenatal care at Cottage Hospital, Ede, Osun State, Nigeria. Data on socio-demographic characteristics, knowledge, attitude, and intake of folic acid were collected using a structured, interviewer-administered questionnaire. Descriptive statistics and inferential analyses were performed using SPSS version 23. Results showed that while 90.3% had heard of folic acid, only 12.6% knew the correct preconception initiation period. Preconception use was very low (12.9%), while 87.1% commenced supplementation after antenatal booking. Dosage practices revealed that 60.1% consumed 1 mg daily (250% of RDA), while 22.8% consumed 2 mg daily (500% of RDA); only 9.2% reported irregular or no use. Knowledge of specific benefits was limited: 43.3% associated folic acid with fetal growth, 23.6% with blood formation, and only 8.9% with birth defect prevention. Awareness of neural tube defects (NTDs) was low (21.8%). Healthcare providers were the main source of information (55.9%). Despite high awareness, delayed initiation and overdosing undermine the preventive benefits of folic acid and raise safety concerns. Strengthened antenatal counselling, community campaigns, and mandatory fortification of staples such as wheat flour and rice with folic acid are urgently needed to optimise maternal nutrition and reduce preventable birth defects.


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Received: 30 August 2025

Accepted: 12 October 2025

Published: 13 October 2025

Cite as

S.A. Abdulkareem, I.A. Hameed, M.M. Mosimabale, E.D. Ekpenyobhiele, I.G. Orji, B.A. Oluwakemi, Late Initiation and Overuse of Folic Acid Supplements : A Public Health Challenge in Maternal Nutrition, React Eng. Environ. Appl. Sci. 1 (2025) 16–23.

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