The critical gap in prevention: knowledge of periconception folic acid supplementation and its predictors among pregnant women in Ethiopia

Folic acid deficiency is the most common pregnancy-related micronutrient deficiency, leading to fetal neural tube defects (NTDs). Periconceptional folic acid supplementation is highly effective in reducing NTDs by 72%-86%. However, awareness of this essential prevention method remains limited in lower-income countries, contributing to a high rate of preventable birth defects. Therefore, this study aims to evaluate the knowledge and factors associated with periconceptional folic acid supplementation among pregnant women attending the Antenatal care clinic at Dilla University Teaching Hospital in 2024. This institution-based cross-sectional study was conducted at Dilla University Teaching Hospital from January to December 2024. A systematic random sampling technique was used to enroll 337 eligible pregnant mothers attending Antenatal Care. Bivariate and multiple logistic regression analyses were performed to identify associated factors. The strength of association was reported using the Adjusted Odds Ratio (AOR) with a Confidence Interval (CI), with p-values considered statistically significant. Only 8.9% (95% CI: 5.85%-11.96%) of pregnant mothers demonstrated good knowledge of periconceptional folic acid supplementation. Factors significantly associated with improved knowledge included higher education (AOR 5.13), current family planning use (AOR 4.06), having a planned pregnancy (AOR 3.59), being in the 26–30 age group (AOR 2.33), and employment status (AOR 1.63). Knowledge of periconceptional folic acid supplementation is extremely poor (8.9%) among pregnant women in the study area. Factors like higher education, family planning use, and planned pregnancy are strong determinants of awareness. There is an urgent need to implement targeted health education programs integrated within Antenatal Care and Family Planning services to improve knowledge and reduce the incidence of preventable NTDs.