The dutch 'Folic acid campaign'-have the goals been achieved?

Periconceptional folic acid use considerably reduces the risk of neural tub e defects. The aim of this study was to measure the effect of the national and the local 'Folic Acid Campaign' on periconceptional folic acid use. Bef ore (1995 survey) and 1 year after the campaign (1996 survey), the awarenes s and use of folic acid was measured among pregnant women in four regions o f the Netherlands. To this end, pregnant women who visited the midwife, gen eral practitioner or obstetrician for the first or second prenatal visit we re asked to complete a questionnaire. The results showed that use of folic acid for any period around conception increased from 25.1% in 1995 to 53.5% in 1996. Appropriate use (4 weeks before until 8 weeks after conception) i ncreased from 4.8% in 1995 to 21.0% in 1996. No additional effect of the lo cal Folic Acid Campaign was found (adjusted odds ratio = 1.0; 95% confidenc e interval = 0.7, 1.4). It was possible to conclude that folic acid use at the recommended time increased considerably as a result of the national and the local Folic Acid Campaign, but the target (use in 46% of women wishing to conceive) was not achieved. New health education programmes are needed to increase further its use at the appropriate times.