Volume 10 No.
Page 45 Ae 59 e-ISSN: 2598-2095 DOI: doi.
org/10.
35747/jcps https://journal.
id/index.
php/jcps/index The Relationship Between Knowledge and Adherence of First-Trimester Pregnant Women Regarding Folic Acid Usage in Independent Medical Practices.
Kediri City Umul Farida1 Abstract Dyah Ayu Kusumaratni1* Pregnancy is a critical period requiring optimal nutritional intake, particularly folic acid.
This nutrient is vital for DNA synthesis and red blood cell formation, playing a crucial role in preventing maternal anemia and severe congenital abnormalities, such as Neural Tube Defects (NTD).
Folic acid deficiency contributes to increased maternal and neonatal mortality.
A mother's knowledge regarding pregnancy supplements is a potential key determinant that correlates strongly with compliance This study aimed to analyze the relationship between the level of knowledge and compliance regarding folic acid use among first-trimester pregnant women.
This analytical observational study employed a cross-sectional approach at Independent Medical Practices in Kediri City.
A total of 67 first-trimester pregnant women were selected using purposive sampling.
Research instruments included a validated 18-item knowledge questionnaire and a 12-item compliance questionnaire utilizing the Adherence to Refills and Medications Scale (ARMS).
Data were analyzed using the Spearman correlation test.
The findings indicated that the majority of respondents possessed good knowledge and exhibited a high level of compliance with folic acid consumption.
Statistical analysis confirmed a significant relationship between knowledge and compliance regarding folic acid use among first-trimester pregnant women .
<0.
Higher levels of maternal knowledge regarding the importance of folic acid are significantly associated with increased consumption compliance.
Since good knowledge serves as a reliable indicator of adherence, continuous health education programs must be strengthened.
Enhancing maternal understanding is essential to support compliance and ultimately prevent serious pregnancy complications and improve neonatal outcomes.
Nur Atiqah Fazliyanah1 Eko Yudha Prasetyo1 Djembor Sugeng Walujo1 Kumala Sari Poespita Dewi Wahyuni1 Shofiatul Fajriyah1 1Program Studi S1 Farmasi.
Institut Ilmu Kesehatan Bhakti Wiyata Kediri *email: dyah.
ayu@iik.
Keyword:
Knowledge Compliance Pregnant Women First Trimester Folic Acid Article Info Received: November 2025 Accepted: March 2026 Published: March 2026 A 2026.
Published by Institute for Research and Innovation Universitas Muhammadiyah Banjarmasin.
This is Open Access article under the CC-BY-SA License .
ttp://creativecommons.
org/licenses/by-sa/4.
0/).
BACKGROUND
Pregnancy is a crucial period that begins with the union of an egg cell .
and sperm .
, resulting in the development of an embryo or fetus within the uterus .
Pregnancy is a time that requires special attention to nutritional needs due to physiological changes and the development of the fetus inside the womb.
Increased intake of energy and nutrients is highly necessary to support the mother's health and the optimal growth and development of the fetus .
Consuming nutritious foods, including carbohydrates, protein, fats, vitamins, and minerals, is essential for the mother's health during pregnancy, and these needs exceed those in the non-pregnant state .
During this period, the mother's nutrient and energy requirements increase significantly .
One of the crucial micronutrients during pregnancy is folic acid.
The World Health Organization (WHO) strongly recommends that all pregnant women take folic acid supplements daily .
Foods containing folic acid include legumes, oranges, and various green fruits and vegetables .
Women of childbearing age and pregnant women require a daily dosage of folic acid Journal of Current Pharmaceutical Sciences.
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Folic acid plays a vital role cases per 1,000 births, with NTD being a commonly reported in red blood cell formation and is the only vitamin whose case .
requirement doubles during pregnancy .
Folic acid holds Efforts to prevent this problem do not solely rely on the an essential function in producing red blood cells and availability of supplements but also on pregnant women's synthesizing DNA.
A deficiency of this nutrient can lead to knowledge and adherence to consuming folic acid.
The low level fatigue, lethargy, and a high risk of anemia during pregnancy, of understanding among pregnant women regarding the which contributes to increased maternal and newborn mortality importance of folate intake is one of the contributing factors to the .
high rate of pregnancy complications, including congenital Folic acid deficiency in pregnant women has serious health abnormalities such as spina bifida and anencephaly .
Good consequences, including anemiaAicharacterized by symptoms knowledge about the benefits of prenatal vitamins, such as folic of easy fatigue, lethargy, and palenessAias well as an increased acid, will encourage higher adherence, allowing pregnant risk of congenital diseases and infant mortality .
Inadequate women to avoid complications during pregnancy and childbirth nutrition, including a lack of folic acid, can also increase the .
Conversely, a lack of adequate information or understanding number of babies born with congenital defects .
One of the can lead to negligence in consuming supplements, resulting in most important complications that can be prevented with the emergence of complications during pregnancy .
Research adequate folic acid supplementation is lowering the risk of examining the level of knowledge among pregnant women and preeclampsia and Neural Tube Defects (NTD), such as Spina their adherence to consuming folic acid found that in the first Bifida .
ncomplete closing of the spin.
and Anencephaly .
he trimester, 40% of the sample had sufficient knowledge and 60% absence of a major portion of the brai.
Neural tube had good knowledge, with a sample of 42 first-trimester formation occurs very early, around the sixth week of pregnancy, pregnant women at Sorong City Public Health Center.
The making folic acid consumption most effective if started well adherence level was 14.
3% non-adherent and 85.
7% good before conception .
Ae8 weeks prio.
This contrasts with research conducted by .
at While the role of folic acid is widely recognized as essential for BPM Sri Rejeki Karanganyar, which found that 66% had poor pregnant women, the rate of anemia cases among expectant knowledge and 2% had good knowledge, with a sample of 36 mothers remains a major global health issue.
The high incidence first-trimester pregnant women.
of this anemia contributes to the risk of maternal mortality Adherence to consuming folic acid supplements occurs when during pregnancy .
The WHO estimates that in 2022, pregnant women comply with the healthcare provider's approximately 40% of all pregnant women across the globe recommendation to take the folic acid supplemen.
The suffered from anemia, accounting for 32 million cases globally adherence level is measured by the quantity of supplements and 27% in the Southeast Asia region .
In developing consumed, the correct method of consumption, and the countries, the prevalence tends to be higher, reaching an average frequency of daily use .
The results of research conducted by of 52% among pregnant women .
Data in Indonesia itself .
indicate that there is a significant relationship between the shows an alarming figure, with 4050% of pregnant women knowledge level of first-trimester pregnant women and their affected by anemia .
Furthermore, the lack of knowledge adherence to consuming folic acid.
This was proven through the among pregnant women regarding the folic acid content in food the Spearman correlation test with a value of p=0.
<0.
also poses a challenge (Indonesian Ministry of Healt.
On the The conclusion is that a higher level of maternal knowledge other hand, the congenital abnormality rate is recorded at 15 Journal of Current Pharmaceutical Sciences.
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Page 45 Ae 59 e-ISSN: 2598-2095 correlates with a greater likelihood for them to regularly women who regularly consumed folic acid, and exclusion consume the supplement .
criteria for pregnant women experiencing mental disorders or Health behavior is influenced by three main factors:
who were currently ill.
The Slovin formula was used to calculate predisposing factors .
uch as knowledge and attitude.
, enabling the minimum sample size for the study.
The margin of error used factors .
vailability of resources and facilitie.
, and reinforcing was 10%, resulting in a total of 67 respondents.
Given the small factors .
ocial and family suppor.
This theory is widely used in sample size, to avoid bias in the results, researchers stratified the health promotion efforts through the PRECEDE-PROCEED population by age (Gen Z and Millennial.
in the hope of framework to analyze behavior and design appropriate representing the population group.
There has been a shift in human thought patterns over time, which has influenced levels of knowledge and behavior.
Generation Z has distinct characteristics compared to previous Therefore, research is crucial to uncover current facts regarding levels of knowledge and compliance among groups with varying respondent characteristics.
This study is expected to complement previous research data by exploring the supporting factors and barriers that prevent pregnant women from using iron and folate supplements.
Therefore, this data can be used to formulate educational strategies to increase knowledge and compliance with folic acid use among pregnant women.
Based on the problems outlined, this study aims to analyze the relationship between knowledge and adherence among firsttrimester pregnant women regarding the use of folic acid in Independent Medical Practices in Kediri City.
Research Instrument The questionnaire was the research instrument used to assess the respondents' knowledge and adherence to folic acid consumption during the first trimester of pregnancy.
instrument has met the standards for validity and reliability.
The questionnaire contained 18 statement items to measure respondents' knowledge regarding the use of folic acid, covering the definition of folic acid, its benefits, side effects, requirements, consumption rules, the appropriate time for consumption, the consumption period, the impact of folic acid deficiency, and external impacts on pregnancy.
The response options used a Guttman scale of 'true' Ae 'false,' where a validity test conducted on 30 respondents yielded results >0.
If rcount>rtable with an alpha of 0.
%), the questionnaire is considered valid .
reliability test was performed on the questionnaire items declared valid.
The reliability test result for the knowledge questionnaire was 0.
A questionnaire is declared reliable if the Cronbach's Alpha value is Ou0.
METHODS
The adherence questionnaire contained 12 questions used to Research Design measure adherence to folic acid supplement use and adherence The design used is analytic with a cross-sectional study to refilling folic acid prescriptions.
The ARMS (Adherence to approach, where data collection or observation is performed Refills and Medications Scal.
questionnaire was translated into simultaneously at one point in time .
Indonesian and adapted to measure adherence to folic acid Population and Sample This questionnaire underwent both validity and reliability The population in this study consisted of pregnant women in The validation test results showed that rcount>0.
their first, second, and third trimesters of pregnancy at in meaning the questionnaire was considered valid.
The reliability Independent Medical Practices dr.
Nur Aini Fatah,.
Sp.
OG.
test result for this questionnaire was 0.
893Ou0.
60, thus indicating Sample selection was done using a purposive sampling that the questionnaire is reliable.
technique, with inclusion criteria being first-trimester pregnant Journal of Current Pharmaceutical Sciences.
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Page 45 Ae 59 e-ISSN: 2598-2095 Data Analysis vitamin B9 and is water-soluble.
Although its natural sources can Univariate analysis was conducted to describe the data collected be obtained from daily foods, the synthetic form of folic acid is from the research by calculating the percentage results for each often utilized as a dietary supplement.
For pregnant women, variable .
Univariate analysis was applied to describe the folic acid is highly important because it plays a role in the profile of the respondents, covering age, gestational age, formation process of one-third of red blood cells and also various occupation, and education, as well as to assess the level of uterine tissues .
knowledge and the level of adherence.
The sample for this study consisted of 67 respondents, who were The relationship between the independent and dependent first-trimester pregnant women recorded as consuming folic acid variables was explained through bivariate analysis.
In this supplements at Independent Medical Practices in Kediri City.
context, this study uses the Spearman correlation test to see the The description of the respondents' characteristics in this study relationship between knowledge and compliance.
It was includes age, gestational age, occupation, and education.
established that a significant .
relationship exists if the p-value is less than or equal to 0.
05 (O0.
, and no significant relationship exists if the p-value is greater than 0.
05 (>0.
Then continues with an ordinal logistic regression test to see how Table 1.
Characteristics of Pregnant Women Respondents Frequency Percentage .
(%) Age much knowledge can predict a mother's chances of being Logistic regression analysis was conducted in two Respondent stages: .
Crude .
analysis Ai simple logistic regression 17-25 (Gen Z) 26-29 (Gen Z) 30-45 (Millenial.
of knowledge on compliance without covariates, resulting in a Highest Level of Education Crude OR.
Adjusted .
analysis Ai multiple Elementary school Junior high school Senior High School Bachelor Housewife Government employees 1 Ae 4 weeks 5 Ae 8 weeks 9 Ae 12 weeks logistic regression by including confounding variables .
ge, gender, duration of illnes.
, resulting in an Adjusted OR.
Confounding is declared significant if the difference between the Occupation Crude OR and Adjusted OR is Ou 10% .
Entrepreneur/self- RESULTS AND DISCUSSION The pregnancy period is crucial because it determines and Gestational age influences the quality of future human resources.
This is because the growth and development of the child closely depend on the health of the fetus in the womb.
Therefore, good physical condition and adequate nutritional status in pregnant women will ensure the fulfillment of fetal nutrition and the safety of the Table 1 shows that among first-trimester pregnant women, the mother during the delivery process .
age group 17Ae25 years comprised 27 respondents .
3%), the During pregnancy, there is a significant increase in nutritional largest group was in the 26Ae35-year range with 35 respondents for instance, the need for folic acid increases by .
2%), and the fewest respondents were in the 36Ae45-year age 100%, protein by 68%, calcium by 50Ae60%, and iron sees the group with 5 respondents .
5%).
This dominance of age aligns highest jump, at 200Ae300% .
Folic acid is the synthetic form of with the theory stating that 20 years is the ideal age for a first Journal of Current Pharmaceutical Sciences.
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Knowledge level results Score
Category 76% - 100% Good
56% - 75%
Enough <56% Less because, at this age, the mother generally has prime physical condition, a strong uterus to carry the fetus, and mental maturity for pregnancy care .
The most frequent final education level among the 67 Number of No.
respondents, with a frequency of 60, was senior high school/vocational school with a percentage of 53.
In contrast.
Based on the research results in Table 2, the knowledge results the lowest frequency for the respondents' final education was the for first-trimester respondents showed that 34 out of 67 junior high school level, with a percentage of 1.
This is respondents, with a percentage of 49.
3%, were in the good consistent with the theory stating that education is an effort to Furthermore, 23 respondents, with a percentage of improve capabilities, including health understanding, as a higher 3%, were in the sufficient category, and 11 respondents, with level of education tends to make it easier for a person to receive a percentage of 16.
4%, were in the poor category.
information and understand health issues .
For the folic acid definition indicator, statement 1, 52 out of 67 Regarding the occupational characteristics of the 67 respondents, respondents .
%) knew that the other name for the folic acid 25 respondents .
3%) were homemakers, 9 respondents supplement is vitamin B9.
This aligns with previous research .
4%) worked as civil servants, and 34 respondents .
explaining that folic acid is the synthetic type of vitamin B9 and worked as entrepreneurs/self-employed.
Pregnant women who is water-soluble .
In statement 2, 47 respondents .
%) knew are entrepreneurs or self-employed tend to have broader that folic acid is the synthetic form of folate needed by the body.
knowledge compared to homemakers and university graduates This is supported by research explaining that folic acid is due to factors such as a work environment that requires social produced synthetically in the form of supplements or added interaction and decision-making, high motivation to maintain through fortification into additional food products, such as health to remain productive, and supporting experience and cereals and milk .
The respondents explained that they education that encourages more active information seeking .
learned about the alternative name for folic acid and that folic Regarding the gestational age characteristics, 4 respondents acid is a synthetic form of folate from health articles and some .
0%) had a gestational age in weeks 1Ae4, 40 respondents .
from health education programs they attended.
Respondents had a gestational age in weeks 5Ae8, and 23 respondents .
obtained information from various sources, leading many had a gestational age in weeks 9Ae12.
According to the respondents to select the correct answer.
respondents' statements, at that gestational age, the respondents For the folic acid benefits indicator, in statement 3, 51 had just undergone an examination and found out that their respondents .
%) knew that regularly consuming folic acid gestational age was already in the 5Ae8-week range.
Some other supplements during pregnancy can reduce the risk of birth reasons included an irregular menstrual cycle and a late period, defects in the fetus.
The occurrence or recurrence of birth defects which prompted the mothers to immediately consult an can be prevented by providing folic acid before and during early This finding is supported by previous research Folic acid supplements can enhance the survival and showing that the majority of women only realize their pregnancy quality of life of the fetus during pregnancy .
A total of 47 when the gestational age has reached 5 to 6 weeks .
%) answered correctly on statement 4 regarding the function of folic acid in preventing brain and spinal cord However, 20 respondents still answered incorrectly.
Journal of Current Pharmaceutical Sciences.
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and continued until the stage of embryogenesis in According to .
, a lack of this nutrient, which is one of the pregnancy is completed or resolved .
important nutrients during pregnancy, has the potential to cause For the consumption rules indicator, in statement 9, 40 damage to the brain and brainstem.
%) answered correctly, indicating that For the drug side effects indicator, in statement 5, 52 respondents respondents know the recommended dosage of folic acid for .
%) answered correctly that a side effect of consuming folic first-trimester pregnant women is 400Oe600 mcg.
This aligns with acid supplements is causing nausea.
According to .
, side the research findings of .
, which found that the daily folic acid effects such as nausea, vomiting, constipation, diarrhea, and requirement for women of childbearing age and first-trimester stomach pain are felt by mothers when consuming folic acid pregnant women ranges from 400 to 600 micrograms.
These reactions even prompt them to reduce or statement 10, 52 respondents .
%) answered correctly that folic stop consuming the supplements without consulting a acid is taken once a day with a composition of 400 mcg per tablet.
healthcare professional.
In statement 6, 52 respondents .
%) The rule for taking folic acid is once a day, in accordance with the knew that side effects from folic acid usually do not occur if first-trimester dosage.
The folic acid requirement for first- consumed according to the doctor's recommended dosage.
Folic trimester pregnant women is around 400Oe600 micrograms per acid is recommended to be taken at night to alleviate the nausea day .
that often occurs after consumption, as the appropriate time to For the appropriate time for consumption indicator, in statement take the supplement is at night closer to bedtime.
Experiencing 11, 52 respondents .
%) answered appropriately, and in nausea when consuming folic acid was reported by almost all statement 12, 51 respondents .
%) answered correctly.
The respondents, but this complaint can be reduced if consumed appropriate time to consume folic acid supplements is after a according to medical instructions .
meal and starting consumption routinely during the period For the folic acid requirement indicator, in statement 7, 42 before and throughout pregnancy .
Research conducted by respondents .
%) knew that consuming foods containing folic .
added that folic acid is highly crucial, especially at the acid .
reen vegetables such as spinach, mustard greens, fruits beginning of pregnancy, because the baby's nervous system is in such as oranges, and legume.
is still insufficient to meet the daily the formation stage during that period.
folic acid requirement, thus making it necessary to consume folic The consumption period indicator is covered in statements 13 acid supplements.
This is supported by research stating that if the In statement 13, 43 respondents .
%) answered folic acid requirement is not met through food sources, pregnant correctly, and in statement 14, 53 respondents .
%) answered women are advised to consume folic acid tablets as Folic acid is not consumed only in the first trimester but supplementary support to ensure adequate intake throughout is consumed before pregnancy begins and throughout the the pregnancy period .
In statement 8, out of 67 respondents, pregnancy process.
Folic acid is needed even before the start of 44 respondents .
%) knew that folic acid consumption is not the pregnancy process.
It is recommended for women to only necessary during the first trimester of pregnancy, while 23 consume 400Oe600 micrograms of folic acid every day, starting at respondents .
%) chose that folic acid consumption is only least three months before conception occurs .
Folic acid needed during the first trimester of pregnancy.
Folic acid needs supplementation starting from the preconception period is to be consumed before and during the early phase of embryo proven to be able to reduce various pregnancy risks, such as Therefore, folic acid supplements must be taken lowering the incidence of maternal anemia, minimizing the risk during the periconceptional period .
few months before of preeclampsia, and reducing the incidence of Neural Tube Journal of Current Pharmaceutical Sciences.
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Folic acid supplementation defects, and low birth weight.
Nevertheless, the risk of stillbirth during pregnancy is proven effective in blocking almost all is much higher in pregnant women who are active smokers occurrences of neural tube defects .
compared to passive smokers .
Consuming alcohol can also For the impact of folic acid deficiency indicator, in statement 15, cause birth defects in the unborn baby .
Alcohol can cross the 45 respondents .
%) answered correctly, and in statement 16, 54 placenta, and the metabolism of alcohol in the fetus is twice as respondents .
%) answered correctly.
The consequence of not slow as in the mother.
Alcohol consumption during pregnancy, regularly consuming folic acid supplements can cause the risk of being a teratogenic substance, can cause problems in pregnancy birth defects in the fetus and can lead to premature birth.
The and puts the mother at risk.
in pregnant women, this effect can increased need for folate during pregnancy occurs because this lead to premature labor and spontaneous abortion in the early nutrient is essential in supporting and accelerating the growth trimester .
and development of the fetus.
Since folic acid plays a crucial role, it must be consumed routinely according to the doctor's prescription for the prevention of congenital defects.
Thus, pregnant women must be more aware and vigilant about the importance of folic acid consumption to avoid the occurrence of congenital abnormalities .
Low folate status during pregnancy is associated with various negative health impacts, including the risk of congenital heart defects, oral clefts .
left lip/palat.
, fetal growth restriction, low birth weight conditions.
In the study conducted at Independent Medical Practices in Kediri City, in table 3 the results obtained for the respondents' level of adherence to folic acid use showed that the majority of pregnant women were highly adherent to consuming folic acid supplements, totaling 58 respondents .
6%).
A total of 7 respondents .
4%) were in the moderate adherence category, and 2 respondents .
0%) were in the low adherence category.
Table 3.
Compliance score results Percentage No.
Score Category The external impact indicator is covered in statements 17 and 18.
12 - 16
High The respondents who answered correctly were 55 respondents 17 - 32 Medium .
%) and 59 respondents .
%), respectively.
This indicates that 34 - 48 Low and also premature birth .
most respondents know and are aware of the dangers of cigarette smoke if inhaled by pregnant women and that consuming alcohol during pregnancy is very dangerous.
Smoking poses a great risk to smokers and their surroundings.
The large number of smokers who disregard their environment leads to high exposure to cigarette smoke for others, including vulnerable pregnant women.
Pregnant women who are passive smokers will experience an increase in carbon monoxide levels up to 5 times and nicotine and tar up to 4 times in their bodies, which potentially triggers premature birth .
In general, exposure to cigarette smoke during pregnancy poses adverse effects on the fetus and can lead to various complications in passive smokers, such as abortion, placental abruption, placenta previa, placental insufficiency, premature birth, fetal
(%)
In statement 1, 47 respondents .
1%) answered 'never,' indicating that the majority of respondents never miss taking folic acid supplements.
Pregnant women must consume folic acid routinely and must not skip it during the period before and throughout pregnancy .
Five respondents .
5%) answered 'sometimes,' and 15 respondents .
4%) answered 'always.
According to the respondents' accounts, they sometimes still miss the schedule for taking folic acid.
The reason given by some respondents was that they missed or forgot to take folic acid due to daily activities or busyness, as almost all respondents are Infrequent folate intake is often due to the mother's demanding condition and dense activity schedule, causing them to forget to consume folic acid .
Journal of Current Pharmaceutical Sciences.
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Due to the awareness of the importance .
6%), answered 'never,' indicating that the majority of of folic acid during pregnancy, the increased need for folic acid respondents never decided to stop taking folic acid.
Folic acid is during pregnancy encourages mothers to routinely consume very important and necessary to prevent the risk of congenital supplements so that their daily requirement of 400Oe600 mcg is abnormalities such as neural tube defects, anemia, and to met, especially in the first trimester which is very crucial for fetal support optimal fetal development.
Therefore, there is no reason development .
Respondents who answered 'sometimes' for mothers to discontinue the use of folic acid supplements totaled 4 respondents .
0%), and those who answered 'always' throughout the pregnancy .
Six respondents .
0%) answered totaled 3 respondents .
5%).
This is because mothers who 'sometimes,' 2 respondents .
0%) answered 'often,' and 3 frequently run out of folic acid supplements are related to their respondents .
5%) answered 'always.
' According to the level of knowledge regarding the importance of folic acid during respondents' accounts, some intentionally decided not to take pregnancy and the economic status of the pregnant mother, folic acid.
The researcher found that some mothers could not leading to frequent shortages .
tolerate the nausea when consuming folic acid.
Mothers In Question 5, the highest percentage, with 59 respondents experienced side effects from folic acid consumption such as .
1%) answering 'never,' shows that they never skip taking a nausea and vomiting .
Factors that cause pregnant women dose of folic acid.
This finding is reinforced by the research of .
, not to adhere to consuming folic acid include: dislike of the which concluded that the high awareness of pregnant women tablet's taste and smell, feeling lazy, forgetfulness, and a lack of regarding the importance of folic acid for maternal and fetal knowledge or unawareness of the supplement's importance .
health is the main driving factor.
Because of a good The highest percentage in question 3, with 63 respondents understanding of the benefits of folic acidAisuch as the .
0%) answering 'never,' indicates that the majority of prevention of neural tube defects (NTD), anemia, and other respondents never forgot to refill their prescription due to their pregnancy complicationsAimothers become committed to awareness of the importance of folic acid supplements during consuming folic acid supplements routinely according to the In a study conducted in Kebonagung Village, some dosage prescribed by a doctor or pharmacist, and never miss a pregnant women showed high adherence to consuming folic single dose.
A total of 8 respondents .
9%) stated 'sometimes' acid supplements to maintain their own health and that of the in their consumption of folic acid.
This can be explained by fetus, thus they never forgot to refill their folic acid supplement several factors, namely a busy schedule, the effects of nausea prescription .
One respondent .
5%) answered 'sometimes,' experienced during pregnancy, and a lack of education or in- and 3 respondents .
5%) answered 'always.
' Some mothers who depth understanding of the importance of regular folic acid answered 'sometimes,' 'often,' and 'always' had irregular consumption .
schedules, such as dense daily routines that could cause "The highest percentage .
%), with 58 respondents .
6%),
pregnant women to forget to refill their folic acid prescription.
answered 'never'.
This indicates that the majority never miss This is supported by research conducted by .
, which explained taking folic acid supplements when they feel better.
Folic acid has that non-adherence can also occur due to a lack of knowledge a crucial role in supporting fetal brain and nervous system regarding the importance of adherence and patients' dense development, especially during the first trimester of pregnancy, and therefore, consumption must be consistent even if the The highest percentage in question 4, with 60 respondents mother feels healthy .
Respondents who answered .
6%) answering 'never,' indicates that they never ran out of 'sometimes' amounted to 9 respondents .
4%), which implies Journal of Current Pharmaceutical Sciences.
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It can be concluded that mothers who do not take the instructions and rules conveyed by healthcare professionals folic acid still lack understanding regarding the importance of .
folic acid supplements during pregnancy to support the For Question 10, the most frequent answer was 'never,' chosen gestational period .
by 63 respondents .
0%).
The rule for taking folic acid is once a "For Question 7, out of 67 respondents, the highest percentage day, adhering to the first-trimester dosage.
Pregnant women in .
0%), representing 65 respondents, answered 'never'.
The the first trimester require approximately 400 to 600 micrograms majority of respondents do not miss consuming folic acid even of folic acid daily .
There were 4 respondents .
0%) who when they are sick.
Meanwhile, 2 respondents .
0%) admitted reported taking folic acid 'sometimes,' which suggests that some to taking the supplement only 'sometimes,' indicating that some of these pregnant mothers are still consuming folic acid more pregnant women are still not taking it routinely.
This than once the recommended dosage.
Therefore, the role of the inconsistency is influenced by several factors: side effects husband or family members is highly necessary to remind and .
ausea, vomiting, constipation, diarrhea, abdominal pai.
support pregnant women.
The aim is to ensure the pregnant reducing or stopping the supplement without consulting a mother does not forget to consume or exceed the established healthcare professional (Doctor.
Midwife.
Nurs.
dose of folic acid .
Family support plays a vital role in burdened to take vitamin supplements every day.
or forgetting increasing patient adherence to treatment.
One concrete form of to take them because the recommended consumption time is at this support is by providing a family member as a medication night .
monitor, as patients who do not have a monitor tend to be less For Question 8, there were 64 respondents .
5%) who compliant with therapy.
The monitor's tasks include: reminding answered 'never,' and 3 respondents .
5%) who answered and accompanying the patient in regular medication Folic acid is an essential nutrient that must be consumption, as well as maintaining diet and physical activity to consumed consistently throughout pregnancy because mothers prevent complications .
understand the importance of folic acid for fetal health during For Question 11, 63 respondents .
0%) answered 'never'.
This gestation .
Factors that can cause pregnant women to miss is supported by the availability of various brands and prices of taking folic acid include laziness or stress.
A person's adherence folic acid supplements on the market at a relatively affordable to medication is influenced by various factors.
These factors There were 4 respondents .
0%) who answered include psychological conditions .
uch as depressio.
, a 'sometimes'.
This is also influenced by one of the adherence personality tending towards low self-esteem and pessimism, factors, namely the socioeconomic factor of economic income.
limited insight, and laziness, all of which can decrease the level of Low income and financial constraints can cause non-adherence adherence to treatment .
to treatment.
Consequently, only a few mothers did not purchase For Question 9, the highest percentage answered 'never,' totaling folic acid due to the high cost .
For Question 12, 37 respondents .
2%) answered 'never'.
This 'sometimes' amounted to 3 respondents .
5%).
Adherence to the suggests that there is still a lack of awareness and commitment recommended dosage facilitates monitoring and reduces the risk among mothers to consistently maintain a sufficient supply of of side effects.
Changing the dosage without consulting a doctor folic acid supplements without having to wait until they run out.
is strongly discouraged because excessive consumption can lead Lack of support from healthcare providers and incomplete to risks.
A pregnant mother's adherence to vitamin healthcare service features cause patients to forget or be hindered .
5%).
Respondents Journal of Current Pharmaceutical Sciences.
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about the benefits and importance of folic acid, the higher their Meanwhile, for mothers who answered 'sometimes' .
level of adherence .
It was also found that 2 first-trimester respondents, 19.
4%), 'often' .
respondents, 16.
4%), and 'always' pregnant mothers .
4%) had good knowledge but moderate .
respondents, 9.
0%), this indicates that these respondents Additionally, 18 respondents .
9%) had sufficient understand the importance of folic acid supplements during knowledge and high adherence.
Mothers with poor knowledge pregnancy and demonstrate full awareness of maintaining a and high adherence amounted to 9 respondents .
5%).
Only supply of supplements before they run out.
This can be fostered two respondents .
3%) had poor knowledge and also by the responsiveness of healthcare workers and the availability demonstrated low adherence.
Although the number is small, this of supplements to increase treatment adherence and make it finding indicates that a lack of knowledge among pregnant easier for mothers to purchase and consume them consistently women can cause them to be unaware of the importance of .
consuming folic acid during pregnancy, which ultimately lowers Table 4.
Cross-tabulation between the Relationship between Knowledge Level and Adherence High women's knowledge, especially regarding the benefits of folic acid for preventing pregnancy complications and supporting Compliance Knowledge their level of adherence.
Therefore, improving pregnant Total Medium Low fetal development, is crucial and contributes significantly to increasing their adherence level .
Good
46,27
2,99
0,00
Enough 26,87 7,46 0,00 Conceptually, this study examines only a single predictor Less 13,43 0,00 2,99 .
86,57 10,45 2,99 mediating and moderating variables.
According to the Health The cross-tabulation shows that, among first-trimester pregnant women with high adherence, there were 31 mothers .
who had good knowledge, 18 mothers .
87%) who had sufficient knowledge, and 9 mothers .
43%) who had poor First-trimester pregnant women who had moderate adherence with a good knowledge level amounted to 2 people .
99%), moderate adherence with a sufficient knowledge level amounted to 5 people with a percentage of 7.
46%, while the poor knowledge level category had 0 respondents .
%).
First-trimester pregnant women with low adherence were not found .
respondents or 0%) in the good knowledge and sufficient knowledge categories, but they were found in the poor knowledge category, totaling 2 respondents .
99%).
Belief Model .
and Self-Determination Theory .
, factors such as self-efficacy, intrinsic motivation, and perceived barriers act as crucial mediators between knowledge and compliance This study only demonstrates the existence of an association, but it does not explain the underlying mechanisms or causal pathways.
Table 5.
Spearman correlation test results between Knowledge and Adherence Parameter Pengetahuan Kepatuhan 0,255* p-value 0,037 Kekuatan Lemah "The analysis results show a SpearmanAos correlation coefficient .
255 with a significance value .
-valu.
Based on .
guidelines for correlation strength, the rs value of 0.
255 falls within the 0.
20Ae0.
39 range, indicating a weak correlation.
The Based on Table 5, the results of the cross-tabulation show that 31 direction of the correlation is positive, meaning that higher levels respondents .
27%) had good knowledge and high adherence.
of respondent knowledge tend to be associated with increased This research finding is consistent with the study Journal of Current Pharmaceutical Sciences.
Vol.
10 No.
March 2026.
Page 45 Ae 59 results by .
, showed a p-value of 0.
<0.
This value indicates a significant relationship between the level of knowledge of pregnant women and their adherence to consuming folic acid at the Malawei Public Health Center.
Manoi District.
Sorong City.
This means that the lower the respondent's e-ISSN: 2598-2095 Tabel 6.
Binary Logistic Regression Analysis Results Ai Crude Model (Without Covariate.
Variabel
Pengetahuan Baik vs Tidak Baik 1,253 0,744 Crude
3,50
0,8215,04
0,037
Keterangan Signifikan* understanding of the benefits and importance of folic acid, the Crude analysis showed that respondents with good knowledge lower their level of adherence.
50 times more likely to be compliant than those with poor The value of rs=0.
=0.
indicates a positive, weak, and knowledge (OR 3.
95% CI 0.
82Ae15.
p = 0.
Nevertheless, statistically significant relationship between knowledge and the wide confidence interval spanning 1 suggests significant As an effect size, an rs of 0.
255 corresponds to a imprecision in the estimate, potentially reflecting the small small-to-medium effect based on .
conventions, where r=0.
sample size of the non-compliant group .
= .
is categorized as small, 0.
30 as medium, and 0.
50 as large.
This value implies that while the knowledge variable provides limited practical contribution in a bivariate context, it remains statistically meaningful within the study population .
= .
Table 7.
Results of Multiple Logistic Regression Analysis Ai Adjusted Model (Controlling for Confounding Variable.
Variable Adjus Perub.
(%)
Confoun Good Knowle 3,31 0,14 5,4% No* Age (>40t.
2,00 0,35 Gender
1,50
0,59
Long Illness (> 5t.
2,50 0,26 The Adjusted OR of 3.
% CI: 0.
65Ae16.
p = 0.
indicates that after controlling for age, gender, and duration of illness, 'Good' knowledge remains associated with 3.
31 times higher odds of compliance compared to 'Poor' knowledge.
However, the p-value of 0.
149 (> 0.
in the adjusted model suggests that this relationship is no longer statistically significant after controlling for covariates.
This may be due to a decrease in statistical power resulting from the increased number of parameters in the model relative to the small sample size .
= "Good knowledge about iron or folic acid supplements increases adherence, and conversely, if knowledge is low, the level of adherence is also low.
The test results demonstrate a directly proportional relationship between the level of knowledge and adherence among first-trimester pregnant
CONCLUSION
women regarding folic acid usage: good knowledge tends to The research findings conducted at Independent Medical increase adherence to consuming folic acid, and conversely.
Practices in Kediri City concluded that there is a significant poor knowledge is associated with lower adherence to folic acid relationship or correlation between the level of knowledge of consumption .
first-trimester pregnant women and their adherence to consuming folic acid supplements.
This correlation was statistically proven with a p-value of 0.
004, which is less than the significance threshold .
O0.
Journal of Current Pharmaceutical Sciences.
Vol.
10 No.
March 2026.
Page 45 Ae 59
ACKNOWLEDGEMENT
e-ISSN: 2598-2095 Tailored Approach.
In Current Developments in Nutrition (Vol.
The researcher would like to convey sincere appreciation to all respondents who took the time to participate in this study by completing the questionnaire.
Thanks, are also extended to the clinic management for granting permission and providing full 6.
Issue 9, pp.
1Ae.
https://doi.
org/10.
1093/cdn/nzac118 Choirunnisa.
Febriyana.
Sari.
Ambarwati.
, & Nurdiantami.
PENGARUH ASAP ROKOK
PADA IBU HAMIL: STUDI LITERATUR.
Jurnal Kesehatan Tambusai, support for the implementation of this research.
183Ae192.
https://doi.
org/10.
31004/jkt.
REFERENCE