Health literacy of pregnant women and its association with methyl-group donor intake and folic acid supplementation: a cross-sectional study

Adequate health literacy (HL) can be particularly important among pregnant women, as it can have an impact on maternal and fetal health. Deliberate intake of folate through food and folic acid supplementation (FAs) is essential for women in reproductive age. Dietary intake of methyl-group donors (MGDs) via maternal nutrition may influence the infant’s health and may affect reproductive outcomes through epigenetic mechanisms. The aim of our study was to assess HL in relation to (MGD) intake among pregnant women, and to assess health knowledge as part of health literacy. 124 pregnant women were involved in this cross-sectional study. Data were collected using two validated HL questionnaires, and a food frequency questionnaire (FFQ) to estimate MGD intake. Statistical analyses included the calculation of means, correlation coefficients, and multiple linear regression analysis. The HL of pregnant women was found problematic (50.8% Newest Vital Sign Test, NVS; 46.7% Brief Health Literacy Screening Tool, BRIEF). The estimated intake of dietary folate, methionine, choline and betaine were 264.7 ± 134.6 µg/d; 2303 ± 1209 mg/d; 248.1 ± 110.8 mg/d, and 127.1 ± 65.8 mg/d (mean ± standard deviation, SD), respectively. Before pregnancy 58.87% of respondents did not take FAs; during pregnancy, this decreased to 31.45%. Pregnant women did not reach adequate HL. Further evaluation of health literacy, MGD intake, is required to formulate suitable nutritional intake for pregnant women in Hungary. It is suggested that providing better information to pregnant women could improve their adherence to folic acid supplementation recommendations.

• Publication year

  2025

• Venue

  BMC Public Health

• Publication date

  2025-11-07

• Fields of study

  Medicine

• Identifiers
  DOI 10.1186/s12889-025-25239-xPMID 41204212PMCID 12595826
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Influence of folic acid knowledge on effective folic acid intake in Chinese pregnant women: a cross-sectional study

  2023cited by this paper
• Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement.

  2023cited by this paper
• Scientific opinion on the tolerable upper intake level for folate

  2023influential reference
• Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review

  2023cited by this paper
• Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies

  2022cited by this paper
• Inadequate Choline Intake in Pregnant Women in Germany

  2022influential reference
• Epigenetic Effect of Maternal Methyl-Group Donor Intake on Offspring’s Health and Disease

  2022influential reference
• Validation of health literacy questionnaires in Hungarian adult sample

  2021influential reference
• Health Literacy in Pregnant Women: A Systematic Review

  2021cited by this paper
• Methyl Donor Nutrients in Chronic Kidney Disease: Impact on the Epigenetic Landscape.

  2019cited by this paper
• “I can’t read and don’t understand”: Health literacy and health messaging about folic acid for neural tube defect prevention in a migrant population on the Myanmar-Thailand border

  2019cited by this paper
• Low health literacy and excess body weight: a systematic review.

  2018cited by this paper
• Maternal intake of methyl-group donors affects DNA methylation of metabolic genes in infants

  2017influential reference
• The effect of paternal methyl-group donor intake on offspring DNA methylation and birth weight

  2017cited by this paper
• [Hungarian Diet and Nutritional Status Survey - The OTAP2014 study. V. Vitamin intake of the Hungarian population].

  2017influential reference
• Dietary Reference Values for vitamin B6

  2016cited by this paper
• Vitamin supplementation for preventing miscarriage.

  2016cited by this paper
• Dietary Reference Values for choline

  2016cited by this paper
• Reproducibility and validity of an FFQ to assess usual intake of methyl-group donors

  2015cited by this paper
• Dietary intake and food sources of choline in European populations.

  2015influential reference
• Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU)

  2015influential reference
• Validation of a food-frequency questionnaire assessment of methyl-group donors using estimated diet records and plasma biomarkers: the method of triads

  2014cited by this paper
• Estimation of choline intake from 24 h dietary intake recalls and contribution of egg and milk consumption to intake among pregnant and lactating women in Alberta

  2014influential reference
• Health literacy and its association with perception of teratogenic risks and health behavior during pregnancy.

  2014cited by this paper
• Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes.

  2013cited by this paper
• Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q)

  2013cited by this paper
• Measurement Variation Across Health Literacy Assessments: Implications for Assessment Selection in Research and Practice

  2012cited by this paper
• Effect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation

  2012cited by this paper
• The role of nutrition on epigenetic modifications and their implications on health.

  2012cited by this paper
• American Diabetes Association Guide to Nutrition Therapy for Diabetes

  2012cited by this paper
• Prevention of Neural-Tube Defects with Periconceptional Folic Acid, Methylfolate, or Multivitamins?

  2011influential reference
• Low Health Literacy and Health Outcomes: An Updated Systematic Review

  2011cited by this paper
• Effects and safety of periconceptional folate supplementation for preventing birth defects.

  2010cited by this paper
• Perinatal folate supply: relevance in health outcome parameters.

  2010cited by this paper
• Folic acid: a public-health challenge.

  2006influential reference
• The newest vital sign?

  2006cited by this paper
• The meaning and the measure of health literacy

  2006cited by this paper
• WHO Health Promotion Glossary: new terms.

  2006cited by this paper
• Folic acid: a public-health challenge.

  2006cited by this paper
• Vitamin supplementation for preventing miscarriage.

  2005cited by this paper
• Quick Assessment of Literacy in Primary Care: The Newest Vital Sign

  2005cited by this paper
• Evidence for suboptimal use of periconceptional folic acid supplements globally

  2004influential reference
• Brief questions to identify patients with inadequate health literacy.

  2004cited by this paper
• Health promotion glossary (1998)

  1998cited by this paper

• No citing papers are available for this paper.