Studies on the extent of adherence to folic acid (FA) and factors related were restricted in a wide variety and confirmed discrepancy in the identical region and among exceptional populations. via detecting those elements, there could be an opportunity to improve the compliance and then decrease in the prevalence of unwanted consequences as NTD. The health care companies have a crucial role in this adherence. A gosectional observe that uses a multistage sampling approach turned into used. It becomes conducted amongst multiple number one health care centers in Al-Ahsa town. The pattern size turned into 176 pregnant ladies based on the superiority of recognition concerning FA intake during being pregnant. It turned into 160 first of all, however, 10% of sufferers were introduced so one can manipulate the dropouts. the prevalence of use of FA among pregnant in their first trimester turned into satisfactory (87%). simplest 2% of pregnant have a previous toddler with NTD. by means of assessing the FA adherence degree, we located that only 15% are especially adherent. A not unusual motive (71%) of low adherence changed into forgetfulness secondary to taking care of others observed via being an operating mother and unawareness of FA significance. 13% of pregnant did now not take FA in any respect.