ASSESSMENT OF FOLATE STATUS OF SOME FILIPINO PREGNANT WOMEN

Background: While pregnancy may bring about folate deficiency due to large fetus requirement for folate and result to macrocytic type of anemia, nutritional anemia in pregnant women is oftentimes, attributed to iron deficiency. In the Philippines, studies on folate status among pregnant women are very limited. Currently, there is a growing interest in the folate status of pregnant women because of its important role in the prevention of neural tube defects, spontaneous abortion and intrauterine growth retardation. Objectives: To assess the folate status of pregnant women at different stages of pregnancy; To determine the association of age, parity, age of gestation, length of education, use of supplements and some nutrients to folate status in terms of red blood cells (RBC) and serum folate of pregnant women. Methods: The study involved 186 pregnant women at various stages of pregnancy who attended prenatal check-up in five different health centers of Parañaque, Metro Manila, who met the inclusion criteria of the study. RBC and serum folate was analyzed using radioimmunoassay. Values lower than 175 ng/mL and 3.0 ng/mL for RBC and serum folate, respectively, were considered as indicative of subclinical folate deficiency. Hemoglobin was determined by cyanmethemoglobin method and was assessed using the WHO criteria. Gynecologically related data, e.g. age, gravida, parity, length of gestation, history of miscarriages and other information (e.g. use of supplements, length of education) were asked from and recorded for each subject. Energy and some nutrients were evaluated using the one-day 24- hr recall. Diet was also evaluated on the basis of frequency of consumption. Adequacy of intakes was evaluated using the 1989 Philippine RDA while intakes of folate from foods, which do not have values in the Philippine FCT, were evaluated based on the FCTs of other Asian countries. Results: Based on RBC folate (<175 ng/mL), folate deficiency was observed in 12.4% of pregnant subjects. Based on serum folate (<3.0 ng/mL), which is a measure of early stage of folate deficiency, the prevalence was 43.5%. The higher prevalence of folate deficiency based on RBC folate among pregnant women in the 1 st trimester compared to pregnant women of 2 nd and 3 rd trimesters suggests that a significant number of women may have entered pregnancy with inadequate folate stores. The lower prevalence of folate deficiency in the later stage of pregnancy may be attributed to the use of prenatal supplements. There were more supplement users among pregnant women in the 2 nd and 3 rd trimesters of pregnancy than in the 1 st trimester. Evaluation of diets showed that iron and folate were the least adequate, meeting only 29.5% and 33.7% of the RDA, respectively, as compared to energy, protein and vitamin A. Pregnant women ate folate-dense foods less frequently than folate-light foods. The significant correlation that exists between mother's education and RBC folate suggests that