worldwide

7.8 Million
children are born with a serious
genetic birth defect, annually
March of Dimes (2008)
3.3 Million
of these children die
due to their birth defect within
the first five years of life

worldwide
Majority of affected children who survive are
disabled for life.
March of Dimes (2008)
Common Causes of Birth Defects
a.Teratogens (alcohol, certain drugs, etc)
b. Maternal Iodine deficiency syndrome
c. Congenital syphilis
d. Congenital rubella syndrome
e. Folic acid deficiency
In the Philippines…
Population of 88.57 Million (NSO, 2007)
Annual Birth Rate of 1.7 Million babies
37.9% births in a health facility
61.4% are home deliveries

Information on birth defects is very limited:

- Causes of most types are unknown
- Risk factors are unknown
- Knowledge on preventive measures is limited
- No established local incidence on birth defects
Ten (10) Leading Causes of Infant Mortality
( Number & Rate/1000 Livebirths & Percentage Distribution)
(Philippine Health Statistics, 2004)

Causes Number Rate Percent

1. Bacterial sepsis of newborn 3,402 2.0 15.1

2. Respiratory distress of newborn 2,500 1.5 11.1
3. Pneumonia 1,940 1.1 8.6
4. Disorders related to short gestation and
1,750 1.0 7.8
low birth weight, not elsewhere classified
5. Congenital Pneumonia 1,501 0.9 6.7
6. Congenital malformation of the heart 1,451 0.8 6.4
7. Neonatal aspiration syndrome 1,256 0.7 5.6
8. Other congenital malformation 1,082 0.6 4.8
9. Intrauterine hypoxia and birth asphyxia 1,030 0.6 4.6
10. Diarrhea and gastro-enterities of
914 0.5 4.1
presumed infectious origin
Top 10 Birth Defects in the Philippines
1. Multiple congenital anomalies
2. Congenital malformations of the tongue, mouth, and pharynx
(ankyloglossia)
3. Cleft palate with cleft lip
4. Down Syndrome
5. Congenital deformities of the feet (talipes equinovarus)
6. Other congenital malformations of the face and neck
(pre-auricular skin tag)
7. Anencephaly
8. Congenital malformations of the musculoskeletal system
(diaphragmatic hernia, gastroschisis)
9. Hypospadias
10. Polydactyly and syndactyly

DOH-ENHR
Research shows :
Adequate intake of folic acid
BEFORE conception can
prevent the incidence of
neural tube birth defects
by 70%.
In the Philippines
• Awareness on the significance of Folic
acid supplementation among Filipino
women in reproductive age is LOW
• There is a need for an intensive
awareness campaign on the significance
of folic acid supplementation among
women in reproductive age
What is folic acid?
• Folic acid or folate is a B vitamin (B9).

• It cannot be stored in the body, so you need a

continuous supply of the vitamin in your diet.

• Folic acid helps

- make healthy new cells
- form red blood cells
- produce DNA, the building block of the human body
which carries genetic information.

• Folic acid works along with other vitamins to help

the body break down, use, and creation of new
proteins.
Who needs folic acid?
EVERYONE!
especially…..
• All women of reproductive age
• Pregnant women
Why should I take folic acid?
• Taking the right amount of
folic acid before and during
pregnancy helps prevent
certain types of neural tube
birth defects.
• Get enough folic acid every
day - especially one month
before getting pregnant
and during the first three
months of pregnancy.
What if I don’t get enough
folic acid?
• Your baby’s brain and/or
spine may not develop
properly.

• The neural tube forms in the

first 28 days of pregnancy,
before a woman knows
she is pregnant.
Craniorachischisis
Meningomyelocoele
sac contains malformed spinal cord tissue
Spina bifida
an incomplete closure of the
spinal cord and spinal column
Encephalocoele
brain tissue protrudes out to the skin
from an abnormal opening in the skull
Anencephaly
severe underdevelopment of the brain
What are the causes of
Neural Tube Defects?
• Multifactorial – a combination of
genetic and environmental causes
• Genetic causes are unknown
• Environmental causes include:
– Diabetes Mellitus
– Anti-epileptic drug Valproate
What is the recommended
levels of folic acid?
• All women in reproductive
age should receive
400 micrograms (0.4 mg)
of folic acid daily
• Women who have had
a previous child with neural
tube defect should receive
4000 micrograms (4 mg)
of folic acid daily
 Where can I get folic acid?

However, you should

still check the label
and make sure that
400mcg or 100% folic
acid is indicated

Pure folic acid supplements

only NTD prevention method proven to date
Where can I get folic acid?
Folic acid Fortified foods
Bread
Pasta
Cereals
Powdered Juice
Where can I get folic acid?
Natural Food Folates

Birth defects prevention

not proven

Need to consume
twice as much

Folate levels decrease

upon cooking
Where can I get folic acid?
Natural Food Folates
Vegetables
Green and Leafy Vegetables

Brocolli Malunggay
Okra Kalabasa
Peas Alugbati
Beans Kangkong
Mungbean Repolyo
String beans
Where can I get folic acid?
Natural Food Folates
Fruits Meat, Fish
Poultry
Orange
Banana Chicken Liver
Strawberry Beef Liver
Mango Fish
Melon Egg
Papaya
Apple
Avocado
 Food Composition
Amount
Food Serving Size (Micrograms) %Daily Value*
Chicken liver 3.5 0z 770 193
Breakfast cereals 1/2 to 1 1/2 cup 100-400 25-100
Braised beef liver 3.5 oz 217 54
Asparagus 1/2 cup 132 33
Spinach, cooked 1/2 cup 131 33
Pasta 2 oz. 100-120 25-30
Black beans 1/2 cup 128 32
Rice,cooked 3/4 cup 60 15
Tomato juice 1 cup 48 12
Orange 1 medium 47 12
Broccoli, coooked 1/2 cup 39 10
French fries large order 38 10
Bread 1 slice 38 10
* based on Daily Value for folate of 400 micrograms
Source: US FDA (Food Values of Portions Commonly Used, 16th edition)