EFFECT OF MULTI MICRONUTRIENT SUPPLEMENTATION ON HEMOGLOBIN LEVELS IN PREGNANT WOMEN WITH ANEMIA

Rati Purnama Sari, Noor Pramono, Sri Wahyuni, Muchlis Achsan Udji Sofro, Melyana Nurul Widyawati


DOI: https://doi.org/10.33546/bnj.291

Abstract


Background: The coverage of 90 Fe tablets in Semarang in 2015 was 26.619 of 29.490 pregnant women (97%) but the incidence of anemia in pregnant women was still quite high. One important factor which influences the levels of hemoglobin is multi micronutrient.

Objective: This study aims to analyze the changes in hemoglobin levels with multi micronutrient supplementation in pregnant women with anemia.

Methods: A quasi-experimental study with randomized control group pre-posttest design. The study samples were 40 pregnant women with gestational age of 20 ± 1 weeks divided into two groups, the intervention group (multi micronutrient supplementation) and the control group (Fe supplementation) for six weeks. The study was conducted from November 2016 to January 2017. The levels of hemoglobin were measured using cyanmethemoglobin. Paired t test and independent t test were used for data analyses.

Results: The average of the increase in hemoglobin levels after multi micronutrient supplementation was 1.545 (1.292) g/dl, whereas the average of the increase in hemoglobin levels after Fe supplementation was 0.757 (0.742) g/dl. The difference in hemoglobin levels before and after multi micronutrient supplementation was significantly different (p=0.049). Cohen’s d effect size test showed value of 0.748.

Conclusion: Multi micronutrient supplementation could improve hemoglobin levels. The increase in the levels of hemoglobin with multi micronutrient supplementation was higher than Fe supplementation.


Keywords


multi micronutrient; Fe; pregnant women with anemia

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References


Almatsier, S. (2002). Prinsip dasar ilmu gizi [Basic principle of science of nutrition]. Jakarta: Gramedia Pustaka Utama.

Azra, P. A., & Rosha, B. C. (2015). Faktor-faktor yang berhubungan dengan status anemia ibu hamil di wilayah kerja Puskesmas Air Dingin Kecamatan Koto Tangah, Kota Padang [Factors related to anemia status in pregnant mothers in the working area of Puskesmas Air Dingin Kecamatan Koto Tangah, Kota Padang]. Jurnal Kesehatan Reproduksi, 6(2), 89-95.

Balitbangkes. (2014). Buku studi diet total: Survei konsumsi makanan individu [Learning of total diet: Survey of individual food consumption]. Jakarta: Balitbangkes Kementerian Kesehatan Republik Indonesia.

bank, W. D. (2016). Prevalence of Anemia among pregnant women. from http://databank.world bank.org/data/reports.aspx?source=2&type=metadata&series=SH.PRG.ANEM

Barasi, M. (2013). Nutrition at a glance. New Jersey: John Wiley & Sons.

Besuni, A., Jafar, N., & Indriasari, R. (2013). Hubungan asupan zat gizi pembentuk sel darah merah dengan kadar hemoglobin pada ibu hamil di Kabupaten Gowa [Relationship of nutrient intake forming red blood cells with hemoglobin level in pregnant mothers in Gova Regency]. Makassar, Indonesia: Universitas Hasanuddin.

Cendani, C., & Murbawani, E. A. (2011). Asupan mikronutrien, kadar hemoglobin dan kesegaran jasmani remaja putri [Micronutrient intake, hemoglobin level, and pysical condition of female adolescents]. Media Medika Indonesiana, 45(1), 26-33.

Chen, L., Liu, Y.-F., Gong, M., Jiang, W., Fan, Z., Qu, P., . . . Li, T.-Y. (2012). Effects of vitamin A, vitamin A plus zinc, and multiple micronutrients on anemia in preschool children in Chongqing, China. Asia Pacific Journal of Clinical Nutrition, 21(1), 3-11.

Dahlan Sopiyudin, M. (2009). Besar sampel dan cara pengambilan sampel [Sample size and sampling]. Jakarta: Salemba Medika.

Departemen Kesehatan. (2008). National report of Riskesdas 2007. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan Republik Indonesia.

Dinkes. (2014). Health profile of Central Java Province. Central Java, Indonesia: Department of Health of Central Java.

Fatimah, S., Hadju, V., Bahar, B., & Abdullah, Z. (2011). Pola konsumsi dan kadar hemoglobin pada ibu hamil di Kabupaten Maros, Sulawesi Selatan [Consumption pattern and hemoglobin level in pregnant mothers in Maros Regency, South Sulawesi]. Makara Kesehatan, 15(1), 31-36.

Grober, U. (2013). Mikronutrien: Penyelarasan metabolik, pencegahan, dan terapi [Microntrient: Metabolic adjustment, prevention, and therapy]. Jakarta: EGC.

Haider, B. A., & Bhutta, Z. A. (2006). Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Systematic Review, 4(4).

Hofbrand, A., Petit, J., & Moss, P. E. (2013). General aspect of anemia. Jakarta: EGC

Hyder, S. M. Z., Haseen, F., Khan, M., Schaetzel, T., Jalal, C. S. B., Rahman, M., . . . Mehansho, H. (2007). A multiple-micronutrient-fortified beverage affects hemoglobin, iron, and vitamin A status and growth in adolescent girls in rural Bangladesh. Journal of Nutrition, 137(9), 2147-2153.

Kawai, K., Spiegelman, D., Shankar, A. H., & Fawzi, W. W. (2011). Maternal multiple micronutrient supplementation and pregnancy outcomes in developing countries: meta-analysis and meta-regression. Bulletin of World Health Organization, 89(6), 402-411.

Kumar, M. V., Nirmalan, P. K., Erhardt, J. G., Rahmathullah, L., & Rajagopalan, S. (2014). An efficacy study on alleviating micronutrient deficiencies through a multiple micronutrient fortified salt in children in South India. Asia Pacific Journal of Clinical Nutrition, 23(3), 413-422.

Ma, A. G., Schouten, E. G., Sun, Y. Y., Yang, F., Han, X. X., Zhang, F. Z., . . . Kok, F. J. (2010). Supplementation of iron alone and combined with vitamins improves haematological status, erythrocyte membrane fluidity and oxidative stress in anaemic pregnant women. British Journal of Nutrition, 104(11), 1655-1661.

MOH. (2013). Riset kesehatan dasar RISKESDAS (Basic health research). Jakarta: Ministry of Health of the Republic of Indonesia.

Oppusunggu, R. (2009). Pengaruh pemberian tablet tambah darah (Fe) terhadap produktivitas tenaga kerja wanita pensortir daun tembakau di PT X Kabupaten Deli Serdang [Effect of Fe tablet on productivity of women labor, tobacco leaf sorter at PT X Kabupaten Deli Serdang] [tesis]. Medan: Universitas Sumatera Utara.

Ramakrishnan, U. (2000). Nutritional anemias. Florida: CRC press.

Tampubolon, B., & Hadi, H. (2005). Hubungan asupan zat gizi dengan status besi pada remaja putri SMU di Kabupaten Jayapura [Relationship of nutrient intake and iron status of female adolescents at SMU di Kabupaten Jayapura]. Yogyakarta: Universitas Gadjah Mada.

Tay, H. S., & Soiza, R. L. (2015). Systematic Review and meta-analysis: What is the Evidence for oral iron supplementation in treating anaemia in older people? Drugs Aging, 32(2), 149-158.

Utama, T. A., Listiana, N., & Susanti, D. (2013). Perbandingan zat besi dengan dan tanpa vitamin C terhadap kadar hemoglobin wanita usia subur [Comparison of of iron with and withouth vitamin C on hemoglobin level in fertile women]. Kesmas: National Public Health Journal, 7(8), 344-348.

WHO. (2015). Multiple micronutrient supplementation during pregnancy. Retrieved January 12, 2016, from http://www.who.int/elena/titles /micronutrients_pregnancy/en/

WHO. (2014). Global nutrition targets 2025: anaemia policy brief. Geneva: World Health Organization.


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