The effect of weekly iron supplementation with and without deworming on hemoglobin was investigated in a double-masked, placebo-controlled field trial. Subjects were 289 preschoolers who were randomly divided into three groups. Groups 1 and 2 received 30 mg Fe once weekly and group 3 received a placebo. Group 1 additionally received anthelminthic treatment. Supplements were administered by the mothers, who were educated about iron deficiency beforehand. In the iron-supplemented groups prevalence of anemia decreased from 37.2% to 16.2% (P < 0.001). Hemoglobin increased by an average of 6.9 +/- 9.8 g/L in the two iron-supplemented groups (n = 191), which was greater (P < 0.001) than the increase of 1.9 +/- 8.0 g/L in the placebo group. None of the subjects had hookworm, and anthelminthic treatment did not have an additional effect. Iron supplements administered once weekly by mothers reduced anemia without major involvement of health staff.
Improving women's knowledge of pregnancy-related risks and involving family members, particularly the husband and importantly for less-educated women, improved adherence to IFA supplementation. ANC visit opportunities must be optimized to provide women with sufficient numbers of IFA tablets along with health information (especially on pregnancy-related risks) and partner support counselling.
Pregnant and non-pregnant women in Indramayu, West Java were examined for nutritional status, using anthropometric indicators. For the pregnant women, longitudinal data on nutritional status, iron consumption and weight gain were examined in relation to neonatal weight and length. Comparing the non-pregnant women's average nutritional status with reference tables for height, weight and MUAC, they placed at the 25th percentile or less on all indicators. Using original formulae to estimate pre-pregnancy weight and pregnancy weight gain, the study showed that 18% of pregnant women had a pre-pregnancy weight of under 40 kg and the average pregnancy weight gain was under 9 kg. Comparing estimated pregnancy weight gain with the amount of weight gain needed to compensate for generally low pre-pregnancy weight, only about 9% of women gained adequately. In multiple regression models that controlled for other maternal and neonatal factors, iron consumption during pregnancy was a significant predictor of full-term (37 weeks or more) neonatal weight (P = 0.01) and length (P = 0.01). Consumption of one or more tablets (200 mg ferrous sulfate and 0.25 mg folic acid) per week by women during pregnancy was associated with increased neonatal weight (by 172 g on average) and length (by 1 cm on average). Adequate weight gain during pregnancy and maternal height also contributed to the specification of the neonatal weight model (P = 0.07 for both). In the neonatal length model, maternal height was also nearly significant (P = 0.03). The same models did not explain the variability in neonatal weight and length in the pre-term group (< 37 weeks gestation).
Obesity is a major contributor to the global burden of chronic disease and disability. In developing countries like Indonesia, obesity often co-exists with undernutrition. Data from national basic health research 2007 showed that overnutrition was found among all age groups, on a double digit scale, with similar magnitude in urban and rural areas and higher prevalence in adult female. In contrary to 14% undernourished children under the age of 5 years, 12% of their counterparts were overnourished; for 6-14 years 10% vs. 6%; and for 15 years and above 15% vs. 19%. The purpose of the review is to raise awareness on the increasing obesity problem and to set recommendations to prevent obesity. Stunted adults in developing countries are 1.2 times more likely to be overweight than non-stunted adults. Approaches to overcoming obesity in adulthood emphasize dietary changes, increasing physical activity and behaviour modification. It is important for Indonesia to target nutrition intervention for female adolescents, pregnant woman to first 2 years of life, initiate nutrition education for school-age children and disseminate Holistic Healthy Framework Approach with key message 'Initiate healthier food choices'. Prompt Nutrition Guidelines and the use of lower body mass index cut-off should be considered.
AbstrakBerat badan lahir 2.500 gram yang hingga kini merupakan standar ukuran risiko morbiditas dan mortalitas bayi merupakan faktor risiko penting yang berdampak hingga usia dewasa. Saat ini, bayi dengan berat badan lahir di bawah 3.000 gram dihubungkan dengan risiko penyakit degeneratif pada usia dewasa. Penelitian ini bertujuan mengetahui hubungan berat badan lahir dengan status gizi ibu meliputi berat badan prahamil, pertambahan berat badan selama kehamilan, dan kadar hemoglobin ibu pada trimester ketiga kehamilan. Penelitian kuantitatif dengan desain cross sectional ini menggunakan sumber data sekunder rekam medis Rumah Sakit Ibu dan Anak Budi Kemuliaan Jakarta. Analisis dilakukan secara bivariat dan multivariat menggunakan metode uji chi square dan korelasi regresi. Hasil studi menunjukkan hubungan yang bermakna antara berat badan prahamil dan pertambahan berat badan ibu selama kehamilan dengan berat badan lahir. Setelah dikontrol berbagai variabel lain, analisis regresi logistik ganda menemukan berat badan ibu prahamil, pertambahan berat badan selama kehamilan, usia ibu, dan urutan kelahiran merupakan faktor yang memengaruhi berat badan lahir. Berat badan prahamil ibu merupakan faktor yang paling berpengaruh terhadap berat badan lahir (odds ratio, OR = 6,64). Oleh sebab itu, ibu dengan status gizi prahamil kurang yang sedang merencanakan kehamilan perlu lebih diperhatikan. Kata kunci: Berat badan lahir, kehamilan, mortalitas bayi, status gizi ibu AbstractThe weight of 2.500 gram is still being used as the cut off point to predict the risk of baby's morbidity and mortality. Recently birth weight of less than 3.000 gram is being rigorously assess as a risk factor for noncommunicable disease in adulthood. Therefore it is important to assess factors that are affecting the fetal growth and development. The objectives of this study is to determine the relationship between infant's birth weight and mother's nutritional status, i.e. pre-pregnancy weight, weight gain during pregnancy, and maternal haemoglobin level in the 3rd trimester as well as several other factors. The study design is cross sectional using secondary data from medical record of Budi Kemuliaan Hospital Jakarta. The result of chi square and correlation regression test shows there is significant relationship between pre-pregnancy weight and weight gain during pregnancy and birth weight. The multiple logistic regression test reveals that pre-pregnancy weight, weight gain during pregnancy, maternal age, and birth order are factors that are effecting birth weight significantly, with pre-pregnancy weight as the dominant factor (odds ratio, OR = 6,643). Therefore, it is imperative to give more attention to undernourished women who are planning their pregnancy.
Lingkar lengan atas (LiLA) telah digunakan sebagai indikator proksi terhadap risiko kekurangan energi kronis (KEK) untuk ibu hamil di Indonesia karena tidak terdapat data berat badan prahamil pada sebagian besar ibu hamil. Selama ini, ambang batas LiLA yang digunakan adalah 23,5 cm. Penelitian ini bertujuan untuk menguji validitas LiLA terhadap indeks massa tubuh (IMT) yang merupakan indikator yang lebih baik untuk mengetahui status gizi wanita dewasa. Penelitian ini menggunakan data Riset Kesehatan Dasar tahun 2007 pada perempuan dewasa usia 20 – 45 tahun di seluruh Indonesia. Hasil penelitian ini ialah ambang batas LiLA yang paling optimal untuk mendeteksi risiko KEK di Indonesia berada pada titik 24,95 cm (Se = 85%; Sp = 75%). Terdapat perbedaan ambang batas antarprovinsi tetapi tidak lebih dari 2 cm, terendah di Provinsi Nusa Tenggara Timur (23,95 cm) dan tertinggi di Provinsi Sulawesi Utara dan Gorontalo (25,95 cm). LiLA mempunyai korelasi yang kuat (r = 0,67; nilai p < 0,000) dengan IMT. Direkomendasikan untuk menggunakan ambang batas LiLA 24,95 cm untuk mendeteksi risiko KEK wanita usia 20 – 45 tahun, sementara23,5 cm untuk outcome kehamilan, yaitu morbiditas dan mortalitas bayi.Kata kunci: Lingkar lengan atas, indeks massa tubuh, kekurangan energi kronisAbstractMid-upper arm circumference has been used in Indonesia as an proxy indicator of chronic energy malnutrition risk for pregnant women because there isn’t any data of prepregnancy weight in most of pregnant women. The boundary used was 23,5 cm. The objective of the study is to validate the currentboundary related to body mass index (BMI) indicator, which is believed as a better indicator in identifying women nutritional status. The study is using Riset Kesehatan Dasar 2007 data on Indonesian adult women aged 20 – 45 years old. The study found the boundary is 24,95 cm for detecting chronic energy malnutrition risk among adult women (Se = 85%; Sp = 75%). There are differences among provinces but not more than 2 cm, the lowest is in Nusa Tenggara Timur (23,95 cm) and the highest is in North Sulawesi and Gorontalo (25,95 cm). Mid upper arm circumference has a strong relationto BMI (r = 0,67; p value < 0,000). It is recommended to use mid-upper arm circumference boundary 24,95 cm to detect chronic energy malnutrition on 20 – 45 years old women and 23,5 cm to pregnancy outcome, baby morbidity, and mortality.Key words: Mid-upper arm circumference, body mass index, chronic energy deficiency
Clinical screening for pallor is one of the most common methods of screening for anaemia. Health workers examine the face, inner lower eyelids or conjunctiva, palms, nail beds, and other body parts for paleness or pallor that may be a sign of anaemia. MotherCare found 17 studies that evaluated the sensitivity and specificity of using pallor to identify individuals with anaemia. The focus was to review the sensitivity of pallor screening to detect individuals with severe anaemia and to make recommendations to improve the sensitivity of screening for pallor. The studies confirmed that sensitivities increased as the haemoglobin level decreased.
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