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    EFFECTS OF A COMBINED MICRONUTRIENT

    SUPPLEMENTATION ON MATERNAL

    BIOLOGICAL STATUS AND NEWBORN  ANTHROPOMETRICS MEASUREMENTS: A

    RANDOMIZED DOUBLE-BLIND, PLACEBO-

    CONTROLLED TRIAL IN APPARENTLY

    HEALTHY PREGNANT WOMEN

    Pembimbing : dr. Min Kyaw Htet, MBBBS, M.Med.Sc, PhD

      dr. Rina K.Kusumaratna, M.Kes

    Journal Reading Jakarta, May 2016

    I Hininger, M Favier, J Arnaud, H Faure, JM Thoulon, E Hariveau, A Favier, AM

    Roussel.

    Departement of Public Health

    Faculty of Medicine – Trisakti University

    GROUP VII

    JUSTHESYA FITRIANI F.P (030.07.128)

     YUTI PURNAMASARI (030.09.282)

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    JOURNAL IDENTITY

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      IDENTITY

    • Effects of a combined micronutrient supplementation on maternal biological status and newborn anthropometrics measurements: a randomized double-blind, placebo-controlled trial in apparently healthy pregnant women

    Title :

    • Prospective study

    Type :

    • I Hininger, M Favier , et.al.

    Researcher :

    • European Journal of Clinical Nutrition p.52-59 •

    Department of obstetrics and gynecology, France

    Publicated on:

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    INTRODUCTION

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    ON

    •  Micronutrient deficiencies contribute to impaired growth,health, and development (Ladipo, 2000) and the relation between maternal diet and the physical measurements of the new born has been described

    • Pregnant woman • New born

     Associated with:

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    NT

    Deficiency percentage of nutrient in pregnant

    Effect to anthropometry new born baby

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    GOAL

    Effects of

    multivitamin dan multimineral

    supplement

    Healthy

    pregnant

    woman

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    SUBJECTS AND METHODS

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    METHOD

    • A total of 100 apparently healthy women receiving prenatalcare between 12 and 16 weeks of gestation in the Obstetric Departments of Grenoble and Lyon Hospitals in France

    Subject

    • the supplement or the placebo from 1472 weeks of gestation to delivery. The tablets were given out for 2 months, but with the recommendation to return the residual blisters every mont

    Treatmet

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    METHOD

    • The subjects received a daily supplement containing vitamin C (60 mg), b-carotene (4.8 mg), vitamin E (10 mg), thiamin (1.4 mg), riboflavin (1.6 mg), niacin (15 mg), pantothenic acid (6 mg), folic acid (200 mg), cobalamin (1 mg), Zn (15 mg as citrate), Mg (87.5 mg as glycerophosphate), Ca (100 mg as

    carbonate) or a placebo.

    Supplementation  

    • At birth, weight, height and clinical parameters were measured in newborns. Maternal blood samples were

    collected after overnight fasting, at the enrolment (1472weeks) and at the last prenatal visit

    Clinical follow-up and sampling

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    MICRONUTRIENT DETERMINATIONS

    Plasma zinc and copper, and red blood cell copper

    concen-trations were determined by flame atomic absorption spectrometry

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    RESULTS

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    S

    Table 1. baseline characteristic of participating woman at enrolmant

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    DISCUSSION

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    ON

    • As expected, the supplemental intake of vitamins was efficient to improve significantly the blood levels of vitamin E, C, b-carotenes, folic acid, B2 and B6

    • The study did not find statistical differences Effects of micronutrients on pregnant women and newborn

    In this study:

    • maternal supplementation resulted in a positive

    effect on infant birth weights, and significantlyreduced the number of infants with birth weights below 2700 g which is associated with an increased risk of morbidity

    In this study showed that:

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    DISCUSSION (2)

    a positive effect of supplementa-tion using single

    micronutrient such as Zn Mg (Makrides &

    Crowther, 2000) or folate (Iyengar & Rajalaksh-

    mi, 1975; Rolschau et al, 1981). Recently, the role

    of vitamins E and C in preventing premature rupture of membrane, which could lead to an

    increased birth weight, was also hypothesized

    (Woods et al, 2001). Since the gestational age was

    not different between the two groups, a possible influence of the maternal nutrient cannot be

    excluded.

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    CONCLUSION

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    CONCLUSION

    • This randomized double-blind study suggests that the use of combined micronutriment supplements, at nutritional doses, improved

    babies birth weight and maternal biological status. These preliminary results need to be confirmed in larger further studies, but suggest that optimal micronutrient nutrition should be encouraged, not only in women with poor

    nutritional status or in complicated pregnancies, but also in apparently healthy pregnant women, without any particular life style risk

    Concluded that:

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    QUESTIONS & ANSWERS

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    1. Based on the journal that we read, we got new information that the

    use of combined micronutriment supplements at nutritional doses

    improved babies birth weight and maternal biological status, while

    the number of infants with birth weights below 2!!g was

    significantl" higher in placebo.

    2.  #o one information which is not in line with us

    $. %he paper ver" helpful as a source of &nowledge to improve

    nutritional status of indonesian children or people.

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    REFERENCES

    REFERENCES

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    REFERENCES

    1.Arnaud J, Bellanger J, Bienvenu F, Chappuis P & Favier A (1986):

    Recommended method for assaying serum zinc with flame atomic absorption. Ann. Biol. Clin. Paris 44, 77–87.

    2.Arnaud J, Bellanger J, Chappuis P, Favier A & Galliot M (1985):

    Recommendations for the assay of serum copper by flame atomic

    absorption spectrometry. Ann. biol. Clin. 43, 297–318.

    3.Arnaud J, Fortis I, Blachier S, Kia D & Favier A (1991): Simultaneous

    determination of retinol, a-tocopherol and b-carotene in serum by isocratic

    high performance liquid chromatography. J. Chromatogr. 572, 103–116.

    4.Bates JH, Young S, Galway L, Traub AI & Hadden A (1997): Antioxidant

    status and lipid peroxidation in diabetic pregnancy.

    5.Br. J. Nutr. 78, 523–532.

    6.Bayoumi RA & Rosalki SB (1976): Evaluation of methods of coenzyme

    activation of erythrocyte enzymes for detection of deficiency of Vitamins

    B1, B2 and B6. Clin Chem 22, 327–335.

    REFERENCES(2)

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    REFERENCES(2)

    7.Briefel RR, Bialostosky K, Kennedy-Stephenson J, McDowell MA,

    Ervin RB & Wright JD (2000): Zinc intake of the U.S. Population: findings from the third National Health and Nutrition Examina-

    tion Survey, 1988–1994. J. Nutr. 130S, 1367S–1373S.

    8.Brown KH, Peerson JM & Allen LH (1998): Effect of zinc supple-

    mentation on children’s growth: a meta-analysis of intervention

    trials. Bibl. Nutr. Dieta 54, 76–83.

    9.Cargnoni AA, Gregorini G, Ceconi C, Maiorca R & Ferrari R

    (1994): Lipid peroxidation in normal pregnancy and preeclampsia.

     Adv. Exp. Med. Biol. 336, 4203–4207.

    10.Cederberg J, Siman CM & Eriksson UJ (2001): Combined

    treatment with vitamin E and vitamin C decreases oxidative stress

    and improves fetal outcome in experimental pregnancy. Pediatr.

    Res. 49, 755–762.

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    THANK YOU 