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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 maternalbiological status and newborn anthropometrics measurements: arandomized double-blind, placebo-controlled trial in apparentlyhealthy 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 betweenmaternal diet and the physical measurements of the new bornhas been described

• Pregnant woman• New born

Associated with:


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NT

Deficiencypercentage ofnutrient inpregnant

Effect toanthropometrynew born baby


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GOAL

Effects of

multivitamin danmultimineral

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 ObstetricDepartments of Grenoble and Lyon Hospitals in France

Subject

• the supplement or the placebo from 1472 weeks of gestationto delivery. The tablets were given out for 2 months, but withthe recommendation to return the residual blisters everymont

Treatmet


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METHOD

• The subjects received a daily supplement containing vitaminC (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 ascitrate), Mg (87.5 mg as glycerophosphate), Ca (100 mg as

carbonate) or a placebo.

Supplementation

• At birth, weight, height and clinical parameters weremeasured 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 atomicabsorption 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 wasefficient to improve significantly the blood levels of vitaminE, C, b-carotenes, folic acid, B2 and B6

• The study did not find statistical differences Effects ofmicronutrients 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 birthweights below 2700 g which is associated withan 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 prematurerupture 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 possibleinfluence of the maternal nutrient cannot be

excluded.


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CONCLUSION


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CONCLUSION

• This randomized double-blind study suggeststhat the use of combined micronutrimentsupplements, at nutritional doses, improved

babies birth weight and maternal biologicalstatus. These preliminary results need to beconfirmed in larger further studies, but suggestthat optimal micronutrient nutrition should beencouraged, not only in women with poor

nutritional status or in complicatedpregnancies, but also in apparently healthypregnant women, without any particular lifestyle 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 atomicabsorption. 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