HUBUNGAN SATUS GIZIMIKRO FO;A VITAMIN B12, SENG DAN VITAMIN A PRA SUPLEMENTASI DENGAN PENCAPAIAN KADAR HOMOGLOBIN HARAPAN IBU HAMOL

Abstract

Anemia prevalence in pregnancy is remarkably high wordwide, particular)/ in developing countries such as Indonesia. Supplementation programs to overcome anemia in pregnant women have been carried out over a long period of time, but the prevalence of anemia is still high. It may because the target define is too highg or other micronutrients deficiency has influenced result of iron supplementation programs. This study was a case control study. A total samples of 60 pregnant, women were obtained. Twenty cases were subjects who could not reach the expected hemoglobin level, while the rest were determined as control groups exposur variables were the level of folic acid, vitamin B12, zinc and vitamin A. Expected hemoglobin level achievement was the dependent variable. While iron and protein status was considered as confounding variables. Bivariate analysis was conducted by calculating odds ratio, while multivariate analysis was carried out using multiple logistic regression. The was no subject with albumin deficiency, while the prevalence vitamin B12, folic acid and zinc deficiency was sufficiently high. There was no significant differences in food intake between those who could and who could not reach expected hemoglobin level. The odds ratio of subject who were and were not folic acid deficient was 2,25 (95% CI = 0,75 —6,79) . The odds ratio for vitamin B12, zinc and vitamin A were 0,89 (95% CI = 0,75 — 6,73), 3,31 (95% CI = 1,01 —10,86), and 16,7 (95% CI = 1,84 — 151,84) respectively. The final model found in the multiple logistical regression where vitamin A, Thefore it could be concluded that only vitamin A is significantly associated with expected hemoglobin level achievement. Prevalensi anemia ibu hamil tinggi terutama di negara-negara yang sedang berkembang termasuk Indonesia. Penanggulangan anemia ibu hamil dengan suplementasi besi folat sudah lama berjalan namun prevalensi anemia masih tinggi. Kemungkinan target yang ditetapkan terlalu tinggi atau karena defisiensi zat gizimikro yang lain mempengaruhi hasil suplementasi besi. Penelitian ini bertujuan untuk mempelajari hubungan antara status gizimikro folat, B12, seng dan vitamin A pra suplementasi dengan pencapaian kadar hb harapan. Rancangan penelitian ini adalah kasus kontrol. Populasi sebanyak 60 sampel yang telah dikumpulkan materinya pada penelitian primer. Kasus diperoleh dari sampel yang tidak dapat mencapai kadar Hemoglobin harapan sebanyak 20 sampel dan kontrol sebanyak 40 sampel. Status folat, vitamin B12, seng dan vitamin A dinyatakan sebagai variabel paparan. Pencapaian kadar hemoglobin harapan ditetapkan sebagai variabel efek. Status besi dan albumin diperhitungkan sebagai variabel perancu. Analisis dilakukan dengan menghitung Casio odds secara bivariat, analisis secara multivariat menggunakan regresi logistik majemuk. Pada semua sampel tidak ada yang mengalami defisiensi albumin, sedangkan defisiensi vitamin B12, folat dan seng cukup tinggi. Asupan zat gizi, selama suplementasi tidak berbeda bermakna antara yang berhasil mencapai kadar hb harapan maupun yang tidak Besar risiko antara kelompok yang defisiensi folat dan tidak dalam mencapai hb harapan sebesar 2,25 (95% CI 0,76 - 6,73). Pada defisiensi vitamin B12 OR-nya sebesar 0,89 (95% CI = 0,75 — 6,73). Besar risiko defisiensi seng sebesar 3,31 (95% CI = 1,01- 6,73) sedangkan path vitamin A OR-nya sebesar 16,71 (95% CI = 1,84 —151,34). Pada pengujian dengan regresi logistik majemuk yang terdapat dalam model akhir adalah status vitamin A sehingga variabel yang paling mempengaruhi pencapaian kadar hemoglobin harapan adalah vitamin A.