PERANAN STATUS VITAMIN A TERHADAP KEBERHASILAN SUPLEMENTASI BESI PADA IBU HAMIL

Abstract

Back ground : Iron and vitamin A deficiency are common nutritional problems in developing countries with high prevelance in pregnant women. iron deficiency anemia has bcen found is pregnant women together. Theoretically there is an interelation between iron and vitamin A metabolism. Thus, it is suggested that there is correlation between iron and vitamin A status. Objective : The aim of this study was to investigate the relationship between vitamin A status presuplementation with the success of iron supplementation in pregnant women. Method : This study was a one jgoup pre lest -postest design conducted in Karangawen and Tlogorejo Public Health Center, Demak Subdistrict during the of period April until November 2002. The subject of this research were 51 pregnant women with 14-24 weeks of pregnancy who were anemic, but with good nutritional status . The vitamin A level was measured by FIPLC, feritin level was measured by IRMA' s method and Hb was measured by SLS method: The reference values for vitamin A deficiency < 30p.gicll and for iron deficiency anemia are feridn level -7. 30 ng/ml and Haemoglobin < 11g/d1. Results : The mean of serum vitamin A level pre supplementation was 32.7 ± 9.32 itgidl which is withim the normal value. Post supplementation the mean \rake became 23,3 ± 6.06 lagl dl , which is lower than the normal value. Feritin level before and after supplementation were 33.5 ± 28.6 nal and 20.9 ± 13.81 ng/dl. The odd ratio of vitamin A deficiency for the increase of lib level postsuplementation was 60.92 (CI : 14,37-258.1). Thus the risk of failure of 1-lb improvement ill pregnant women with vitamin A deficiency was 60.92 limes higher. Conclusion : The risk for failure in a lib kvel improvement after iron supplementation is higher in pregnant women with vitamin A deficiency. Latar. Belakang : Defisiensi besi dan vitamin A merupakan ganguan gizi yang sering dijumpai di negara berkembang dengan prevalensi yang cukup tinggi pada ibu hamil. Pada penderita dengan defisiensi vitamin A sub klinik kronis terjadi anemia dengan karakteristik yang sama dengan anemia .clefisiensi besi. Secant teoritis ditengarai adanya interelasi rnetabolisme zat besi dengan vitamin A, hingga di duga ada hubungannya antara status vitamin A dan status besi pada seseorang. Tujuan penelitian int adalah : untuk mengetahui apakah ada hubungan antara status vitamin A pra suplementasi dengan keberhasilan suplementasi path ibu hamil anemia Metode Penelitian : Penelitian ini merupakan penelitian one group pre test postest yang dilakukan di Puskesinas Karangawen dan Tlogorejo pada priode April sanmai November 2002. Subic!: penelitian adalah ibu hamil dengan umur kehamilan 1424 ininggu yang menderita anemia dan lidak rnenderila gizi huruk. Pada subjek pcnelitian dilakukan pengukuran kadar vitamin A serum deng•n metode HPLC, kadar feritin dengan metode IRMA dan kadar Hb dengan sysmex. Dikategori delisiensi vitamin A apabila kadar vitamin A < 30 ng/d1, detisiensi bcsi apabila kadar feritin < 30 ng/ml dan anemia bila kadar Hb < 11.0 g/dl. Basil : Rerata kadar vitamin A serum (retinol) pm suplementasi 32.7 ± 9.32 tighil yang menunjukan nilai batas kadar normal. Sedangkan kadar viarnin A scrum pascasuplementasi 23.3 ± 6.06 tig/d1, di bawah batas kadar vitamin A serum normal. Feritin prasuplementasi (33.5 ± 28.6 ng(ml) menunjukan cadangan besi cukup baik dan feritin pasca suplementasi (20.9 ± 13.81 ng/rn1). Besar risiko (rasio odds) defisiensi vitamin A terhadap terjadinya kegagalan peningkatan Hb pasca suplementasi 60.92 (CI:14.37-258.1) berati resiko gagal kenaikan Hb pada orang yang deft siensi vitamin A lebih besar. Kesimpulan : Resiko gagal kenaikan pasca suplementasi pada ibu hamil yang detisiensi vitamin A lebth besar dati path mereka yang tak mengalaini defisiensi vitamin A.