Jakarta, May 2016

Journal Reading

EFFECTS OF A COMBINED MICRONUTRIENT

SUPPLEMENTATION ON MATERNAL
BIOLOGICAL STATUS AND NEWBORN
ANTHROPOMETRICS MEASUREMENTS: A
RANDOMIZED DOUBLE-BLIND, PLACEBOCONTROLLED TRIAL IN APPARENTLY
HEALTHY PREGNANT WOMEN
I Hininger, M Favier, J Arnaud, H Faure, JM Thoulon, E Hariveau, A Favier, AM
Roussel.

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

dr. Rina K. Kusumaratna, M.Kes
GROUP VII
JUSTHESYA FITRIANI F.P (030.07.128)
YUTI PURNAMASARI (030.09.282)

Departement of Public Health

Faculty of Medicine Trisakti University

JOURNAL IDENTITY

JOURNAL
IDENTITY
Title

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

Type

Prospective study
Researcher

I Hininger, M Favier, et.al.

Publicated on :
European Journal of Clinical Nutrition p.52-59
Department of obstetrics and gynecology, France

INTRODUCTION

INTRODUCTI
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
Associated with:
Pregnant woman
New born

MICRONUTRIE
NT

Deficiency
percentage of
nutrient in
pregnant

Effect to
anthropometry
new born baby

GOAL

Effects of
multivitamin dan
multimineral
supplement

Healthy
pregnant
woman

SUBJECTS AND METHODS

METHOD
Subject
A total of 100 apparently healthy women receiving prenatal
care between 12 and 16 weeks of gestation in the Obstetric
Departments of Grenoble and Lyon Hospitals in France
Treatmet
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

METHOD
Supplementation
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.

Clinical follow-up and sampling

At birth, weight, height and clinical parameters were

measured in newborns. Maternal blood samples were
collected after overnight fasting, at the enrolment (1472
weeks) and at the last prenatal visit

MICRONUTRIENT DETERMINATIONS

Plasma zinc and copper, and red blood cell copper

concen-trations were determined by flame atomic
absorption spectrometry

RESULTS

RESULT
S
Table 1. baseline characteristic of participating woman at enrolmant

DISCUSSION

DISCUSSI
ON
In this study:
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 showed that:

maternal supplementation resulted in a positive

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

DISCUSSION (2)

a positive effect of supplementa-tion using single

micronutrient such as Zn Mg (Makrides &
Crowther, 2000) or folate (Iyengar & Rajalakshmi, 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.

CONCLUSION

CONCLUSION

Concluded that:
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

QUESTIONS & ANSWERS

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 2700g was
significantly higher in placebo.

2.

No one information which is not in line with us

3.

The paper very helpful as a source of knowledge to improve

nutritional status of indonesian children or people.

REFERENCES

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, 7787.
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, 297318.
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, 103116.
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, 523532.
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, 327335.

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 Examination Survey, 19881994. J. Nutr. 130S, 1367S1373S.
8. Brown KH, Peerson JM & Allen LH (1998): Effect of zinc supplementation on childrens growth: a meta-analysis of intervention
trials. Bibl. Nutr. Dieta 54, 7683.
9. Cargnoni AA, Gregorini G, Ceconi C, Maiorca R & Ferrari R
(1994): Lipid peroxidation in normal pregnancy and preeclampsia.
Adv. Exp. Med. Biol. 336, 42034207.
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, 755762.

THANK YOU