HUBUNGAN ASUPAN MAKANAN, SUPLEMENTASI Fe DAN ASAM FOLAT DENGAN KADAR HEMOGLOBIN PADA IBU HAMIL RIWAYAT KURANG ENERGI KRONIS DAN ANEMIA SAAT MENYUSUI (THE RELATIONSHIP OF FOOD INTAKE, Fe AND FOLIC ACID SUPPLEMENTATION ON HEMOGLOBIN LEVEL IN PREGNANT WOMEN)

Abstract

Pregnant women with past history of CED have a higher risk 2,76 times to suffer anemia than normal pregnant women. Fe and folic acid supplementation is one program to overcome iron deficiency anemia in the pregnant women in Boyolali but the incidence rate of anemia remains high (42,9%). This study was to analyze the relationship of food intake, Fe and folic acid supplementation on hemoglobin level in pregnant women with history of CED and anemia of breastfeeding women. This research study used analytic observation with cross sectional approach. The subject of 42 breastfeeding women with past history of CED and anemia in the third trimester of pregnancy in five public health centers in Boyolali. Data of supplementation and nutrient intake was obtained by interview. Nutritional status was determined using upper arm circumference and BMI. Hemoglobin level was measured by using cyanmethemoglobin method. Statiscally analyzed using correlation and multiple regression tests. The breastfeeding women had low food intake (<70% RDA) including macro and micro nutrients. Food intake and nutritional status in breastfeeding women negatively affected hemoglobin level in breastfeeding women (B=-0,005; p=0,040 and B=-0,134; p=0,016 respectively). Fe and folic acid supplementation in pregnant women  with CED and anemia significantly influenced hemoglobin level during breastfeeding (B=0,720; p=0,016). Completed supplementation of iron-folic acid in pregnant women with CED and anemia could increase 0,720 g/dL hemoglobin levels during breastfeeding.

Ibu hamil dengan kurang energi kronis (KEK) berpeluang menderita anemia 2,76 kali dari pada ibu hamil normal. Suplementasi Fe dan asam folat merupakan salah satu cara mengatasi anemia defisiensi besi tetapi angka kejadian ibu hamil di Kabupaten Boyolali dengan anemia masih tinggi (42,9%). Penelitian ini bertujuan menganalisis hubungan asupan makanan, suplementasi Fe dan asam folat dengan kadar hemoglobin pada ibu hamil riwayat KEK dan anemia saat menyusui. Jenis penelitian observasional analitik dengan pendekatan cross sectional. Subjek penelitian 42 ibu menyusui dengan riwayat KEK dan anemia pada trimester III dari lima Puskesmas di Boyolali. Data suplementasi Fe dan asam folat serta asupan zat gizi diperoleh dengan wawancara. Status gizi ditentukan dengan LILA dan IMT. Kadar hemoglobin ditentukan dengan metode cyanmethemoglobin. Analisis statistik menggunakan uji korelasi dan multivariat regresi ganda. Hasil menunjukkan bahwa asupan energi, lemak, karbohidrat, zat besi dan asam folat pada ibu menyusui termasuk kategori defisit (<70% AKG). Asupan makanan dan status gizi ibu menyusui berhubungan negatif terhadap kadar hemoglobin saat menyusui (B=-0,005, p=0,040 dan B=-0,134, p=0,016). Suplementasi Fe dan asam folat pada ibu hamil riwayat KEK dan anemia berhubungan secara signifikan terhadap kadar hemoglobin saat menyusui (B=0,720, p=0,016). Dapat disimpulkan bahwa suplementasi Fe dan asam folat pada ibu hamil KEK dan anemia berpeluang menaikkan 0,720 g/dL kadar hemoglobin ibu saat menyusui.