Manfaat dan Keamanan Multiple Micronutrient Supplements dalam Kehamilan

Oleh :

dr. William Alexander Setiawan, SpOG

Suplementasi mikronutrien dengan multiple micronutrient supplementation atau MMS penting dan aman dikonsumsi selama kehamilan. MMS mengandung berbagai vitamin dan mineral yang berkontribusi penting dalam menjaga kesehatan ibu serta mendukung pertumbuhan dan perkembangan janin selama kehamilan.[1]

Peningkatan kebutuhan nutrisi pada masa kehamilan meningkatkan risiko morbiditas ibu serta luaran janin, seperti berat badan lahir rendah (BBLR), prematuritas, dan small-for-gestational age (SGA). Risiko ini akan menurun bersamaan dengan konsumsi MMS, yang juga memiliki risiko efek samping yang rendah, sehingga aman untuk dikonsumsi selama kehamilan.[1-3]

Peran Mikronutrien dalam Kehamilan

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Referensi

1. Stevens GA, Beal T, Mbuya MNN, Luo H, Neufeld LM, Addo OY, et al. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from population-representative surveys. The Lancet Global Health 2022;10:e1590–9. https://doi.org/10.1016/S2214-109X(22)00367-9.
2. Saros L, Hart K, Koivuniemi E, Egan B, Raats M, Laitinen K. Micronutrient supplement recommendations in pregnancy vary across a geographically diverse range of countries: a narrative review. Nutrition Research 2024;123:18–37. https://doi.org/10.1016/j.nutres.2023.12.012.
3. Keats EC, Haider BA, Tam E, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2019. https://doi.org/10.1002/14651858.CD004905.pub6.
4. World Health Organization. WHO guideline: Implementing effective actions for improving adolescent nutrition 2018.
5. UNICEF East Asia and Pacific Regional Office. Multiple Micronutrient Supplementation in Pregnancy: Implementation Guidance in Southeast Asia 2022.
6. Bourassa MW, Osendarp SJM, Adu‐Afarwuah S, Ahmed S, Ajello C, Bergeron G, et al. Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low‐ and middle‐income countries. Annals of the New York Academy of Sciences 2019;1444:6–21. https://doi.org/10.1111/nyas.14121.
7. Shinde S, Wang D, Yussuf MH, Mwanyika-Sando M, Aboud S, Fawzi WW. Micronutrient Supplementation for Pregnant and Lactating Women to Improve Maternal and Infant Nutritional Status in Low- and Middle-Income Countries: Protocol for a Systematic Review and Meta-analysis. JMIR Res Protoc 2022;11:e40134. https://doi.org/10.2196/40134.
8. Smith ER, Shankar AH, Wu LS-F, Aboud S, Adu-Afarwuah S, Ali H, et al. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries. The Lancet Global Health 2017;5:e1090–100. https://doi.org/10.1016/S2214-109X(17)30371-6.
9. West KP, Shamim AA, Mehra S, Labrique AB, Ali H, Shaikh S, et al. Effect of Maternal Multiple Micronutrient vs Iron–Folic Acid Supplementation on Infant Mortality and Adverse Birth Outcomes in Rural Bangladesh: The JiVitA-3 Randomized Trial. JAMA 2014;312:2649. https://doi.org/10.1001/jama.2014.16819.
10. Kementerian Kesehatan Republik Indonesia. Hasil Utama Riskesdas 2018 2019.
11. Christian P, Stewart CP. Maternal Micronutrient Deficiency, Fetal Development, and the Risk of Chronic Disease. The Journal of Nutrition 2010;140:437–45. https://doi.org/10.3945/jn.109.116327.
12. Mei Z, Jefferds ME, Namaste S, Suchdev PS, Flores‐Ayala RC. Monitoring and surveillance for multiple micronutrient supplements in pregnancy. Maternal & Child Nutrition 2018;14:e12501. https://doi.org/10.1111/mcn.12501.
13. Sunawang, Utomo B, Hidayat A, Kusharisupeni, Subarkah. Preventing low Birthweight through Maternal Multiple Micronutrient Supplementation: A Cluster-Randomized, Controlled Trial in Indramayu, West Java. Food Nutr Bull 2009;30:S488–95. https://doi.org/10.1177/15648265090304S403.
14. Shankar AH, Jahari AB, Sebayang SK, Aditiawarman, Apriatni M. Effect of maternal multiple micronutrient supplementation on fetal loss and infant death in Indonesia: a double-blind cluster-randomised trial. The Lancet 2008;371:215–27. https://doi.org/10.1016/S0140-6736(08)60133-6.
15. Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Nomor HK.01.07/MENKES/1092/2024 tentang Standar Suplemen Zat Gizi Mikro Untuk Ibu Hamil 2024.
16. World Health Organization. WHO Model List of Essential Medicines. 23rd edition. Geneva: World Health Organization; 2023.

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