3. ONWUDE & et al 1996 A RANDOMIZED Two hundred and thirty-three Two group: placebo vs. 2.7 g of There is no evidence 17
DOUBLE BLIND pregnant women at high risk of MaxEpa daily (1.62 g of from this study for
PLACEBO developing proteinuric or eicosapentaenoic acid and 1.08 any useful effect of
CONTROLLED TRIAL nonproteinuric pregnancy induced g of docosahexaenoic acid) fish oil
OF FISH OIL IN HIGH hypertension or asymmetrical supplementation for
RISK PREGNANCY intrauterine growth retardation women at high risk
of adverse outcomes
from a pregnancy
4. Olsen & et al 2000 Randomized clinical Four prophylactic trials enrolled fish oil provided 2.7 g and 6.1 g Fish oil had no 18
trials of fish oil 232, 280, and 386 women who n-3 fatty acids/day in the effect on
supplementation in had experienced previous pre- prophylactic and therapeutic
high risk pregnancies term delivery, intrauterine growth trials
intrauterine
retardation, or pregnancy induced growth retardation
hypertension respectively, and 579
with twin pregnancies. Two
therapeutic trials enrolled 79
women with threatening pre-
eclampsia and 63 with suspected
intrauterine growth retardation
5 Kramer, M 2002 Balanced Thirteen trials, involving 4665 Energy/protein supplementation Balanced 19
protein/energy women, for pregnant women in which the energy/protein
supplementation in protein content of the supplementation
pregnancy (Cochrane supplement was 'balanced' improves fetal
Review) (protein content less than 25% of growth and may
total energy content). reduce the risk of
fetal and neonatal
death
6. Kramer,M 2002 Isocaloric balanced Three trials involving 966 women All acceptably controlled Balanced protein 20
protein comparisons of isocaloric protein supplementation
supplementation in supplementation, as long as the alone (ie without
pregnancy (Cochrane protein content of the energy
Review) supplement was 'balanced', ie supplementation) is
the protein provided <25% of its unlikely to be of
total energy content benefit to pregnant
women or their
infants
7. Duley, L. & 2002 Reduced salt intake Two trials were included, with 603 a low salt diet with no dietary No significant effect 21
Henderson-Smart, compared to normal women advice on SGA reduction
D dietary salt, or high
intake, in pregnancy
(Cochrane Review)
8. Mahomed, K 2002 Iron supplementation Twenty trials were included Iron supplementation No significant effect 22
in pregnancy on fetal growth
(Cochrane Review)
9. Cuervo, L. G. & 2002 Treatments for iron Five trials, involving IRON No significant effect on fetal growth and LBW 23
Mahomed, K deficiency anemia in approximately 1234 supplementation reduction
pregnancy (Cochrane anemic women
Review)
10. Makrides, M. & 2002 Magnesium Ten trials involving magnesium was no statistically significant effects of magnesium 24
Crowther, C. A supplementation in 9090 women administered orally supplementation on the frequency of perinatal
pregnancy (Cochrane at mortality or small-for-gestational age
Review any time during infants when compared with placebo or no treatment
the antenatal
period, regardless
of dose
11. Mahomed, K 2002 Zinc supplementation in included 21 zinc No significant effect on fetal growth and SGA 25
pregnancy (Cochrane randomized supplementation in
Review). In: The controlled trials pregnancy
Cochrane Library (RCTs) reported in 54
papers involving over
17,000 women and
their babies
12. Mahomed, K. & 2002 Vitamin D Two trials involving vitamin D In one trial the mothers had higher mean daily 26
Gulmezoglu, A. supplementation in 232 women supplementation weight gain and lower number of low
M pregnancy (Cochrane during pregnancy birth weight infants. In the other trial the
Review). supplemented group had lower birth weights
13. Hofmeyr, G. J., 2006 Calcium 12 trials, comparing at least There was no overall effect on the relative risk of the 27
Atallah, A. N. & supplementation during 15,206 women one gram daily of baby being
Duley, L pregnancy for preventing calcium during born small-for-gestational age
hypertensive disorders pregnancy with
and related problems placebo
14. Muthayya & et al 2006 Low maternal vitamin 478 women were Prospective vitamin B12 deficiency in pregnancy 28
B12 status is associated recruited at 12.973.3 observational combined with appropriate interventions are likely to
with intrauterine growth weeks of gestation study play an important role in reducing IUGR
retardation in urban
South Indians
15. SH Jahanian 2011 Effect of Some Risk Fifty hundred four cross-sectional, IUGR is higher in woman whose weight gain was 29
Sadatmahale& Factors Associated with pregnant women, descriptive- lower than normal rang, female newborn and
et al Intrauterine Growth between the age of analytical study( in housekeeper mothers. There is a direct link between
Retardation (IUGR) 18 and 35 years Persian) IUGR and the history of chronic disease in mothers.
• Berdasarkan penelitian sebelumnya, keterbatasan
asupan protein dan energi selama kehamilan
menyebabkan PJT pada hewan. Kondisi ini
berlaku untuk ibu hamil yang membatasi asupan
energi dan protein dapat menyebabkan PJT.
• Pada sistematic review, bahwa ibu yang
menerima cukup energi / protein akan
menyebabkan risiko lebih kecil terjadinya PJT.
(OR= 0,77)
• Di Chili, ditemukan bahwa ibu hamil yang
menerima jenis susu yang diperkaya dengan
vitamin dan mineral mengalami IUGR lebih
sedikit dibandingkan dengan kontrol.
• di Tanzania melaporkan para ibu yang menerima
kapsul multivitamin (mengandung riboflavin,
niasin, tiamin, vitamin B6, B12, C, E, dan asam
folat) berada pada risiko IUGR yang lebih rendah
dibandingkan dengan kelompok yang menerima
plasebo
Keseimbangan energi protein:
Zinc:
05
Magnesium:
• 04
Dalam tujuh uji klinis,
• suplementasi zinc
suplementasi
tidak memiliki
magnesium telah efek signifikan
terbukti mempengaruhi pada pengurangan
PJT. risiko SGA.
• Terdapat penurunan • Penggunaan zinc
risiko SGA sebesar selama kehamilan
30% dalam konsumsi
juga tidak
magnesium.
• Ibu hamil yang diberi berpengaruh
suplementasi signifikan
magnesium selama terhadap berat
kehamilan memiliki lahir
bayi dengan berat
badan lahir 51 gram
Vitamin D: Studi tentang suplemen ini terbatas dan hasil
penelitian ini belum memberikan bukti yang mendukung
efek signifikan dari suplemen ini pada pengurangan risiko
PJT
Vitamin C dan E: studi tentang suplemen ini juga
menunjukkan bahwa penggunaan kedua mikronutrien ini tidak
memiliki pengaruh yang signifikan dalam mengurangi risiko
PJT
Vitamin B12: Dalam sebuah studi dilaporkan bahwa
kekurangan vitamin B12 dikaitkan dengan PJT, dan
menyarankan bahwa selama kehamilan, kondisi ibu harus
diperiksa, dan dilakukan tindakan yang diperlukan jika terjadi
defisiensi
Minyak ikan: Konsumsi minyak ikan selama kehamilan tidak
berpengaruh signifikan terhadap pertumbuhan janin . Hasil
studi klinis lain juga menunjukkan bahwa minyak ikan tidak
mempengaruhi pertumbuhan janin dan tidak memiliki efek
suportif pada PJT
KESIMPULAN
• Pertumbuhan Janin Terhambat merupakan faktor
risiko penting terjadinya BBLR dan kematian
neonatal.
• Pengamatan dan studi yang menunjukkan bahwa
kondisi sosial ekonomi, tingkat melek huruf ibu dan
gizi makanan dapat mempengaruhi hambatan
pertumbuhan intrauterin.
• Mengkonsumsi jumlah protein dan energi yang
direkomendasikan selama kehamilan merupakan
intervensi nutrisi yang tepat untuk mengurangi
kejadian PJT.
• Dan asupan tiga mikronutrien asam folat,
magnesium dan vitamin B12 selama kehamilan juga
memiliki efek antisipatif pada gangguan tersebut.
• Beberapa penelitian juga telah dilakukan pada
penggunaan mikronutrien yang telah terbukti secara
signifikan mengurangi kejadian PJT.
THANK YOU