Detty Siti Nurdiati

The impact of prenatal vitamin A and zinc supplementation on birth size and neonatal survival - a double-blind, randomized controlled trial in a rural area of Indonesia.

BACKGROUND Prenatal supplementation with micronutrients may increase birth weight and thus improve infant health and survival in settings where infants and children are at risk of micronutrient deficiencies. OBJECTIVE To assess whether vitamin A and/or zinc supplementation given during pregnancy can improve birth weight, birth length, neonatal morbidity, or infant mortality. METHODS A double-blind, randomized controlled trial supplementing women (n = 2173) in Central Java, Indonesia throughout pregnancy with vitamin A, zinc, combined vitamin A+zinc, or placebo. RESULTS Out of 2173 supplemented pregnant women, 1956 neonates could be evaluated. Overall, zinc supplementation improved birth length compared to placebo or combined vitamin A+zinc (48.8 vs. 48.5 cm, p = 0.04); vitamin A supplementation improved birth length compared to placebo or combined vitamin A+zinc (48.7 vs. 48.2 cm, p = 0.04). These effects remained after adjusting for maternal height, pre-pregnancy weight, and parity. There was no effect of supplementation on birth weight, the proportion of low birth weight, neonatal morbidity, or mortality. CONCLUSIONS Prenatal zinc or vitamin A supplementation demonstrates a small but significant effect on birth length, but supplementation with zinc, vitamin A or a combination of zinc and vitamin A, have no effect on birth weight, neonatal morbidity, or mortality.

Concurrent Prevalence of Chronic Energy Deficiency and Obesity among Women in Purworejo, Central Java, Indonesia

There are few studies on the nutritional status of non-pregnant women. A population-based, cross-sectional study of nutritional status in 5,817 non-pregnant women 15 to 49 years of age was conducted in Purworejo District, Indonesia, in 1996. Weight, height, mid-upper-arm circumference (MUAC), and triceps skinfold thickness were measured, and information on socio-economic, demographic, and reproductive factors was collected. Seventeen percent of the women had chronic energy deficiency and 11% were obese. Mean weight, MUAC, and triceps skinfold thickness corresponded to the 25th percentile of standards and mean height to the 5th percentile. Obesity was more common among older women and chronic energy deficiency among both the oldest and the youngest women. Women working in agriculture, not using contraceptives, and not owning a television, radio, or refrigerator were more likely to have chronic energy deficiency. in summary, both chronic energy deficiency and obesity existed in Purworejo, and risk factors were identified. Interventions are needed to improve the nutritional status of girls and women before and after pregnancy.

Predicting under- and overnutrition among women of reproductive age: a population-based study in central Java, Indonesia.

OBJECTIVES To evaluate changes over 1 year in weight and body mass index (BMI) among a population-based sample of non-pregnant women in Indonesia and to identify risk factors for developing under- and overnutrition. DESIGN Cross-sectional studies in 1996 and 1997 in the same population. SETTING Purworejo District, central Java, Indonesia. SUBJECTS Non-pregnant women (n = 4132) aged 15-49 years of age who participated in both 1996 and 1997. Based on BMI, women were classified as having chronic energy deficiency (CED), and as being either of normal weight or obese. RESULTS The mean height of the women was below the fifth percentile of international standards. In 1996, 16.2% had CED, 72.2% were normal and 11.6% were obese. In 1997, the corresponding figures were 14.4%, 71.2% and 14.3%, respectively, revealing a significant mean increase in weight and BMI. Among women classified as normal in 1996, 3.0% developed CED in 1997. Significant risk factors for developing CED were experiences of child deaths and non-use of contraceptives. Among women classified as normal in 1996, 5.3% developed obesity in 1997. Here, significant risk factors included most indicators of wealth as well as occupation. CONCLUSIONS The results should be important for future efforts to prevent CED and obesity in the general population; conditions which are both associated with health risks.

Prestasi Belajar pada Remaja yang Mengalami Dismenorea Primer

Background: Primary dysmenorrhea occurs in approximately 50% of teenage girls and cause serious disruptions in the quality of life and daily activities. Primary dysmenorrhea makes teenagers difficult to concentrate in school which will decrease their academic achievement. Objective: to investigate whether there is a correlation between Primary dysmenorrhea and academic achievement of students of SMP Islam Terpadu Pondok Pesantren Tahfidzul Qur’an (SMP IT PPTQ) Ibnu Abbas Klaten. Method: This study is a case-control study through a quantitative approach and was supported with qualitative data. The research sample is 68 teenage girls of SMP IT PPTQ Ibnu Abbas Klaten who fulfilled the inclusion criteria. The cases groups are female students with low learning achievement, while the control group was female students with high learning achievement. The samples were taken using simple random sampling. Researcher used a structured questionnaire, interview and secondary data to collect the data. The data analysis was using descriptive and inferential analysis including bivariate analysis using chi-square test and multivariate analysis using logistic regression with 95% confidence intervals (CI) and a significance level of p <0.05. Result and Discussion: The bivariate and multivariate analysis showed a significant correlation between primary dysmenorrhea and learning achievement. The possibility of finding girls with primary dysmenorrhea in the group of students who received a low learning achievement is 3 times larger than the group of students who received high learning achievement. Below-average intelligence is greater in the group of low-achieving students than the group of high-achieving students. There is a correlation between the variables of intelligence, stress level and frequency of dysmenorrhea and academic achievement. The variable of absences frequency not related to learning achievement. Conclusion: There is correlation between primary dysmenorrhea and learning achievement (p=0.026). This study indicates that women and their school should pay attention to their menstrual function and dysmenorrhea phenomenon. Keywords: learning achievement, primary dysmenorrhea, teenage, menstrual disorder