Pengaruh suplementasi vitamin A dan Zink selama kehamilan terhadap kejadian ketuban pecah dini

RISANTO, Esti Utami, dr. H. Zain Alkaff, SpOG(K)

2006 | Tesis | PPDS I Obstetri dan Ginekologi

Tujuan: Untuk mengetahui pengaruh suplementasi vitamin A dan zink selama kehamilan terhadap kejadian ketuban pecah dini (KPD) Disain: Randomised controlled trial. Tempat: Kabupaten Purworejo, Jawa Tengah. Subjek penelitian: 1889 ibu hamil yang secara buta dirandom untuk mendapat suplementasi vitamin A (2400 RE), 20 mg zink-sulfat, campuran vitamin A dan zink atau plasebo. Suplementasi diberikan sejak trimester pertama sampai persalinan. Luaran utama: Ketuban pecah dini, yaitu pecahnya membran amnion minimal 1 jam sebelum timbulnya persalinan tanpa melihat umur kehamilan. Hasil: Insidensi KPD secara umum adalah 6,0%. Tidak ditemukan adanya perbedaan status kesehatan, nutrisi dan subjek karakteristik pada semua kelompok perlakuan. Risiko relatif dan rasio odds untuk suplementasi kombinasi vitamin A dan zink dibandingkan plasebo untuk KPD tidak bermakna secara statistik, baik dalam analisis bivariat maupun pada analisis multivariat dengan mengontrol variabel luar (RR=0,89, 95%CI=0,42-1,90 dan OR=0,88, 95%CI=1,51-1,53). Pada analisis factorial design, tampak bahwa suplementasi zink dapat menurunkan kejadian KPD sebesar 34% dibandingkan yang tidak mendapat zink (RR=0,66, 95%CI=0,45-0,96). Simpulan: Suplementasi zink selama kehamilan dapat menurunkan kejadian KPD, namun tidak demikian halnya dengan suplementasi vitamin A selama kehamilan.

Objective: To assess the impact of vitamin A and zinc supplementation during pregnancy on premature rupture of the membrane. Design: Randomised controlled trial. Setting: Purworejo District, Central Java, Indonesia. Participants: 1889 pregnant women who were random-blindly treated with daily either vitamin A (2400 RE), 20 mg zinc sulphate, the same dose of vitamin A and zinc, or placebo from 1st trimester to delivery. Main outcome measure: Premature rupture of the membrane, which defined as rupture of the amniotic membrane at least one hour before the onset of contraction regardless the gestational age. Results: The incidence of premature rupture of the membrane was 6.0%. There were no significant differences among treatment groups were found. The relative risk and adjusted odds ratios for vitamin A and zinc supplementation groups compared with the placebo group for premature rupture of the membrane remained non-significant when other potential confounding variables controlled for in multivariate analyses, (RR=0.89, 95%CI=0.42-1.90 and OR=0.88, 95%CI=0.51-1.53). In factorial design analysis, zinc supplementation reduced the incidence of premature rupture of the membrane by 34% compared with non-zinc supplementation (OR=0.66, 95%CI=0.45-0.96). Conclusions: Zinc supplementation during pregnancy decreased the incidence of premature rupture of the membrane in relatively healthy women living in a rural community in developing country that it is in transition.

Kata Kunci : Ketuban Pecah Dini,Vitamin A dan Zink, premature rupture of the membrane, micronutrient, zinc, vitamin A