Tesis

Profil Kadar Seng, Selenium, Besi dan Tembaga pada Serum Ibu Hamil dengan Pertumbuhan Janin Terhambat = Profile of Maternal Serum Zinc, Selenium, Iron and Copper Levels in Pregnancies with Fetal Growth Restriction.

Latar Belakang: Pertumbuhan janin terhambat dihubungkan dengan banyak efek yang merugikan serta meningkatkan risiko mortalitas perinatal hingga lebih dari 10 kali lipat. Data terkini menunjukkan defisiensi mikronutrien maternal dapat menyebabkan dampak negatif pada pertumbuhan janin. Seng, selenium, besi dan tembaga memiliki peran penting terkait dengan sistem imun, proses inflamasi, hingga stress oksidatif yang mendasari terjadinya kehamilan dengan pertumbuhan janin terhambat. Tujuan: Penelitian ini bertujuan membandingkan kadar seng, selenium, besi dan tembaga pada serum maternal antara ibu hamil normal dan ibu hamil dengan pertumbuhan janin terhambat. Metode: Penelitian dilakukan dengan uji potong-lintang yang dilaksanakan di Instalasi Gawat Darurat Kebidanan RSCM Jakarta dan RS Kabupaten Tangerang pada Februari hingga Mei 2017. Seluruh ibu hamil normal dan ibu hamil yang mengalami pertumbuhan janin terhambat diikutsertakan dalam penelitian ini. Darah ibu diambil sebelum melahirkan, lalu dilakukan pengukuran kadar serum seng, selenium, besi dan tembaga. Hasil: Terdapat 30 ibu hamil normal dan 30 ibu hamil dengan pertumbuhan janin terhambat yang diikutsertakan dalam penelitian ini. Rerata atau median kadar seng, selenium, besi dan tembaga pada kehamilan normal berturut-turut adalah 42,07 µg/dL, 69,80 µg/L, 70,50 µg/dL dan 2177 µg/L, sementara itu rerata atau median kadar seng, selenium, besi dan tembaga pada kehamilan dengan pertumbuhan janin terhambat berturut-turut adalah 43,53 µg/dL, 80,83 µg/L, 106 µg/dL dan 2133,5 µg/L. Terdapat perbedaan kadar serum selenium (p=0,013) dan besi (p=0,009) yang bermakna antara kedua kelompok. Tidak terdapat perbedaan yang bermakna pada kadar serum seng dan tembaga antara kedua kelompok. Kesimpulan: Terdapat perbedaan kadar serum selenium dan besi yang bermakna antara ibu hamil normal dengan ibu hamil yang mengalami pertumbuhan janin terhambat. Kadar serum selenium dan besi lebih tinggi pada kehamilan dengan pertumbuhan janin terhambat. Tidak terdapat perbedaan yang bermakna pada kadar serum seng dan tembaga antara kedua kelompok.
Kata kunci: pertumbuhan janin terhambat, seng, selenium, besi, tembaga


Background: Fetal growth restriction is associated with many adverse effects and increases the risk of perinatal mortality by more than 10-fold. Current data show that maternal micronutrient deficiencies may contribute to a negative impact on fetal growth. Zinc, selenium, iron and copper have important roles related to immune system, inflammation process and oxidative stress which serve as a basic for development of fetal growth restriction. Objective: The aim of this study is to compare maternal serum zinc, selenium, iron and copper levels between normal pregnancies and pregnancies with fetal growth restriction. Methods: It was a cross sectional study conducted in Labor and Delivery Unit of Cipto Mangunkusumo National Hospital Jakarta and Tangerang General Hospital from February through May 2017. All normal pregnant women and pregnant women diagnosed with fetal growth restriction were enrolled in this study. Maternal blood were drawn before delivery to measure serum zinc, selenium, iron and copper levels. Results: There were 30 normal pregnant women and 30 pregnant women with fetal growth restriction enrolled in this study. The mean or median serum levels of zinc, selenium, iron and copper in normal pregnant women were 42.07 µg/dL, 69.8 µg/L, 70.5 µg/dL, and 2177 µg/L, respectively. Meanwhile, the mean or median serum levels of zinc, selenium, iron and copper in pregnant women with fetal growth restriction were 43.53 µg/dL, 80.83 µg/L, 106 µg/dL dan 2133.5 µg/L, respectively. There were significant difference in serum selenium (p=0.013) and iron levels (p=0.009) between both groups. There were no difference in serum zinc and copper levels in both groups. Conclusion: There were significant difference in serum selenium and iron levels between normal pregnancies and pregnancies with fetal growth restriction. Serum selenium and iron levels were higher in pregnancies with fetal growth restriction. There were no difference in serum zinc and copper levels in both groups.
Keywords: fetal growth restriction, zinc, selenium, iron, copper