EFFECT OF PRECONCEPTIONAL SUPLLEMENTATION OF MULTI- MICRONUTRIENTS ON HEMOGLOBIN LEVEL DURING PREGNANCY

Introduction: Anemia during preconceptional period was relatively neglected issues. The other issue is the efficacy of single micronutrient versus multi-micronutrients supplementation. Objective: This study aims to evaluate the effect of multi micronutrient (MMN) supplementation during preconceptional period among the newly married women on hemoglobin level during pregnancy. Methods:A randomized double blind community-based trial had been conducted at Probolinggo District, East Java. Newly married women were recruited as stydy subjects, and randomly assigned into two group: Group I (MMN group) received mutlti micronutrient containing 14 micronutrients 2 other days during preconception, continue with daily dose during pregnancy. Group II (IFA group) received placebo during preconception period and continue with daily iron & folat during pregnancy. Total of 420 eliglible subjects were enrolled to meet approximately 120 pregnancy. The outcome variables is level in week 12, week 28 and week 35 of pregnancy. Social economic background, body mass index, and blood pressure also being assessed as base line data. Nutrients in take also been assesed in each trimester. Base line data was analyzed by using independent-t test and multivariate analysis by general linear model to compare mean differentiation between MMN group and IFA group. Statistical analysis to hypothetical testing has been done to examine effect of treatment on hemoglobin level of MMN group and IFA group. Result: The baseline characteristic between two groups were not different, indicating that two groups are comparable ( Box’s M value = 44.95 and p = 0.65; Hotelling's Trace T2 value = 0.094, F = 1.098 and p = 0.371). There were no significant different hemoglobin level in week 12 (p=0.191), week 28 (p=0,655), and week 35 (p=0,865) between MMN group and IFA group. The average of hemoglobin level at last pregnancy (week35) more than11g/dL in both groups. Conclusion: Prolonging supplementation of MMN during preconception will protect anemia or decreasing hemoglobin level less than 11 g/dL as affective as IFA supplementation at last pregnancy, although it stil can not increase the hemoglobin level for non anemic women before pregnancy