Kenaikan Berat Badan Ibu Hamil dan Hubungannya Dengan Berat Badan Lahir Bayi

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Kenaikan Berat Badan Ibu Hamil dan Hubungannya Dengan Berat Badan Lahir Bayi

Sarma N. Lumbanraja, Delfi Lutan, Makmur Sitepu,M. Rhiza Z. Tala, Sarah Dina, Ismail Usman

Departemen Obstetri and Ginekologi, Fakultas Kedokteran Universitas Sumatera Utara,

Medan, Indonesia, Januari 2013

______________________________________________________________________

ABSTRAK

Tujuan Penelitian: Untuk mengetahui penambahan berat badan ibu hamil pada trimester pertama, kedua dan ketiga dan hubungannya dengan luaran berat badan bayi.

Metode: Studi kohort dilakukan pada RSUP.H. Adam Malik Medan dan RS. Sundari pada bulan Agustus 2012 dan selesai pada Januari 2013. Besar sampel adalah 104 ibu hamil yang melakukan kunjungan antenatal rutin sejak kehamilan trimester pertama sampai ketiga, serta yang melakukan persalinan di RSUP. H. Adam Malik Medan dan RS. Sundari.

Hasil: Karakteristik sampel berumur 20-35 tahun (80.8%), umur lebih dari 35 tahun (12,5%) dan umur kurang dari 20 tahun (6,7%). Paritas multigravida 56,7% dan hanya 1% grande multigravida. Karakteristik dari 104 sampel diperoleh berat badan sebelum hamil pada rentang 40,0-68,0 kg dengan rata-rata berat badan sebelum hamil 53,06 kg ± SD 7,09 dan tinggi badan 140-166 cm dengan nilai rata-rata 155,85 cm ± SD 5,8. Kenaikan berat badan ibu pada trimester I rata-rata 1 kg pada kelompok umur 20-35 tahun dan usia>35 tahun, sedangkan pada usia dibawah 20 tahun rata-rata 0,43 kg ± SD1,13. Tidak terdapat hubungan yang bermakna antara umur ibu dengan kenaikan berat badan pada trimester I (p>0,05). Pada trimester II, kenaikan berat badan ibu berdasarkan kelompok umur rata-rata 5 kg. Tidak terdapat hubungan yang bermakna antara umur ibu dengan kenaikan berat badan pada trimester II (p>0,05). Pada trimester III, kenaikan berat badan ibu paling tinggi pada kelompok umur 20-35 tahun yaitu rata 5,75 kg ± SD 2,19 dan terendah pada usia dibawah 20 tahun yaitu rata-rata kenaikan berat badan 4,64 kg ± SD 2,17, terdapat hubungan yang bermakna antara umur ibu dengan kenaikan berat badan pada trimester III(p<0,05). Berdasarkan data yang didapatkan dari pertambahan berat badan ibu per trimester, didapati pada trimester I berat badan ibu bertambah pada rentang 0–3,5 kg dengan nilai rata-rata 0,90±SD 0,92. Pada trimester II berat badan ibu mengalami penambahan lebih besar yaitu sebesar 0-10 kg dengan rata-rata 5,21 ± SD 2,14. Pada trimester III penambahan berat badan ibu relatif sama dengan pada trimester II yaitu 0,5-10,5 kg dengan nilai rata-rata 5,45 ± SD 2,24. Secara keseluruhan usia kehamilan dijumpai total kenaikan berat badan 5-20 kg dengan rerata 11,56 ± SD3,50. Rerata kenaikan berat badan ibu hamil tertinggi pada ibu dengan usia kehamilan 37 minggu (13 kg) dan yang terendah pada usia kehamilan 40 minggu (10,75 kg).

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relatif sama ± 1 kg. Secara statistik menunjukkan tidak ada perbedaan yang bermakna (p>0,05). Kenaikan rata-rata berat badan ibu pada trimester II paling tinggi pada primigravida dan multigravida yaitu ± 5 kg dan paling rendah pada grande multigravida yaitu 2 kg namun tidak terdapat perbedaan bermakna (p>0,05). Kenaikan rata-rata berat badan ibu pada trimester III paling tinggi pada primigravida 6,08 kg ± SD 2,18, multigravida 5,03 kg ±SD 2,18, sedangkan paling rendah pada grande multigravida yaitu 2 kg. Terdapat perbedaan yang bermakna (p<0,05). Karakteristik berat badan sebelum melahirkan 48,0–83 kg dengan rata-rata 64,75 ± SD 8,85 dan berat badan ibu pada masa 24 jam post partum mengalami penurunan menjadi 42,0- 78,50 kg dengan nilai rata-rata 59,92 ± SD 8,81. Luaran berat badan bayi 2.500-4.000 gr dengan rerata 3119 ± SD 399,86 gr. Terdapat hubungan yang bermakna antara total kenaikan berat badan ibu dengan berat lahir bayi (p<0,05),dengan korelasi lemah (r=0,2).

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Maternal Weight Gain And Corellation With Birth Weight Infants

Sarma N. Lumbanraja, Delfi Lutan, Makmur Sitepu,M. Rhiza Z. Tala, Sarah Dina, Ismail Usman

Department of Obstetrics and Gynecology, Faculty of Medicine University of Sumatera Utara,

Medan, Indonesia, Januari 2013

ABSTRACT

Objective: Knowing maternal weight gain during the first, second and third trimester of pregnancy and correlation with birth weight infants.Methods: Cohort studies was conducted at the Hospital H. Adam Malik Medan and Sundari Hospital in August 2012 and finished at January 2013. Sample were 104 pregnant women who do routine ANC from the first to the third trimester and delivery at term H Adam Malik Hospital and Sundari. Results: Maternal characteristics are generally aged between 20-35 years (80.8%), followed by the age group over 35 years (12.5%) and lowest in the age group less than 20 years (6.7%). Parity multigravida (56.7%) and only 1 person (1%) with grandemultigravida. Most mothers into labor at 38 weeks gestation (51.9%) and the lowest at 37 weeks (4.8%). Characteristics of 104 women found prepregnancy weight in the range of 40.0 to 68.0 kg with an average weight before pregnancy SD 7.09 ± 53.06 kg and height in the range of 140-166 cm with a mean value The average 155.85 cm ± 5.8 SD. Body mass index (BMI) was 18.03 to 25.00 with an average value of 21.78 ± 2.06 SD. Maternal weight gain trimester I average about 1 kg in the age group 20-35 years and age> 35 years, while under 20 years of age on average 0.43 kg ± SD1, 13. In the second trimester, maternal weight gain by age group unchanged at an average of about 5 kg. In the third trimester, maternal weight gain was highest in the age group of 20-35 years on average 5.75 kg ± 2.19 SD and the lowest

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gain in pregnancy grandemultigravida lower than the primi and multigravida.

Keywords: Maternal weight, infant birth weight, body mass index

Introduction

The gestation period is the period

that determine the quality of human

resources. Growth and development of a

child, is determined by the condition during

in the womb. Pregnant women were healthy,

with good nutrition will certainly produce a

healthy baby. The low nutritional status of

the mother during pregnancy can result in a

negative impact. Among others, the high

maternal mortality rate and infant mortality.

Besides maternal risk of having low birth

weight babies (babies with low birth

weight). LBW rate in developing countries

four times higher than developed countries.

During the years 1990-2000 shows a variety

of sources ranging from 2-17% proportion

of LBW. If the proportion of pregnant

women 2.5% of the total population,

estimated 355000-710000 of 5 million

babies will be born with a low birth weight.

More than 9 million babies die each year,

98% occur in developing countries, and one

cause is low birth weight.

Therefore, maternal weight gain

optimum is essential for perinatal morbidity

and mortality. In 1987 The Global Safe

Motherhood Initiative was launched with the

aim of improving antenatal care and

counseling throughout the world. This

movement concentrates on nutrition and

weight gain during pregnancy, as are the two

important things that affect mothers and

baby outcomes.

1

Institute of medicine (IOM), in 2009

issued a recommendation maternal weight

gain recommendations are revising earlier in

1990. A new recommendations for total and

rate of weight gain during pregnancy

according to body mass index before

pregnancy.

2,3

According to Beyerlin to recent

research conducted Nohr showed an

increase in weight

4

lessbodyincreases the risk

oflow birth weight,but theweight

gainduringpregnancywill

causeexcessiveopposite effect, such

asobesity inchildhoodandinfantlarger.2

According toOlsonfromresearch

conducted byLowlerandChaturverdihave

foundevidence to support

theexcessiveintrauterinenutritionwillpromote

obesityafter birth. Meanwhile, according

toresearch conductedClaessonfromKiet,

showed that the degree ofweight gain

duringpregnancy isassociated with increased

riskof preeclampsia, cesarean saesarea, large

(5)

pregnancy. Andseveralother studieshave

shown arisingincidence ofweight andbody

mass indexduring

pregnancywithobstetriccomplicationsand

neonatus outcomes.5

Based on the above background, the authors

are interested in doing research on

relationship of increase weight gain during

pregnancy with the baby's outcomes, with

the hope we will get a real picture of the

weight gain of pregnant women and their

relationship with the baby's outcomes.

, 6

Method

This is a cohort study assessing the

weight gain during the first trimester of

pregnancy, second, third, and total increases

and relationship (correlation) with birth

weight infants. Assessment of maternal

weight gain correlation with birth weight

infants using Pearson correlation. The study

was conducted at the Hospital H. Adam

Malik Medan and Sundari Hospital in

August 2012 until the sample met. The

population in this study were all pregnant

women who perform routine ANC from the

first to the third trimester and at birth at term

gestation RS H. Adam Malik Hospital in

Medan and Sundari. The sample is

representative of the population that is

affordable pregnant women perform routine

ANC from the first to the third trimester in

pregnancy and delivery at term RS H. Adam

Malik Hospital and Sundari Hospital in

Medan. Sampling was conducted in

consecutive sampling in pregnant women

who gave birth to the ANC and RS H. Adam

Malik Medan and RS. Sundari. In this study,

the sample obtained is 104 people.

The way it works is that whole

pregnant inpartu that met the inclusion

criteria and were willing to follow the study.

Do mothers weighing before and 24 hours

post partum and infant birth weight. Then do

the recording of weight gain during the first

trimester of pregnancy up to three so

unknown total maternal weight gain during

pregnancy, the data is taken from state

control (ANC Card) patients. Statistically be

searched relations total maternal weight gain

weight babies born.

This study used primary and

secondary data were obtained from the

results of the weighing of pregnant women

and inpartucontrol statusof pregnant

womenin the hospitalwhere the study

wasconducted. The data obtained

wereprocessed witha computerprogram, then

the data ispresented in tabular

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Result

Characteristics ofmotherswho are the

subjectof researchthat included age,

parityand gestational agecan be seenin the

tablesbelow.

Table 1. Characteristics ofthe

studymothersby age

Age

( years )

N %

< 20 7 6,7

20-35 84 80,8

>35 13 12,5

Total 104 100

Maternal characteristicsof the study

sampleare

generallyagedbetween20-35years(80.8%), followed bythe age

groupover 35 years(12.5%) and lowestin the

age groupless than 20 years(6.7%). It canbe

explainedthat theageis lessthan 20

Table 2. Characteristics of the study

subjects based on parity

years of

age is not recommended for a marriage by

the Marriage Law in Indonesia, while the

age of over 35 years, including high risk. As

quoted Rasmussen of Cleary-Goldman et al

that a pregnant woman over the age of 35

years at risk of developing chronic diseases

such as Type 2 diabetes can lead to

complications and increased morbidity post

partum.

Paritas N %

Primi 44 42,3

Multi 59 56,7

Grande 1 1,0

Total 104 100

Based on the characteristics of the

most parity is obtained with parity

multigravida (56.7%) and only 1 person

(1%) with grandemultigravida. The low

grandemultigravida can be explained due to

the easy obtainfamily planning servicesand

has beenwidely acceptedby the public.

Table 3. Karakteristikresearch

subjectsbygestational age

Minim um

Maxi mum

Mea n

SD

Prepregn ancy weight (kg)

40,0 68,0 53,0 6

7,09

Height (cm) 140,0 166,0 155, 85

5,8

Body Mass Index

(BMI)

18,03 25,00 21,7 8

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The above tableshows

thatmostmothersdolaborat38 weeks

gestation(51.9%) and the lowestat 37

weeks(4.8%).

Age

Pregnancy

(weeks)

Table4.Characteristics ofthe study

subjectsbased onnutritionalstatus

N %

Characteristicsofthe study sampleof 104

womenfoundprepregnancy weightin the

range of40.0 to 68.0kgwith an

averageweight before

pregnancySD7.09±53.06kgand heightin the

range of140-166cmwith amean value.The

average155.85cm±5.8SD. Foundbody mass

index (BMI) of104 womenwas18.03 to

25.00withan averagevalue of21.78±2.06SD.

Maternalweight gainduring pregnancycanbe

apicture ofthenutritional status of

mothersand birth weightbabieswillbe born.

This studymatchesthat duringpregnancythere

isincrease inmaternal weight. This weight

gain willmore

specificallydescribeunfoundedtrimester,

parityand gestational ageon

thesubsequenttables. Pregnant

womenwithanormalbodymass

indexmorewillproduce offspring

withabetteroutcomethan women witha body

mass indexoutsidethe recommended.

Table5.Relationsmaternalweight gainwith

agePertrimester

The table above showsthat, the

picture of maternalweight

gaintrimesterIaverage about1 kgin the age

(8)

whereastheage below the20 yearaverage

of0.43kg±1.13SD. Statisticallyshowed

nosignificant associationbetweenmaternal

ageweight gainbytrimesterI (p>0.05).

In thesecondtrimester,

maternalweight gainby age groupunchanged

atan average of about5 kg.

Statisticallyshowed nosignificant

associationbetweenmaternal agewithweight

gain in thesecondtrimester(p>0.05).

In thethirdtrimester, maternalweight

gainwas highest intheage group of20-35

yearson average5.75kg±2.19SDand the

lowestunder the ageof 20 yearsbeing the

averageweight

gain4.64kg±SD2.17statisticallyshowednosig

nificant associationbetweenmaternal

agewithweight gain in

thethirdtrimester(p<0.05).

In termsof maternal weightby ageof

pregnant womeneachtrimester,

thenItrimesterweight gainwas highest inthe

age group20-35 yearswith an average

of0.93±0.91kgand the lowestin the age

group<20 year with an average of 0.43 ±

1.13 kg, but showed no statistically

significant difference in maternal weight

gain during trimester I by age group (p>

0.05). Similarly in the second trimester

weight gain was highest in the age group

20-35 years with an average of 5.33 ± 1.93 kg,

but statistics show no significant difference

in maternal weight gain during the second

trimester by age group (p > 0.05). In the

third trimester weight gain was also highest

in the age group 20-35 years with an average

of 5.75 ± 2.19 kg and showed a statistically

significant difference in weight gain of the

mother during the third trimester, by age

group (p <0, 05). It is clear that maternal age

between 20-35 years old is a good age for

pregnancy weight gain because it gives a

higher and suitable for pregnancy compared

with other age groups.

Table 6. Maternal weight gain per

trimester

Body weight

(Kg)

Trimester II

Trimester III

Total increase in

Weight Loss

0

Kruskall-Wallis test p=0,0001

Based on the data obtained from the

mother's weight gain per trimester, I found

trimester maternal weight gain in the range

from 0 to 3.5 kg with an average value of

0.90 ± 0.92 SD. In the second trimester

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increase in the amount of 0-10 kg with an

average of 5.21 ± 2.14 SD. In the third

trimester maternal weight gain is relatively

the same as in the second trimester is from

0.5 to 10.5 kg with a mean value of 5.45 ±

2.24 SD. Overall total pregnancy weight

gain encountered 5-20 kg with a mean of

11.56 ± SD3, 50. Based on test statististik

with Kruskall-Wallis test obtained p

<0.0001 indicating a significant difference

maternal weight gain per trimester. In first

trimester, weight gain is quite slow with a

maximum weight gain of 3.5 kg. In the

second trimester, weight gain increases

faster with a maximum of 10 kg. Similarly,

the third trimester, the maximum increase in

weight up to 10.5 kg. And total weight gain

up to 20 pounds during pregnancy. If we

refer to the IOM recommendations in 1990

and 2009, the average weight gain was

found with this. Research conducted by Ota

also found the average weight gain of the

same. Significant weight gain in the second

trimester has been described in the study by

Yang in 2005 due to the increased appetite

pregnant after passing the 12th week

because of complaints of nausea vomiting

has begun to decrease, coupled with the

uterus and other organic tissue began to

increase the size and volume. If returned to

the theory, the weight gain was also affected

by the compounds leptin, which is a protein

produced by adipose tissue, regulatebody

weight,especiallyappetite.

Table7.The meanincrease

infull-termWeight LossMotherandBirth

Weightchildren based ongestational age

atdelivery

2.72 426.614 58

3.43 316.570 11

Minimu

(10)

Maximu

3.32 327.350 06

4.27 388.007 02

Minimu

m 5 2500.00

Maximu

m 18 3800.00

Based on thetable aboveit can be seenthat

the averageweight gainwas highest

inpregnantmothers with a gestational age of

37 weeks (13 kg) and the lowest at 40 weeks

gestation (10.75 kg). Statistically by Anova

test for total maternal weight gain during

labor obtained p values> 0.05. This showed

no significant difference in weight gain of

pregnant women during labor at term.

Based on the above table can also be seen

that the average weight gain was highest in

infants born to mothers with gestational age

37 weeks (3430 g) and the lowest at 38

weeks gestation (3068.5 g). Statistically by

Anova test for birth weight infants of

pregnant women at term obtained p values>

0.05. However, the Post Hoc LSD test found

a significant difference between birth weight

infants at 37 weeks' gestation to 38 weeks (p

= 0.023).

Table 8. Relationshipof maternal

weightincreaseswith parity

pertrimester.

It can be seenfromTable8,the

average increaseimagematernal

weighttrimesterIwas highest

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inprimiandmultigravidasame

relativeincrease±1 kg. Statisticallyshowed

nosignificant difference(p>0.05).

Picture ofthe average increase inweight of

the motherat thesecondtrimesterwas highest

intheprimigravidaandmultigravida

Picture of the average increase in

weight of the mother at the highest in the

third trimester primigravidaie 6.08 SD 2.18

kg ± 5.03 kg followed multigravida SD ±

2.18, while the lowest in the

grandemultigravida 2 kg. Statistically

showed no significant difference (p <0.05). ± 5 kg

and lowest in grandemultigravida is 2 kg.

Statistically showed no significant

difference (p> 0.05).

Based on parity, the first trimester

weight gain was highest in the group

grandemultigravida is 2 kg and the lowest in

the primigravida group, with an average of

0.86 ± 0.92 kg, but statistics show no

significant difference in maternal weight

gain during I trimester by parity (p> 0.05).

In the second trimester weight gain was

highest in the primigravida with an average

of 5.51 ± 2.13 kg and lowest in the group

grandemultigravida only 3.5 kg, but showed

no statistically significant difference

maternalweight gainduring

thesecondtrimesterbyparity(p>0.05). And in

thethirdtrimesterweight gainwas highest

intheprimigravidawith an average6.08±2.18

kgand the lowestin the

groupgrandemultigravidais only2 kg, but

statisticsindicate asignificant differencein

weight gainbythe mother during

thethirdtrimesterof parity(p <0.05). The

results ofthis studyexplainthat

ingrandemultigravidamaternalweight

gainduring pregnancyis relativelysmall and

stayabout 2kg.

Table9.Weight of the motherbefore

deliveryand 24hourspost partum

Body Before the

birth

Maternal characteristics by prenatal

weight is in the range of 48.0 to 83 kg with

an average value of 64.75 ± 8.85 SD and

maternal weight at 24 hours post-partum

period decreased to 42.0 to 78.50 kg with an

average value of 59.92 ± 8.81 SD. Based on

statistical tests to obtain paired t-test p <0.05

indicating a difference in weight of the

mother before and 24 hours post partum

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Table 10. Birth weight infants

Weight

(gr)

Minimum Maximum Mean SD

Baby's

birth

weight

2500.0 4000.0 3119 399,86

Based on research data obtained, birth

weight infants in 2500-4000 range 3119 g

with a mean ± SD 399.86.

Table 11.

Weight (kg) r p

The correlationbetween

thetotalincrease inmaternal

weightBirthweightbabies

Total increase In maternal body weight 0,213 0,03

With a birth weight infants

As shown in the table above shows

there is a significant correlation between

total maternal weight gain, infant birth

weight (p <0.05), with the correlation (+)

weak (r = 0.2). Infant birth weight obtained

from this study were within the normal

range is the range of 2500 g - 4000 g and

mean ± 399.86 gr 3119gr. Statistically

showed a significant association between

total maternal weight gain with birth weight

infants (p <0.05), with the correlation (+)

weak (r = 0.2). This suggests that maternal

weight gain during pregnancy period can be

a predictor for birth weight infants.

However, total maternal weight gain is not

entirely influenced by the weight of the baby

but also influenced by the amniotic fluid,

placental weight, and also increased

maternal organ and tissue edema.

References

1. Chairunita, Model

PendugaBeratBayiLahirBerdasarkan

PengukuranLingkarPinggangIbuHam

il. ITB, Bogor; 2006.

2. Beyerlien A, Schiessl B, Lack N,

Kries R V Optimal Gestational

weight Gain Ranges For the

Avoidance of Adverse Birth Weight

Outcomes : a Novel Approach. AM J

ClinNutr 2009-90 :1552-8, USA :

2009.

3. Ota E, Haruna M, Suzuki M, Anh D

D, Tho L H, Tam N T T et al.

Maternal Body Mass Index and

Gestasional Weight Gain and Their

Association With Perinatal

Outcomes in Viet Nam. Bull World

Health Organ 2011; 89: 127-136.

4. Anonymous, Weight Gain During

(13)

Guidelines, Report Brief. Intitute Of

Medicine Of The National

Acedemies May: 2009.

5. Olson M C, Strawderman S M,

Dennison BA. Maternal Weight Gain

During Pregnancy and Child weight

at Age 3 Years. Matern Child Health

J 13 : 839-846. USA. 2009

6. Claesson I M, Brynhildsen J,

Cedergren M, Jeppsson A, Sydsjo A,

Josefsson A. Weight Gain

Restriction During Pregnancy is Safe

For Both The Mother And Neonate.

ActaObstetricia et Gynecologica ; 88

: 1158-1162. Sweden. 2009.

7. American College of Obstetrics and

Gynecology Committe on Obstetric

Practice. Obstetric and Gynecology

106. 2005, pp: 671-75

8. Bodnar L M, Wisner K L, Kolko E

M, Sit D K Y, Hanusa B H,

edPrepregnancy Body Mass Index,

Gestational Weight Gain and The

Likelihood of Major Depression

During Pregnancy. Department of

Obstetrics, Gynecology, and

Reproductive Sciences, Pittsburgh;

2008.

9. Kinnunen TI. Prevention of

Excessive Pregnancy-Related

Weight Gain, [dissertation],

Tampere: University of Tampere.

2009.

10.Commitee to Reexamine IOM

Pregnancy Weigth Guidelines Food

and Nutrition Board and Board on

Children, Youth, and Families.

Rasmussen K N, Yaktine A L,

Weight Gain During Pregnancy : Re

Exemaining the Guidelines.

Washington D C : The National

Academies Press. 2009.

11.Jenifer Ng, Magee L A, Yarker E K.

Maternal Overweight and Excess

Gestational Weight Gain:

Identification of Maternal and

Perinatal Implications and Primary

Maternity Caare Providers’

Opportunities for Interventions to

Improve Health Outcomes.

Departements of Medicine, Obstetric

and Gynecology and Population and

Public Health, University of British

Columbia, Vancouver, BC. 2009

12.Kiel DW, Dodson EA, Artal R,

Boehmer TK, Leet TL. Gestational

Weight Gain and Pregnancy

(14)

much is enough?. American College

of Obstetricians and Gynecologist.

Vol 110 (4), October 2007, pp:

752-758.

13.Derbyshire E, Davies J, Costarelli V,

Dettmar P. Prepregnancy Body mass

Index and Dietary Intake in The First

Trimester of Pregnancy. J Hum

NutrDietet 2006, 19;267-273

14.Sahu MT, Agarwal A, Das V,

Pandey A. Impact of Maternal Body

mass Index on Obstetrics Outcome. J

ObstetGynaecol Res 2007,

33(5);655-659

15.Seligman LC, Duncan BB,

Branchtein L, Gaio DSM, Mengue

SS, Schmidt MI. Obesity and

Gestational Weight Gain : Caesarean

Delevery and Labor Complication.

Rev SaudePublica, 2006: 40 (3):

457-65.

16.Abrams B, Altman SL, Pickett KE.

Pregnancy Weight Gain : Still

controversial. Am J ClinNutr2000 ;

71 ( Suppl ): 1233S-41S.

17.Arkkola T. Diet During Pregnancy.

[dissertation], Tampere, University

of Tampere. Oulu University Press.

2009.

18.Naeye RL. Maternal Body Weight

and Pregnancy. Am J ClinNutr.

1990, 52. pp: 273-9.

19.Yang M J. Interrelationship of

Maternal Serum Leptin, Body Mass

Index and Gestational Age. J Chin

Med Assoc 2005, 68(10); 452-457.

20.Nohr EA, Vaeth M, Baker J L,

Sorensen T I A, Olsen J, Rasmussen

K M, Combined Association of

Pre-Pregnancy Body Mass index and

Gestational Weight Gain With the

Out Come of Pregnancy. AM J Clin

Nutr,2008;87 : 1750-9.

21.Chen Z, Du J, Shao L, Zheng L, Wu

M, Ai M, Zhang Y. Pre pregnancy

Body Mass Index , Gestational

Weight Gain, and Pregnancy

Outcomes in China. International

Journal of Gynecologic and

Obstetrics, 109 (2010), pp

41-44.

22.Anonymous. Epidemiology of

Gestational Weight Gain and Body

Weight Changes After Pregnancy.

[Epidemiologic Reviews].

EpirevOxfordJournals, 1999,

(15)

23.Upaydhyay S, Biccha RP, Sherpa

MT, Shrestha R, Panta PP.

Association between Maternal Body

Mass Index and The Birth Weight of

neonates. Nepal Med Coll J 2011,

13(1);42-45

24.Yazdani S, Yosofniyapasha Y,

Nasab BH, Mojaveri MH, Bouzari Z.

Effect of Maternal Body Mass Index

on Pregnancy Outcome and

Newborn Weight. BMC Research

Notes 2012, 5;34

25.Kalk P, Guthmann F, Krause K,

Relle K, Godes M, Gossing G et al.

Impact of Maternal Body mass Index

on Neonatal Outcome. Eur J Med

Res 2009, 14;216-222

26.Fraser A, Tilling K, Wallis C M,

Hughes R, Sattar N, Nelson S M et

al. Associations of gestational weight

gain with maternal body mass index,

waist circumference, and blood

pressure measured 16 years after

pregnancy ; the Avon Longitudinal

Study of Parents and Children. Am J

ClinNutr 2011,

doi:10.3945/ajcn.110.008326

27.Duggleby SL, Jackson AA.

Relationship of Maternal Protein

Turnover and Lean Body Mass

during Pregnancy and Birth Length.

Clinical Science 2001, 101;65-72

28.Han W H, Chen LM , Li C Y.

Maternal Weight ( BMI ), pregnancy

Weight Gain, and Risks of Adverse

Pregnancy Outcomes in Chinese

Women. Graduate Institute of Health

Polic and Management, College of

Public Health, National Taiwan

University, Taipei, Taiwan, R. O. C.

2010.

29.Crane JMG, White J, Murphy P,

Burrage L, Hutchens D. The Effect

of Gestational Weight Gain by Body

mass Index on maternal and neonatal

Outcomes. JOGC Janvier, 2009;

29-35.

30.Cunningham Gary F, et al, Obstetri

Williams, PenerbitBukuKedokteran

EGC,

RekomendasiPertambahanBerat,

Edisi 21, Vol 1, 2006; 252-4.

31.Islam A, Khan NA, Ehsan A.

Complications of Raised BMI in

Pregnancy. Professore Med J 2010,

17(3);498-504

32.Chang M, Kuo C, Chiang K. The

(16)

Index and Gestational Weight Gain

on Neonatal Birth Weight in Taiwan.

International Journal of Nursing and

Midwifery 2010, 2(2);28-34

33.Goli L. The Relationship Among

Pre-pregnancy BMI, Pre Pregnancy

Weight Gain, and Self Reported Post

Partum Depression. 2009

34.Suitor CW. Maternal Weight Gain ;

A Report of an Expert Work Group,

1997. Arlington, VA: National

Centre for Education in Maternal and

Child Health.

35.Viswanathan M, et al. Outcomes of

Maternal Weight Gain, Evidence

Report/Technology Assessment No

168. AHRQ Publication No. 08.

E009. Rockville, MD; Agency for

Healthcare Research and Quality.

Figur

Table 8.

Table 8.

p.10

Referensi

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