Maternal-Fetal Relations, Stunting
Conditions
Keywords
Insulin-like Growth Factor 1, Zinc, Hemoglobin, Health Education, Stunting, Low-income Family
Brief summary
Background : It is important to tackle the issue of malnutrition at an early stage. A stunted mother has a tendency of having adverse neonatal outcomes including growth restriction. The multidisciplinary intervention followed by micronutrient supplementation is developed to prevent these adverse outcomes. Zinc has been associated with better neonatal growth and brain growth. This study aims to assess the impact of family-based health education programs plus zinc supplementation on the important biomarker of pregnancy and neonatal growth. Objective : 1. To assess the impact of Family-based health education programs plus zinc supplementation on the outcome of pregnancy in stunted mother 2. 1\. To assess the impact of Family-based health education programs plus zinc supplementation on the outcome of neonatal growth in stunted mother Methodology : A Quasi-experimental study involving stunted pregnant mother with parallel intervention Hypothesis : Mother who receives the intervention will have the better maternal and neonatal outcome
Detailed description
Details of Family-Based Health Education Program + Zinc : 1. Home-visit and health promotion by trained midwives 2. Supervision by health volunteer 3. Zinc Supplementation General target population : 1. Stunted pregnant mother on the third trimester of pregnancy 2. Conducted in Primary Health Care Center Design of Study : two arms quasi-experimental study with one group receiving the intervention and comparison receiving standard Antenatal Care. The baseline measurement is conducted at the beginning of the third trimester, followed by the day of delivery and 6 months after delivery (for assessing the outcome of the infant). Participants are matched by certain variables Variable : 1. Sociodemographic information 2. Food recall using Food Frequency Questionnaire List of outcomes 1. Zinc level in breastmilk and blood of mother and infant 2. Insulin-like growth factor 1 (IGF-1) level of mother and infant 3. Hemoglobin level of mother and infant 4. Infant and placental anthropometry 5. Tumor growth Factor Beta 1 (TGF beta 1) in infant 6. Brain-derived neurotrophic factor (BDNF) in infant Sample size using the difference between two means of neonatal birth weight who received zinc and did not receive zinc according to a study in Iran 1. Type 1 error 5% 2. Effect size: 0.4486 3. Power of study: 80% 4. With the equal allocation ratio, the total sample needed is 126 Proposed statistical analysis 1. Independent T-test 2. Linear Mixed Model
Interventions
DIETARY_SUPPLEMENTZinc
Zinc is given as written in the arm description, two hours after lunch
OTHERControl
This group will not receive zinc
Sponsors
Hasanuddin University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
One group is assigned for health education intervention and zinc supplementation, and the comparison group receives only standard antenatal care.
Eligibility
Sex/Gender
FEMALE
Age
19 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Body height is less than 150 cm 2. Upper Arm Circumference less than 23.5 cm 3. Family income is less than Rp 2,500,000,- following the minimum wage of targeted area 4. 24-26 weeks pregnant.
Exclusion criteria
1. has pregnancy complications 2. multiple infants 3. refuse to follow the protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Infant weight | changes of weight at birth up to 6 months | This includes weight at birth, weight at 3 months and 6 months |
| Infant Length | changes of length at birth up to 6 months | This includes length of body at birth, at 3 months and 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Zinc level of mother in breast milk | changes of Zinc in breast milk of mother from the delivery day to 6 months after delivery | Zinc level of mother measured in blood using atomic absorption spectrometric |
| Hemoglobin level of infant | changes of hemoglobin level of infant from the day of birth to 6 months | Hemoglobin level of infant measured in blood using hematology analyzer |
| Insulin-like growth factor 1 (IGF-1) of mother | changes of IGF-1 level of mother from the baseline to day of delivery | Insulin-like growth factor 1 (IGF-1) of mother measured in blood using Human IGF-1 enzyme-linked Immunosorbent Assay (ELISA) |
| Hemoglobin level of mother | changes of hemoglobin level of mother from the baseline to delivery time | Hemoglobin level of mother measured in blood using hematology analyzer |
| Brain-derived neurotrophic Factor (BDNF) of infant | changes of BDNF level of infant from the day of birth to 6 months | Brain-derived neurotrophic Factor (BDNF) of infant measured in blood using enzyme-linked Immunosorbent Assay (ELISA) |
| Tumor Growth Factor Beta 1 (TGF beta 1) of infant | changes of TGF Beta 1 level of infant from the day of birth to 6 months | Tumor Growth Factor Beta 1 (TGF beta 1) of infant measured in blood using enzyme-linked Immunosorbent Assay (ELISA) |
| Insulin-like growth factor 1 (IGF-1) of infant | changes of IGF-1 level of infant from the day of birth to 6 months | Insulin-like growth factor 1 (IGF-1) of infant measured in blood using Human IGF-1 enzyme-linked Immunosorbent Assay (ELISA) |
| Zinc level of mother in blood | changes of Zinc in blood of mother from the baseline to 6 months after delivery | Zinc level of mother measured in blood using hematology analyzer |
Countries
Indonesia
Contacts
Primary ContactHalisah Halisah, M.Keb
Backup ContactHalisah Halisah, M.Keb
Outcome results
None listed