Translated from Indonesian to English - www.onlinedoctranslator.

com

IRON NEEDS IN PREGNANT WOMEN

Husnah1*, Maisarah sofyanr2, Raudhatul Jannah3, Khairun Nisa4
1
Staff of ClinicalNutrition Department, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
2,3,4
Undergraduate MedicalDoctor Program, Faculty of Medicine, Syiah Kuala University, Banda Aceh
Indonesia Corresponding Author*:dr_husnah@unsyiah.ac.id

ABSTRACT
Pregnant women need adequate nutrition for the health of the mother and fetus. If the nutritional
needs of the mother are not fulfilled, it can cause nutritional problems. However, pregnant
women often do not know that the need for nutrients increases during pregnancy. The purpose of
this article is to discuss nutritional problems that pregnant women may experience. Literature
research is used as the method. The data used is secondary information in the form of reports
from government agencies and previous research. Pregnant women are vulnerable to various
problems of malnutrition. Nutritional problems that are common in pregnant women include
chronic energy deficiency (IBD), anemia and iodine deficiency disorders. Nutritional problems
in pregnant women have a negative impact on the health of mothers and children.
Keywords:

INTRODUCTION usually caused by iron deficiency anemia.

Pregnant women are a group that is The main cause of iron deficiency anemia is
vulnerable to nutritional problems. This a lack of iron in the diet, especially in the
refers to the growth of the fetus and the form of heme iron. Socioeconomic factors
growth of various organs in the body to influence the occurrence of anemia.4
support pregnancy. Pregnant women need
Anemia during pregnancy is a
quality nutritional supplements that are
condition of a mother whose hemoglobin
healthy, intelligent and powerful.1A
(Hb) level is < 11 g% during the first and
common problem for pregnant women is not
third trimesters, while in the second
realizing the increased nutritional needs
trimester the hemoglobin level is < 10.5 g
during pregnancy. As a result, there are still
Anemia during pregnancy requires serious
pregnant women who do not follow the
attention because it can harm the mother and
recommendations of health workers, for
her baby.4Anemia during pregnancy can be
example, Mrs. B. took 90 iron tablets during
fatal and interfere with work, motor and
pregnancy.2
intellectual development in infants, children
Nationally, the proportion of
and adolescents. In pregnant women, anemia
pregnant women consuming more than 90
can cause low birth weight, prematurity,
tablets (90+) is still low, namely only
miscarriage, prolonged labor spasms, uterine
18.0%. With that in mind, it can be said that
atony, as well as bleeding and shock.5
the purpose of this article is to discuss
Research conducted by Amalia
nutritional problems that may arise in
(2011) at RSU Dr. MM Dunda Limboto,
pregnant women.3
Gorontalo Regency, showed that pregnant
Nutritional anemia in Indonesia is
women with anemia had a 4.643 chance of
 giving birth to LBW babies compared to
mothers who were not anemic.6Other
studies have shown a link between
gestational anemia and miscarriage.
Mothers with anemia are 3,317 times more
likely to have a miscarriage than pregnant
women without anemia.7
NUTRITION IN PREGNANT WOMEN
During pregnancy, the mother must
increase the amount and type of food,
pregnant women must meet their own needs
and the growth and development of their
fetus/infant. Therefore, pregnant women need
more nutrients than non-pregnant women as
long as their diet is varied and balanced in
quantity and proportion.8
Franca Marangoni in her article Diet and
Mother's Needs During Pregnancy and
Breastfeeding, an Italian consensus document
explaining that the caloric needs of a healthy,
normal weight, and moderately active
lifestyle during pregnancy increase
moderately (depending on the stage of
pregnancy), which can be offset by energy
intake. slightly increased. Macronutrients in
dietary guidelines. In fact, an excess of
calories and macronutrients during pregnancy
can be just as harmful as a deficiency,
especially in overweight and obese women,
who have an increased risk of miscarriage,
gestational diabetes, preeclampsia, but also
obesity and type 2 diabetes. In particular, the
additional needs of pregnant women is 69
kcal/day in the first trimester, 266 kcal/day in
the second trimester and 496 kcal/day in the
third trimester (additional total of 76.9
Strong scientific evidence supports the
importance of lifestyle and diet (adequate
nutritional intake) during pregnancy and
breastfeeding for the health of women and
their offspring. A varied and balanced diet
from conception is essential to ensure the
mother's well-being and a good pregnancy.
Even in most developed countries, intake of
certain foods is often insufficient during
pregnancy and lactation. Available data from
the Italian population indicate that intake of
selected nutrients is often insufficient, both in
certain population groups and in pregnant and
lactating women. This is especially true for
DHA, iron, iodine, calcium, folic acid and
vitamin D. Indispensable micronutrients9:
Folic acid: it is important to supplement
the mother's diet during pregnancy by adding
food (in appropriate diets) and using food
additives during conception, according to
national and international guidelines.
Vitamin D: there is no consensus on
recommended intake. A consensus document
recently published by the Societies of
Pediatrics in Italy emphasizes the high
prevalence of deficiency and the importance of
prevention also during pregnancy and
lactation.
Iron: although there is general agreement
on the benefit of systemic nutritional
supplementation in populations at high risk of
anemia during pregnancy, different countries
offer different recommendations; In general,
iron supplementation should be decided based
on individual clinical judgment.
Iodine: adequate intake must be ensured
during pregnancy, for example through
iodine-rich foods and iodized salt.
Calcium: the majority of the fertile female
population in Europe (and Italy) does not
reach optimal levels; In addition, special
attention should be paid to the bioavailability
of different foods.
DHA: benefits during pregnancy and
lactation confirmed by recent studies;
 Inadequate intake is linked to lower
consumption of omega-3 rich fish.
IRON
Iron is one of the most abundant micro
minerals in the human body, which is as
much as 3-5 grams in the adult human
body.10Iron is a micro-element that has
essential functions for the body, namely as a
means of transporting oxygen from the lungs
to the body's tissues, as a means of
transporting electrons within cells and as an
integrated part of various enzyme reactions in
the body's tissues.11
In the body, most of the iron is
conjugated with protein and is present in the
ferrous or ferric form. The active form of iron
is usually ferrous, while the inactive form is
ferrous. The conjugated forms of iron are
hemoglobin, myoglobin, transferrin, ferritin
and hemosiderin.10
Iron in the body comes from three
sources, namely iron obtained from the
destruction of red blood cells, iron taken from
storage in the body and iron absorbed from
the digestive tract. The main source of iron in
food is liver. In addition, meat, egg yolks,
green leafy vegetables and nuts are good
sources of iron.12
IRON NEEDS IN PREGNANT WOMEN
During pregnancy the need for iron (Fe)
averages about 1000 mg. About 500 mg is
required to increase red blood cell mass, and
about 300 mg is transported to the fetus,
mainly in the last 12 weeks of gestation. The
remaining 200 mg is needed to compensate
for involuntary losses through the skin, feces,
and urine.13
The need for iron in the first trimester is
± 1 mg/day, namely the basal requirement of
0.8 mg/day plus the needs of the fetus and red
cell mass = 30-40 mg. In the second
trimester, the required iron is ± 3 mg/day,
namely the basal requirement of 0.8 mg/day
plus the needs of the fetus and red cell mass =
300 mg and conceptus.= 115mg. As well as in
the third trimester, the required iron is ± 5
mg/day, namely the basal requirement of 0.8
mg/day plus the needs of the fetus and red cell
mass = 150 mg and conceptus= 223 mg.10
CONCLUSION
The hemodilution process that occurs
during pregnancy, the increased macronutrient
and micronutrient needs of the mother and the
fetus, and the lack of iron intake through food
results in a decrease in the Hb level of
pregnant women. To prevent this incident, the
need for the mother and fetus for iron tablets
must be met. Iron deficiency anemia as a result
of a lack of iron intake in pregnancy not only
has a negative impact on the mother, but also
has a negative impact on the welfare of the
fetus. This was confirmed by previous studies
which stated that iron deficiency anemia could
cause impaired fetal growth and premature
birth. Furthermore, in his research on the
biological mechanism of the impact of iron
administration on fetal growth and the
incidence of premature birth, he reported that
anemia and iron deficiency can cause stress to
the mother and fetus as a result of the
production of corticotropin-releasing hormone
(CRH). Increased CRH concentration is a risk
factor for preterm birth, pregnancy-induced
hypertension. Besides that, it also affects the
growth of the fetus.
 BIBLIOGRAPHY
1. Notoatmodjo S. Science & Art of
Public Health. Jakarta: Rineka Cipta;
2007.
2. Republic of Indonesia Ministry of
Health. Guidelines for Health Center
Staff: Balanced Nutrition Towards a
Healthy Life for Pregnant and
Breastfeeding Mothers. Jakarta; 2000.
Breastfeeding. An Italian Consensus
Document. Nutrients. 2016;8(10):1–17.
10. Pertiwi N. Comparison of the Success
of Iron Supplementation in Pregnant
Women with Anemia at the Wirobrajan
Health Center Yogyakarta [Internet].
Yogyakarta Muhammadiyah University;
2018. Available from:
http://repository.umy.ac.id/handle/1234
56789/20612

3. Republic of Indonesia Ministry of 11. Harvey LJ, Dainty JR, Hollands WJ et

Health. Regulation of the Minister of al. Effect of High-dose Iron
Health of the Republic of Indonesia, Supplements on Fractional Zinc
Number 75 of 2013 concerning Absorption and Status in Pregnant
Recommended Nutrition Adequacy Women. Am J Clin Nutr.
Rates for the Indonesian Nation. 2013. 2007;85(1):131–6.

4. Manuaba IAC, Manuaba IBGF, 12. Sediaoetama. Nutrition Science for

Manuaba IBG. Understand Women's
Reproductive Health. Jakarta: EGC
Medical Book; 2009.
13.
5. Rai NIGB, Kawengian SES, Mayuki
N. Analysis of Factors Associated with
Hemoglobin Levels in Pregnant
Women. J e-Biomedic. 2016;4(2).
Students and Professionals. Jakarta:
Dian Rakyat; 1999.
Romlah, Sari AP. Consumption of Iron
Tablets on Hemoglobin Levels of
Second Trimester Pregnant Women.
JPP (Journal of Health Poltekkes
Palembang). 2020;15(1):45–51.

6. Amalia L. Risk Factors for Low Birth

Weight Babies (LBW) at RSU Dr. MM
Dunda Limboto, Gorontalo Regency. J
Saintek. 2011;6(3).

7. Irayani F. Analysis of the Relationship

of Anemia in Pregnant Women with
Abortion Incidence at Demang Se
Island Raya Hospital, Central
Lampung Regency. J Health.
2015;6(2):190–200.

8. Republic of Indonesia Ministry of

Health. Balanced Nutrition Guidelines.
Jakarta; 2014.

9. Marangoni F, Cetin I, Verduci, E et al.

Maternal Diet and Nutrient
Requirements in Pregnancy and