ABSTRAK ABSTRACTBackground: Maternal nutrition before and during pregnancy is important for a healthy pregnancy outcome. According to National Basic Health Research (Riskesdas) 2013, 24.2% of pregnant women are at risk of chronic malnutrition and 37.1% of them suffer from anemia. The aim of this study was to obtain information about the nutrient intake and serum micronutrient status in the first trimester of pregnant women in Jakarta.

We report a 23-year-old pregnant woman who presented with acute high-grade fever, vomiting, and diarrhea for 5 days. She was first hospitalized in RSUD Tangerang—a secondary hospital based in Tangerang and were referred to Cipto Mangunkusumo General Hospital as a tertiary hospital. Initial laboratory results from previous hospital revealed leukopenia, low platelet, elevated aspartate transaminase, and alanine transaminase. Chest radiograph showed no pulmonary infiltration. Reverse transcriptase–PCR (RT-PCR) of the nasopharyngeal swab detected SARS-CoV-2, and NS1 antigen or IgM dengue-specific antibodies were positive. COVID-19 with dengue fever co-infection was diagnosed. Haemorrhagic manifestations were seen in both the mother (gum and gastrointestinal bleeding) and pregnancy (placental abruption). Patient was put on ventilator and was unfortunately lead to her death that were caused by multiorgan dysfunction failure due to co-infection of dengue and COVID-19. Both dengue and COVID-19 had similar manifestation, as it is a warning sign in pregnant patient experienced both that can lead to fatal result in mother and baby. Early diagnosis and management of co-infection is high clinical importance, especially in endemic area of dengue like Indonesia.

Introduction: Preeclampsia has been one of the leading causes of maternal death in Indonesia. It is postulated that its relationship with oxidative stress may be the underlying pathology of the disease. Nutrients and amino acids have been suggested as a scavenger for oxygen-free radicals. No previous study regarding the amino acid status in preeclampsia has been conducted in women in Indonesia. Methods: This was a cross-sectional study of a total of 64 pregnant women, 30 with normal pregnancy and 34 with severe preeclampsia. Data were obtained in Cipto Mangunkusumo National Referral Hospital in Jakarta from July to December 2020. Maternal blood samples were taken during or soon after delivery. Amino acid levels were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Bivariate analysis was then performed. Results: We identified 19 different levels of amino acids in this study. Four amino acids that were elevated in the preeclampsia group were phenylalanine, serine, glycine, and glutamate. Serine (331.55 vs. 287.43; p = 0.03), glycine (183.3 vs. 234.35, p = 0.03), and glutamate levels (102.23 vs. 160.70, p = 0.000) were higher in preeclamptic patients. While in the essential amino acids group, phenylalanine levels (71.5 vs. 85.5, p = 0.023) were higher, and methionine levels (16.3 vs. 12.9, p = 0.022) were lower in preeclamptic patients. Conclusions: These findings suggest that severe preeclampsia had differences in concentration of some amino acids compared to normal pregnancy. Glutamate and methionine were associated with preeclampsia. Furthermore, a more detailed study regarding amino acids in the pathomechanism of preeclampsia is suggested.