Peran Kalsium dan Vitamin C dalam Absorpsi Zat Besi dan Kaitannya dengan Kadar Hemoglobin Ibu Hamil: Sebuah Tinjauan Sistematis

Abstract

Latar belakang: Kadar hemoglobin rendah menyebabkan anemia dalam kehamilan. Faktor yang mempengaruhi kadar hemoglobin adalah zat besi, vitamin C sebagai enhancer besi, dan kalsium sebagai inhibitor besi. Tujuan penelitian ini adalah untuk mengetahui pengaruh asupan besi, kalsium, dan vitamin C terhadap kadar hemoglobin ibu hamil.Metode: Penelitian ini menggunakan pendekatan tinjauan sistematis dengan metode PRISMA. Pencarian literatur menggunakan database elektronik yaitu SCOPUS, PubMed, dan Garuda dengan kata kunci: asupan besi, kalsium, vitamin C, kadar hemoglobin, ibu hamil. Pembatasan ditetapkan pada artikel: artikel asli dari sumber utama dengan teks penuh, diterbitkan sepuluh tahun terakhir, berbahasa Indonesia dan/atau Inggris. Variabel dalam artikel: pengaruh asupan besi, kalsium dan artikel terhadap kadar hemoglobin. Dari 663 artikel yang ditemukan, didapatkan 15 artikel yang memenuhi kriteria dan selanjutnya diidentifikasi. Hasil: Asupan zat besi meningkatkan kadar hemoglobin ibu hamil. Selain zat besi, vitamin C juga membantu meningkatkan kadar hemoglobin ibu hamil. Hal ini dikarenakan vitamin C merupakan faktor pendukung penyerapan zat besi. Asupan zat besi yang dikonsumsi bersama vitamin C lebih efektif dalam meningkatkan kadar hemoglobin. Sedangkan, kalsium merupakan faktor penghambat penyerapan zat besi, sehingga kalsium menurunkan jumlah kadar hemoglobin pada ibu hamil.Simpulan: Asupan zat besi, kalsium dan vitamin C memberikan pengaruh yang cukup signifikan pada kadar hemoglobin ibu hamil.Kata kunci: zat besi; kalsium; vitamin C; hemoglobin ABSTRACTTitle: Effect of Iron Intake, Calcium, and Vitamin C on Pregnant Women’s Hemoglobin Levels: Systematic ReviewBackground: Low hemoglobin levels cause anemia in pregnancy. Factors that affect hemoglobin levels are iron, vitamin C as an iron enhancer, and calcium as an iron inhibitor. This study aims to determine the effect of iron intake, calcium, and vitamin C on the hemoglobin levels of pregnant women.Method: This study uses a systematic review approach with the PRISMA method. A literatur search using electronic databases namely, SCOPUS, PubMed, and Garuda with the following keywords: iron intake, calcium, vitamin C, hemoglobin levels, pregnant women. Search limits included: original and full text articles from primary sources, published in the last ten years, Indonesian and/or English language. Variables in the articles: effect of iron intake, calcium, and vitamin C on hemoglobin levels. From 663 articles that founded, 15 articles were obtained fulfilling the criteria and then were identified.Result: Iron intake increases hemoglobin levels in pregnant women. In addition to iron, vitamin C also helps to increase the hemoglobin levels of pregnant women. This is because vitamin C is a supporting factor for iron absorption. Iron intake consumed with vitamin C is more effective in increasing hemoglobin levels. Meanwhile, calcium is a factor inhibiting the absorption of iron, so calcium lowers hemoglobin levels in pregnant women.Conclusion: Iron intake, calcium, and vitamin C has a significant influence on the hemoglobin levels of pregnant women.Keywords: iron; calcium; vitamin C; hemoglobin

The Important Role of Iron, Protein and Vitamin C With the Incident of Anemia

“…Taking vitamin C along with iron can increase iron absorption by up to 67%. By taking vitamin C together with iron tablets, iron absorption increases, so that hemoglobin levels in the blood also increase (Rieny et al, 2021). To reduce the risk of anemia, it is important to eat foods that contain iron and vitamin C.…”

The Experiences of Nutrition Fulfillment in Mothers with a History of Anemia During Pregnancy: A Qualitative Study

“…However, it is different from the calcium contained in food. Calcium in food is a nutrient that inhibits iron absorption in other types of food 22 . Calcium will bind iron before the intestinal mucosa absorbs it into an insoluble substance, reducing its absorption.…”

“…Calcium will bind iron before the intestinal mucosa absorbs it into an insoluble substance, reducing its absorption. With reduced absorption of iron due to these inhibitory factors, the amount of ferritin will also decrease, which impacts decreasing the amount of iron used to replace damaged hemoglobin 22,23 . This condition causes the hemoglobin level in the blood to be low 22,23 .…”

“…With reduced absorption of iron due to these inhibitory factors, the amount of ferritin will also decrease, which impacts decreasing the amount of iron used to replace damaged hemoglobin 22,23 . This condition causes the hemoglobin level in the blood to be low 22,23 . Research explains that during pregnancy, consuming between 40 and 300 mg of calcium per day, there will be an interaction between calcium and iron.…”

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“…Hemoglobin protein yang ada pada sel darah merah yang dapat digunakan sebagai parameter dalam mendiagnosa anemia defisinesi besi (Rieny et al, 2021). Rendahnya kadar hemoglobin dalam darah pada kondisi anemia ditandai dengan berkurangnya jumlah eritrosit dan kemampuan menurunkan kapasitas pembawa oksigen ke jaringan (Lebso et al, 2017); (Lin et al, 2018).…”