The Impact of Dehydration in the Third Trimesters on Pregnancy Outcome-Infant Birth Weight and Length
This cohort study aimed to analyze the effect of dehydration on pregnancy outcome. A total of 66 pregnant women aged (18-35 years) at second trimester (>12 weeks) of pregnancy was recruited from seven health centers (Puskesmas) Kebon Jeruk, West Jakarta from December 2016 to January 2018. Five biomarkers (urine color, urine osmolality, urine specific gravity, serum osmolality, serum sodium) were utilized to determine hydration status. Based on the result, subjects were then assigned to dehydration group (DG) and normal group (NG), 51.5% was in the DG and 48.5%, in the NG respectively. Independent t-tests and Chi-square were employed to answer research questions. There were differences in weight of the mothers in the second and third trimester between the two groups (p<0.05), but no differences in weight gain during pregnancy (p≥0.05). More than fifty percent of subjects suffered nausea and vomiting during pregnancy in the two groups. Water intake level in DG (72.53±14.41%) were lower than NG (118.68±14.37%). The accounted difference in Infant birth weight, length, chest circumference and head circumference; were 491.84 g, 0.98 cm, 0.98 cm, and 1.11 cm, respectively where infant from the NG had higher measurements than DG. After adjustment for water intake level, the infant birth weight and length in DG (2,798.53±97.85 g; 47.32±0.32 cm) was lower than NG (3,371.77±102.60 g; 49.09±0.33 cm). The accounted difference in infant birth weight and length between the two groups were 596.1 g and 1.8 cm, respectively. Thus in addition to nutrient intake and weight gain during pregnancy, pregnant mothers should also concern for their fluid intake in order to maintain their health condition and feotal growth - development.
Almatsier S. 2009. Prinsip Dasar Ilmu Gizi. Jakarta: PT Gramedia Pustaka Utama.
Anderka M, Mitchell AA, Louik C, Werler MM, Hernández‐Diaz S, Rasmussen SA. 2012. Medications used to treat nausea andvomiting of pregnancy and the risk of selected birth defects. Birth Defects Res A Clin Mol Teratol 94(1):22-30. doi:10.1002/bdra.22865.
Armstrong LE, Evan CJ, Colleen XM, Brittany S, Laurent LB, Liliana J, Doglas JC, Carl MM. 2012. Hydration Biomarkers and Dietary Fluid Consumption of Women. J Acad Nutr Diet 112(7):1056-1061.
Bardosono S, Morin C, Guelinckx I, Pohan R. 2017. Pregnant and Breastfeeding Women: Drinking for Two?. Ann Nutr Metab 70(S1):13–17. doi: 10.1159/000462998.
Beetz R. 2003. Mild dehydration: a risk factor of urinary tract infection? Eur J Clin Nutr 57(2):S52-S58. doi:10.1038/sj.ejcn.1601902.
Blumfield ML, Clare EC. 2014. High-protein diets during pregnancy: healthful or harmful for offspring?. Am J Clin Nutr 100:993-5.
Bottin JH, G Lemetais, M Poupin, L Jimenez dan ET Perrier. 2016. Equivalence of afternoon spot and 24-h urinary hydration biomarkers in free-living healthy adults. Eur J Clin Nutr 70(8):904-907.
Chassin C, Mathias WH, Marcelle B, Michael L, Jean-Michel G, Sophie V, Guillaume A, Alexandre H, Eric R, Alain V. 2007. Hormonal control of the renal immune response and antibacterial host defense by arginine vasopressin. JEM The Rockefeller University Press 204(12):2837-2852 www.jem.org/cgi/doi/ 2837 10.1084/jem.20071032.
Committee on Practice Bulletins-Obstetrics. 2018. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gyneco 131(1):e15-e30. doi:10.1097/AOG.0000000000002456.
Danileviciute A, Regina G, Jone V, Algimantas P, Mark JN. 2012. Exposure to drinking water trihalomethanes and their association with low birth weight and small for gestational age in genetically susceptible women. Int J Environ Res Public Health 9(12):4470-4485. doi:10.3390/ijerph9124470.
Emmett PM, Louise RJ. 2015. Diet, growth, and obesity development throughout childhood in the avon longitudinal study of parents and children. Nutrition Reviews 73(S3):175-206. doi: 10.1093/nutrit/nuv054.
Febriyani NMPS, Hardinsyah, Briawan D. 2012. Minuman berkalori dan kontribusinya terhadap total asupan energi remaja dan dewasa. J Gizi Pangan 7(1):35-42. doi: http://dx.doi.org/10.25182/jgp.2012.7.1.36-43.
Festin M. 2014. Nausea and vomiting in early pregnancy. Clinical Evidence 03:1405.
Forbes K, Melissa W. 2010. Maternal growth factor regulation of human placental development and feotal growth. J Endocrinol 207(1):1-16. doi: 10.1677/JOE-10-0174.
Ghezzi F, Massimo F, Debora B, Barbara L, Maria CM, Salvatore A, Pierfrancesco B. 2001. Bioelectrical impedance analysis during pregnancy and neonatal birth weight. Eur J Obstet Gynecol Reprod Biol 98(2):171-176.
Hardinsyah, Sriardiningsih, Razaktaha, Briawan D, Effendi YH, Aries M, Lestari KS, Nindya TS, Hidri N, dan Fatimah S. 2010. Kebiasaan minum dan status hidrasi pada remaja dan dewasadi dua wilayah ekologi berbeda. Tim THIRST (The Indonesian Regional Hydration Study). FEMA IPB. FKM UNAIR dan FKM UNHAS.
Ibrahim NSI, Hardinsyah, Setiawan B. 2018. Hydration status and liver function of young men before and after Ramadan fasting. J Gizi Pangan 13(1):33-38. doi: 10.25182/jgp.2018.13.1.33-38.
Jequier E, Constant F. 2010. Water as an essential nutrient: the physiological basis of hydration. Eur J Clin Nutr 64:115-23. doi:10.1038/ejcn.2009.111.
Lee NM, Saha S. 2011. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am 40(2):309-vii. doi:10.1016/j.gtc.2011.03.009.
Malisova O. Bountziouka V, Panagiotakos D.B, Zampelas A, Kapsokefalou M. 2013. Evaluation of seasonality on total water intake, water loss and water balance in the general population in Greece. J Hum Nutr Diet 26(S1):90-96. doi:10.1111/jhn.12077.
Malisova O, Athanasios P, Anastasia N, Vassiliki B, Aristides A, Antonis Z, dan Maria K. 2014. Estimations of water balance after validating and administering the water balance questionnaire in pregnant women. Int J Food Sci Nutr 65(3):280-285.
Malhotra B, Deepika D. 2002. Effect of maternal oral hydration on amniotic fluid index in women with pregnancy-induced hypertension. J Obstet Gynaecol Res 28(4):194-198.
Manz F, Wentz A. 24-h hydration status: parameters, epidemiology and recommendations. 2003. Eur J Clin Nutr 57(S2):S10-8. doi: 10.1038/sj.ejcn.1601896.
McKenzie AL, Colleen XM, Lindsay AE, Erica TP, Isabelle G, Alexis K, Stavros AK, Lawrence EA. 2015. Urine color as an indicator of urine concentration in pregnant and lactating women. Eur J Nutr 1085-1089. doi: 10.1007/s00394-015-1085-9.
Mulyani EY, Hardinsyah, Briawan D, Santoso BI. Hydration status of pregnant women in West Jakarta. 2017. Asia Pac J Clin Nutr 26(S1):S26-S30. doi: 10.6133/apjcn.062017.s14.
Ogbuanu IU, Zeko S, Chu SY et al. 2014. Maternal, feotal, and neonatal outcomes associated with measles during pregnancy: Namibia, 2009-2010. Clin Infect Dis 58(8):1086-1092.
Ratnasari D, Suhartono, Mohammad Zen R. 2017. Faktor risiko kejadian berat badan lahir rendah di area pertanian (studi di kabupaten Brebes). J Gizi Pangan 12(1):41-48. doi: 10.25182/jgp.2017.12.1.41-48.
Rigaud M, Sevalho Corçao C, Perrier ET, Boesen-Mariani S. 2017. Assessing a tool for self-monitoring hydration using urine color in pregnant and breastfeeding women: a cross-sectional, online survey. Ann Nutr Metab 70(S1):23-29. doi: 10.1159/000463000
Sari AE, Hardinsyah, Ikeu T. 2015. Effect of water intake on sprague-dawley rat off spring’s linear growth. Pak. J Nutr 14 (7):436-439.
Savitz DA, Andrews KW, Pastore LM. 1995. Drinking water and pregnancy outcome in Central North Carolina: source, amount, trihalomethane levels. Environ Health Perspect 103:592-6.
Schrier RW. 2006. Body water homeostasis: clinical disorders of urinary dilution and concentration. J Am Soc Nephrol 17(7):1820-1832. doi: 10.1681/ASN.2006030240.
Shirreffs SM. 2003. Markers of hydration status. Eur J Nutr 57(S2): S6-S9.
Stuempfle KJ, Daniel GD. 2003. Comparison of 3 methods to assess urine specific gravity in collegiate wrestlers. J Athl Train 38(4):315-319.
Tanner JM. 1978. Fetus into Man (Physical Growth from Conception to Maturity). P.41-42. USA: Havard University Press.
Wegrzyniak LJ, Repke JT, Ural SH. 2012. Treatment of hyperemesis gravidarum. Rev Obstet Gynecol 5:78-84. doi: 10.3909/riog0176.
Widen EM, D Gallagher. 2014. Body composition changes in pregnancy: measurement, predictors and outcomes. Eur J Nutr 68(6):643-652.
Wiltbank MC, A. Garcia-Guerra, P.D. Carvalho, K.S. Hackbart, R.W. Bender, A.H. Souza, M.Z. Toledo, G.M. Baez, R.S. Surjus, R. Sartori. 2014. Effects of energy and protein nutrition in the dam on embryonic development. Anim Reprod 11(3):168-182.