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"Tujuan: Mengetahui pengaruh penurunan berat badan terhadap kadar asam urat plasma dan urin subjek dengan berat badan lebih.Tempat: Sebuah pusat kebugaran di Kelapa Gading, Jakarta UtaraMetodologi: Dilakukan penelitian pada 26 perempuan peserta program penurunan berat badan (BB) yang bersedia mengikuti penelitian ini. Penelitian ini merupakan eksperimen kuasi pra dan pasca perlakuan tanpa pembanding. Tiap subjek mendapat diet rendah kalori seimbang dan olahraga aerobik selama 12 minggu. Diet rendah kalori seimbang diberikan berdasarkan pengurangan kalori sebesar 1000 kkal/hari.Dengan perhitungan keluaran energi selama olahraga aerobik yang diprogramkan berkisar antara 200-400 kkal/hari, diet yang diberikan kira-kira 800-1100 kkal/hari. Sebelum diberikan olahraga aerobik dilakukan tes Cooper untuk menilai kemampuan maksimal tiap subjek dalam berolahraga. Olahraga aerobik diberikan dengan intensitas 60-80% kemampuan maksimal, lama latihan 60 merit; dan frekuensi 5 kali seminggu Pemeriksaan antropometri dan kadar asam urat dilakukan pada awal, minggu ke 2, dan akhir perlakuan.Hasil Terjadi penurunan BB secara signifikan (p<0,05; uji t berpasangan) dan 74,30 ± 10,48 kg menjadi 65,31 ± 8,56 kg (penurunan 12,10%); penurunan indeks massa tubuh (IMT) secara signifikan (p<0,05) dari 29,79 ± 4,28 menjadi 26,19 ± 3,41 kglm2 (pemmman 12,08%); dan penurunan massa lemak (ML) secara signifikan (p<0,05) Bari 36,21 ± 2,80 menjadi 25,97 ±2,94% (penurunan 28,28%). Pada minggu ke 2 terjadi peningkatan kadar asam urat plasma dan urin, masing-masing dari 5,40 ± 1,29 menjadi 5,96 ± 1,44 mg/dL (peningkatan 10,37%) dan dari 542,23 ± 179,39 menjadi 583,15 ± 202,35 mg/dL (peningkatan 7,55%). Setelah perlakuan 12 minim' terjadi penurunan kadar asam urat plasma dan urin yang signifikan (p<0,05) masing-masing dari 5,40 ± 1,29 menjadi 4,39 t 1,21 mg/dL (penurunan 18,70%) dan dari 542,23 ± 179,39 menjadi 479,06 ± 134,73 rng/dL (pemurumn 11,60%). Penurunan berat badan mempunyai korelasi lemah dengan penurunan kadar asam urat plasma (r = 0,32) dan penurunan kadar asam urat urin (r = 0,33) namun tidak signifikan (p >0,05). Dengan uji multivariat didapat korelasi positif atas peningkatan kadar asam urat plasma minggu ke 2 dengan BB awal. Penurunan kadar asam urat plasma pada akhir penelitian mempunyai korelasi positif dengan person ML akhir perlakuan. Penurunan kadar asam carat urin akhir perlakuan berkorelasi positif dengan asupan protein awal, serta berkorelasi negatif dengan clearance asam urat swat.Kesimpulan: Pada proses penurunan berat badan dengan diet rendah kalori seimbang dan olahraga aerobik, kadar asam urat plasma dan urin mula-mula akan meningkat, kemudian menurun mencapai kadar yang lebih rendah daripada kadar awal.

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Effects of Weight Reduction by Balanced Low-Calorie Diet (LCD) and Aerobic Exercise on Plasma and Urinary Uric Acid Levels of Overweight WomenObjective: To investigate the effects of weight reduction on plasma and urinary uric acid levels of overweight subjects

Place: One fitness centre at Ketapa Gading, North Jakarta

Methods: Twenty six overweight women were studied in a pre and posttest, using control group as the same subjects as the treatment group. Subjects received a balanced LCD and aerobic exercise for 12 weeks. Balanced LCD was given based on energy deficit 1000 kcal/day. Energy expenditure from aerobic exercise was 200 to 400 kcal and the subject were given diet of 800-1100 kcallday. All subjects had to undergo Cooper test for designing the aerobic exercise program. The intensity of the aerobic exercise was 60-80% of maximum capacity with duration of 60 minutes 5 days a week Anthropometric measurements and plasma and urinary uric acid were examined at the beginning, second week and after the treatment

Results: Balanced LCD and aerobic exercise given for 12 week significantly (p<0.05; paired t test) decreased body weight (BW), body mass index (BM), and fat mass from 74.30 ± 10.48 kg to 65.31 ± 8.56 kg (decreased 12.10%), from 29.79 ± 4.28 to 26.1.9 ± 3.41 kg/m2 (12.08%), and from 36.21 ± 2.80 to 25.97 ± 2.94% (28.28%) respectively. In the second week, plasma and urinary uric acid levels increased from 5.40 ± 129 to 5.96 ± 1.44 mg/dL (10.7%) and from 542.23 ± 179.39 to 583.15 ± 202.35 mg/dL (7.55%). After 12 weeks of treatment, plasma and urinary uric acid levels decreased significantly (p<0,05) from 5.40 ± L29 to 4.39 ± 1.21 mg/dL (18.70%), and from 542.23 ± 179.39 to 479.06 ± 134.73 mg/dL (11.60%) respectively. There was a weak correlation between weight reduction and plasma (r = 0.32) and urinary uric acid levels (r = 0.33), but not significant (p X0.05). With multivariate analysis, there was a positive correlation between increased plasma uric acid level with BW before treatment There was a positive correlation between decreased of plasma uric acid after treatment with fat mass after treaatment (%). There was a positive correlation between decreased after treatment urinary uric acid level and before treatment protein intake, and had a negative correlation with before treatment uric acid clearance.

Conclusions: In the process of weight reduction with balance LCD and aerobic exercise, plasma and urinary uric acid levels increased in the second week, and decreased to the levels lower than the base line at the end of treatment."

"Latar belakang:. Data tahun 2007 menunjukkan prevalensi perempuan dewasa dengan obesitas di Indonesia 13,9% dan terus mengalami peningkatan, yaitu 15,5% pada 2010 dan 32,9% pada 2013. The Royal College of Obstetricians and Gynaecologists (RCOG) mendefinisikan obesitas dalam kehamilan sebagai indeks massa tubuh (IMT) >30 kg/m2 pada kunjungan antenatal pertama. Risiko kehamilan terkait berat badan berlebih dan obesitas diantaranya adalah peningkatan risiko hipertensi dalam kehamilan (termasuk preeklampsia), tromboemboli, dan diabetes melitus gestasional. Peningkatan lama persalinan dan peningkatan risiko seksio sesaria juga diketahui terkait dengan berat badan berlebih dan obesitas. Obesitas dalam kehamilan juga meningkatan risiko janin makrosomi, kematian dalam kandungan, dan malformasi kongenital. Tujuan: a. Diketahuinya luaran maternal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. b. Diketahuinya luaran perinatal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. c. Diketahuinya kualitas Asuhan Antenatal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. c. Diketahuinya pandangan tenaga kesehatan terhadap ibu hamil dengan berat badan berlebih dan obesitas, d. Diketahuinya pandangan ibu hamil , serta keluarga terhadap kehamilan dengan berat badan berlebih dan obesitas Metode: Dilakukan studi kuantitatif dan kualitatif pada kasus ibu hamil dengan berat badan berlebih dan obesitas yang bersalin RSCM tahun 2015-2019. Pengambilan data kuantitatif dilakukan dengan telaah rekam medis dan kelengkapan pengisian buku KIA secara umum, dimana akan dilihat untuk luaran maternal, perinatal serta edukasi ANC yang berhubungan dengan kehamilan dengan berat badan berlebih dan obesitas. Pengambilan data kualitatif dilakukan dengan wawancara mengenai pemahaman ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM dan tenaga kesehatan pemberi pelayanan asuhan antenatal di fasyankes asal asuhan antenatal serta keluarga Hasil: Terdapat 509 kasus ibu hamil dengan obesitas dan berat badan berlebih yang bersalin di RSCM selama tahun 2015-2019, Dari 509 subjek, diketahui 189 subjek (37,1%) mengalami obesitas dan 320 subjek (62,9%) mengalami berat badan berlebih. Berdasarkan data tersebut, didapatkan insidensi obesitas dan berat badan berlebih persalinan di RSCM periode tahun 2015-2019 masing-masing sebesar 4,28% dan 2,53%.Luaran maternal ibu dengan obesitas dan berat badan berlebih yang bersalin di RSCM, ditemukan morbiditas persalinan prematur, ketuban pecah dini, dan preeklampsia, dengan jumlah masing-masing 249 (48.9%), 133 (26.1%), dan 121 (23.8%). Luaran Perinatal luaran perinatal patologis yang paling sering dijumpai adalah asfiksia, IUGR, dan IUFD, dengan jumlah masing-masing sebanyak 113 (22.2%), 46 (9.0%), 31 (6.1%). Luaran cara persalinan Mayoritas subjek melahirkan dengan cara seksio sesarea dan pervaginam, dengan jumlah masing-masing 345 (67.8%) dan 154 (30.2%) orang. Secara kualitatif, didapatkan pandangan ibu hamil dengan obesitas dan berat badan berlebih yang bersalin di RSCM dan tenaga kesehatan pemberi asuhan antenatal serta keluraga masih kurang tepat Kesimpulan: Secara kuantitatif dan kualitatif Terjadi kegagalan Identifikasi Kehamilan dengan berat badan berlebih dan obesitas pada kasus-kasus yang dirujuk ke RSCM pada saat dilakukan ANC di faskes primer
. Kata kunci: Luaran maternal dan perinatal. Pandangan Ibu hamil dengan berat badan berlebih dan obesitas, tenaga kesehatan, keluarga, Asuhan antenatal

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Background: Data shows in 2007 the prevalence of obese adult women in Indonesia is 13.9% and continues to increase, namely 15.5% in 2010 and 32.9% in 2013. The Royal College of Obstetricians and Gynecologists (RCOG) defines obesity in pregnancy as body mass index (BMI) >30 kg/m2 at the first antenatal visit. Obesity-related pregnancy risks include an increased risk of hypertension in pregnancy (including preeclampsia), thromboembolism, and gestational diabetes mellitus. Increased length of labor and increased risk of cesarean section are also known to be associated with obesity. Obesity in pregnancy also increases the risk of fetal macrosomy, stillbirth, and congenital malformations Aim: (1) To determine the maternal outcomes in overweight and obese pregnant women who give birth in RSCM. b. To determine perinatal outcomes in overweight and obese pregnant women who give birth in RSCM. c. To know the quality of Antenatal Care in pregnant women with overweight and obesity who gave birth in RSCM. c. To determine the views of health workers on pregnant women with excess weight and obesity, d. To determine the views of pregnant women, as well as their families towards overweight and obesity pregnancies Method: A set of Quantitative and qualitative studies were conducted on cases of overweight and obese pregnant women who gave birth to RSCM in 2015-2019. Quantitative data retrieval was carried out by reviewing medical records and the completeness of filling out the ANC book in general which to see for maternal, perinatal and ANC education related to pregnancy with overweight and obesity. Qualitative data was collected by deep interviewing about the understanding of pregnant women with excess weight and obesity who gave birth at the RSCM and health workers who provide antenatal care services in health facilities from antenatal care and families. Result: There were 509 cases of pregnant women with obesity and overweight who gave birth at the RSCM during 2015-2019. From 509 subjects, 189 subjects (37.1%) were obese and 320 subjects (62.9%) were overweight. Based on these data, the incidence of overweight and obesity in labor at the RSCM for the 2015-2019 period was 4.28% and 2.53%, respectively. preterm, premature rupture of membranes, and preeclampsia, with a total of 249 (48.9%), 133 (26.1%), and 121 (23.8%). Perinatal Outcomes The most common pathological perinatal outcomes were asphyxia, IUGR, and IUFD, with a total of 113 (22.2%), 46 (9.0%), 31 (6.1%). Outcomes of mode of delivery The majority of subjects gave birth by caesarean section and vaginally, with a total of 345 (67.8%) and 154 (30.2%) people, respectively. Qualitatively, it was found that the views of pregnant women with obesity and overweight who gave birth at the RSCM and health workers who provided antenatal care and their families were still inaccurate. Conclusion : Quantitatively and qualitatively there was a failure to identify pregnancies with excess weight and obesity in cases referred to the RSCM at the time of ANC at primary health facilities. Keyword: Maternal and perinatal outcomes. Views of pregnant women with excess weight and obesity, health workers, families, antenatal care"

"This book provides a timely update on the latest knowledge on maternal obesity and pregnancy. A very wide range of issues are covered, including macrosomia and associated shoulder dystocia, the risk of miscarriage, malformations, and complications of pregnancy, the impact of hyperglycemia, clinical management, consequences for anesthesia and ultrasound, impacts on breastfeeding, fertility, and childhood obesity, and pregnancy following gastric surgery. "