POLA MAKAN DAN KENAIKAN BERAT BADAN GESTASIONAL BERLEBIH PADA KEHAMILAN ATERM DI PONOROGO
DOI:
https://doi.org/10.51878/healthy.v5i4.14741Keywords:
pola makan, berat badan gestasional, kehamilan aterm, asuhan kebidanan, laporan kasusAbstract
Gestational weight gain exceeding recommended clinical ranges can occur in pregnant women with normal prepregnancy body mass index. This descriptive case report evaluates dietary patterns, excessive gestational weight gain, comprehensive midwifery care, and perinatal outcomes in a term pregnancy in Ponorogo. Clinical data were collected from a 29-year-old multigravida receiving Continuity of Care services at Berkah Prima Medika Clinic. Maternal meal frequency increased from three to five times daily accompanied by routine milk consumption, while portion sizes and energy intake were not measured. Total weight increased from 50 kg to 72 kg at 39 weeks of gestation, showing a 22 kg gain that exceeded the 11.5–16 kg guideline. Midwifery interventions focused on balanced nutritional education, portion regulation, restriction of energy-dense foods, and monitored light physical activity. Spontaneous term delivery occurred at 40 weeks, resulting in a male infant weighing 3,900 g with Apgar scores of 9/10. Early nutritional assessment and serial maternal weight tracking are critical, although direct causality cannot be confirmed from a single clinical report.
ABSTRAK
Pertambahan berat badan gestasional (gestational weight gain) yang melebihi rentang klinis yang direkomendasikan dapat terjadi pada wanita hamil dengan indeks massa tubuh pranikah/prakehamilan (prepregnancy body mass index) normal. Laporan kasus deskriptif (descriptive case report) ini mengevaluasi pola makan, pertambahan berat badan gestasional berlebih, asuhan kebidanan komprehensif, dan luaran perinatal (perinatal outcomes) pada kehamilan aterm di Ponorogo. Data klinis dikumpulkan dari seorang multigravida berusia 29 tahun yang menerima layanan Continuity of Care di Klinik Berkah Prima Medika. Frekuensi makan ibu meningkat dari tiga menjadi lima kali sehari disertai konsumsi susu secara rutin, sementara ukuran porsi dan asupan energi tidak diukur. Berat badan total meningkat dari 50 kg menjadi 72 kg pada usia kehamilan 39 minggu, menunjukkan kenaikan sebesar 22 kg yang melebihi pedoman 11,5–16 kg. Intervensi kebidanan berfokus pada edukasi nutrisi seimbang, pengaturan porsi, pembatasan makanan padat energi (energy-dense foods), dan pemantauan aktivitas fisik ringan. Persalinan aterm spontan terjadi pada usia 40 minggu, melahirkan bayi laki-laki dengan berat 3.900 g dan skor Apgar (Apgar scores) 9/10. Penilaian nutrisi dini dan pelacakan berat badan ibu secara serial sangat penting dilakukan, meskipun kausalitas langsung tidak dapat dikonfirmasi dari laporan klinis tunggal.
References
Aji, A. S., Lipoeto, N. I., Yusrawati, Y., Malik, S. G., Kusmayanti, N. A., Susanto, I., Majidah, N. M., Nurunniyah, S., Alfiana, R. D., Wahyuningsih, W., & Vimaleswaran, K. S. (2022). Association between pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes: A cohort study in Indonesian pregnant women. BMC Pregnancy and Childbirth, 22(1), Article 492. https://doi.org/10.1186/s12884-022-04815-8
American College of Obstetricians and Gynecologists. (2013). ACOG Committee Opinion No. 548: Weight gain during pregnancy. Obstetrics & Gynecology, 121(1), 210–212. https://doi.org/10.1097/01.AOG.0000425668.87506.4c
An, A. D., Alwiandono, I., Maulidya, A. N., & Arumningtyas, R. M. (2026). Fetal macrosomia with suboptimal antenatal care: A case report. International Journal of Health and Pharmaceutical (IJHP), 6(1), 373–377. https://doi.org/10.51601/ijhp.v6i1.443
Behnam, S., Timmesfeld, N., & Arabin, B. (2022). Lifestyle interventions to improve pregnancy outcomes: A systematic review and specified meta-analyses. Geburtshilfe und Frauenheilkunde, 82(11), 1249–1264. https://doi.org/10.1055/a-1926-6636
Calancie, L., Brown, M. O., Choi, W. A., Caouette, J. L., McCann, J. J., Nam, E. Y., & Werner, E. F. (2025). Systematic review of interventions in early pregnancy among pregnant individuals at risk for hyperglycemia. American Journal of Obstetrics & Gynecology MFM, 7(3), Article 101606. https://doi.org/10.1016/j.ajogmf.2025.101606
Cantor, A. G., Jungbauer, R. M., McDonagh, M., Blazina, I., Marshall, N. E., Weeks, C., Fu, R., LeBlanc, E. S., & Chou, R. (2021). Counseling and behavioral interventions for healthy weight and weight gain in pregnancy: Evidence report and systematic review for the US Preventive Services Task Force. JAMA, 325(20), 2094–2109. https://doi.org/10.1001/jama.2021.4230
Chen, Y., Sarnthiyakul, S., Michel, S., Wu, C., Hauner, H., von Ehrenstein, O. S., Liu, J., & Chen, L. (2025). Energy intake and physical activity over the course of pregnancy and gestational weight gain: A systematic review and dose-response meta-analysis of data from randomized controlled lifestyle intervention trials. Nutrition Journal, 24(1), Article 123. https://doi.org/10.1186/s12937-025-01182-w
Dasmasela, M. K. (2026). Efficacy of nutrition education and supplementary feeding on the nutritional status of pregnant women and follow-up of infants up to six months of age [Tesis master, IPB University]. IPB Scientific Repository. http://repository.ipb.ac.id/handle/123456789/172220
Deierlein, A., Siega?Riz, A. M., & Herring, A. H. (2020). Dietary energy density but not glycemic load is associated with gestational weight gain. UNC Libraries. https://doi.org/10.17615/652y-1g95
Figueroa, R., Saltzman, J. A., Kang, A., Mini, F. N., Davison, K. K., & Taveras, E. M. (2020). Antenatal dietary concordance among mothers and fathers and gestational weight gain: A longitudinal study. BMC Public Health, 20(1), Article 1071. https://doi.org/10.1186/s12889-020-09182-7
Gagnier, J. J., Kienle, G., Altman, D. G., Moher, D., Sox, H., Riley, D., & CARE Group. (2014). The CARE guidelines: Consensus-based clinical case report guideline development. Journal of Clinical Epidemiology, 67(1), 46–51. https://doi.org/10.1016/j.jclinepi.2013.08.003
Goldstein, R. F., Abell, S. K., Ranasinha, S., Misso, M., Boyle, J. A., Black, M. H., Li, N., Hu, G., Corrado, F., Rode, L., Kim, Y. J., Haugen, M., Song, W. O., Kim, M. H., Bogaerts, A., Devlieger, R., Chung, J. H., & Teede, H. J. (2017). Association of gestational weight gain with maternal and infant outcomes: A systematic review and meta-analysis. JAMA, 317(21), 2207–2225. https://doi.org/10.1001/jama.2017.3635
Goldstein, R. F., Abell, S. K., Ranasinha, S., Misso, M. L., Boyle, J. A., Harrison, C. L., Black, M. H., Li, N., Hu, G., Corrado, F., Hegaard, H., Kim, Y. J., Haugen, M., Song, W. O., Kim, M. H., Bogaerts, A., Devlieger, R., Chung, J. H., & Teede, H. J. (2018). Gestational weight gain across continents and ethnicity: Systematic review and meta-analysis of maternal and infant outcomes in more than one million women. BMC Medicine, 16, Article 153. https://doi.org/10.1186/s12916-018-1128-1
Institute of Medicine, & National Research Council. (2009). Weight gain during pregnancy: Reexamining the guidelines. National Academies Press. https://doi.org/10.17226/12584
International Weight Management in Pregnancy Collaborative Group. (2017). Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: Meta-analysis of individual participant data from randomised trials. BMJ, 358, Article j3119. https://doi.org/10.1186/bmj.j3119
Itani, L., Radwan, H., Hashim, M., Hasan, H., Obaid, R. S., Ghazal, H. A., Hilali, M. A., Rayess, R., Mohamed, H. J. J., Hamadeh, R., Rifai, H. A., & Naja, F. (2020). Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: Results from the MISC cohort. Nutrition Journal, 19(1), Article 36. https://doi.org/10.1186/s12937-020-00553-9
Kampmann, U., Suder, L. B., Nygaard, M., Geiker, N. R. W., Nielsen, H. S., Almstrup, K., Bruun, J. M., Magkos, F., Ovesen, P., & Catalano, P. (2024). Prepregnancy and gestational interventions to prevent childhood obesity. The Journal of Clinical Endocrinology & Metabolism, 110(1), e46–e60. https://doi.org/10.1210/clinem/dgae724
Kementerian Kesehatan Republik Indonesia. (2020). Pedoman pelayanan antenatal terpadu. Kementerian Kesehatan Republik Indonesia.
Kominiarek, M. A., & Peaceman, A. M. (2017). Gestational weight gain. American Journal of Obstetrics and Gynecology, 217(6), 642–651. https://doi.org/10.1016/j.ajog.2017.05.040
Li, Q., Piaseu, N., Phumonsakul, S., & Thadakant, S. (2024). Effects of a comprehensive dietary intervention program, promoting nutrition literacy, eating behavior, dietary quality, and gestational weight gain in Chinese urban women with normal body mass index during pregnancy. Nutrients, 16(2), Article 217. https://doi.org/10.3390/nu16020217
Li, Q., & Wang, J. (2025). Effectiveness of nutrition literacy intervention on pregnancy weight and eating behavior: A randomized controlled trial. Scientific Reports, 15(1), Article 21858. https://doi.org/10.1038/s41598-025-07979-3
LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group. (2019). Association of gestational weight gain with adverse maternal and infant outcomes. JAMA, 321(17), 1702–1715. https://doi.org/10.1001/jama.2019.3820
Marshall, N., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J. M., & Thornburg, K. L. (2021). The importance of nutrition in pregnancy and lactation: Lifelong consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035
Masri, D. E., Alemayohu, M. A., Loperfido, F., Bianco, I., Ferrara, C., Cerbo, R. M., Ghirardello, S., Monti, M. C., Maccarini, B., Sottotetti, F., Civardi, E., Garofoli, F., Angelini, M., Cena, H., & Giuseppe, R. D. (2024). Associations of maternal lifestyle factors with inadequate pregnancy weight gain: Findings from the baseline data of the LIMIT prospective cohort study. European Journal of Nutrition, 63(8), 2911–2920. https://doi.org/10.1007/s00394-024-03473-0
Minami, M., J-P, N. A., Noguchi, S., Eitoku, M., Muchanga, S. M. J., Mitsuda, N., Komori, K., Yasumitsu?Lovell, K., Maeda, N., Fujieda, M., Suganuma, N., Japan Environment and Children’s Study (JECS) Group, Kamijima, M., Yamazaki, S., Ohya, Y., Kishi, R., Yaegashi, N., Hashimoto, K., Mori, C., … Katoh, T. (2022). Gestational weight gain mediates the effects of energy intake on birth weight among singleton pregnancies in the Japan Environment and Children’s Study. BMC Pregnancy and Childbirth, 22(1), Article 568. https://doi.org/10.1186/s12884-022-04898-3
Moholdt, T., & Hawley, J. A. (2020). Maternal lifestyle interventions: Targeting preconception health. Trends in Endocrinology and Metabolism, 31(8), 561–569. https://doi.org/10.1016/j.tem.2020.03.002
Perichart?Perera, O., Reyes-Muñoz, E., Borboa-Olivares, H., Rodríguez-Cano, A. M., Solís-Paredes, J. M., Hernández?Hernández, L., Rodríguez-Hernández, C., González-Ludlow, I., Suárez-Rico, B. V., Sánchez-Martínez, M., Torres-Herrera, U., Canul-Euan, A. A., Tolentino?Dolores, M., Espejel-Núñez, A., & Estrada?Gutiérrez, G. (2024). Optimizing perinatal wellbeing in pregnancy with obesity: A clinical trial with a multi-component nutrition intervention for prevention of gestational diabetes and infant growth and neurodevelopment impairment. Frontiers in Medicine, 11, Article 1339428. https://doi.org/10.3389/fmed.2024.1339428
Riley, D. S., Barber, M. S., Kienle, G. S., Aronson, J. K., von Schoen-Angerer, T., Tugwell, P., Kiene, H., Helfand, M., Altman, D. G., Sox, H., Werthmann, P. G., Moher, D., Rison, R. A., Shamseer, L., Koch, C. A., Sun, G. H., Hanaway, P., Sudak, N. L., Kaszkin-Bettag, M., & Gagnier, J. J. (2017). CARE guidelines for case reports: Explanation and elaboration document. Journal of Clinical Epidemiology, 89, 218–235. https://doi.org/10.1016/j.jclinepi.2017.04.026
Santos, S., Voerman, E., Amiano, P., Barros, H., Beilin, L. J., Bergström, A., Charles, M. A., Chatzi, L., Chevrier, C., Chrousos, G. P., Corpeleijn, E., Costet, N., Crozier, S., Devereux, G., Eggesbø, M., Ekström, S., Fantini, M. P., Farchi, S., Forastiere, F., & Jaddoe, V. W. V. (2019). Impact of maternal body mass index and gestational weight gain on pregnancy complications: An individual participant data meta-analysis of European, North American and Australian cohorts. BJOG: An International Journal of Obstetrics & Gynaecology, 126(8), 984–995. https://doi.org/10.1111/1471-0528.15661
Sauder, K. A., & Ritchie, N. D. (2021). Reducing intergenerational obesity and diabetes risk. Diabetologia, 64(3), 481–490. https://doi.org/10.1007/s00125-020-05341-y
Scheidl, T. B., Brightwell, A. L., Easson, S., & Thompson, J. (2023). Maternal obesity and programming of metabolic syndrome in the offspring: Searching for mechanisms in the adipocyte progenitor pool. BMC Medicine, 21(1), Article 50. https://doi.org/10.1186/s12916-023-02730-z
Stephenson, J., Heslehurst, N., Hall, J., Schoenaker, D. A. J. M., Hutchinson, J., Cade, J. E., Poston, L., Barrett, G., Crozier, S. R., Barker, M., Kumaran, K., Yajnik, C. S., Baird, J., & Mishra, G. D. (2018). Before the beginning: Nutrition and lifestyle in the preconception period and its importance for future health. The Lancet, 391(10132), 1830–1841. https://doi.org/10.1016/S0140-6736(18)30311-8
Teede, H. J., Bailey, C., Moran, L. J., Bahri Khomami, M., Enticott, J., Ranasinha, S., Rogozinska, E., Skouteris, H., Boyle, J. A., Thangaratinam, S., & Harrison, C. L. (2022). Association of antenatal diet and physical activity-based interventions with gestational weight gain and pregnancy outcomes: A systematic review and meta-analysis. JAMA Internal Medicine, 182(2), 106–114. https://doi.org/10.1001/jamainternmed.2021.6373
Uddin, S., Abdullah, T., Nursalim, N., & Hasan, E. (2024). Peningkatan literasi melalui edukasi gizi ibu hamil di posyandu dan kunjungan rumah. Jurnal Pengabdian Meambo, 3(2), 112–117. https://doi.org/10.56742/jpm.v3i2.98
US Preventive Services Task Force. (2021). Behavioral counseling interventions for healthy weight and weight gain in pregnancy: US Preventive Services Task Force recommendation statement. JAMA, 325(20), 2087–2093. https://doi.org/10.1001/jama.2021.6949
Wang, Y., Wang, Z., Sun, Y., Yang, L., Ma, L., Li, J., Zhang, S., & Yang, X. (2024). Critical threshold of average weekly weight gain in overweight pregnant women during the second and third trimesters: A strategy to prevent macrosomia. Diabetes, Metabolic Syndrome and Obesity, 17, 3683–3695. https://doi.org/10.2147/dmso.s470863
World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization.
Yilmaz, A. D., Çal?k, K. Y., & Budak, M. (2025). The effect of body mass index on maternal and neonatal health in term pregnancies: A cross-sectional study in Turkey. BMC Pregnancy and Childbirth, 25(1), Article 572. https://doi.org/10.1186/s12884-025-07690-1
