SUPLEMENTASI MIKRONUTRIEN UNTUK REDUKSI KECEMASAN DAN NYERI PERSALINAN: SISTEMATIK REVIEW

Abstract

Background: Antenatal anxiety is closely linked to labor pain perception through psychoneuroimmune pathways, including HPA axis activation, proinflammatory cytokines, and neurotransmitter modulation, which influence pain threshold and coping during contractions. Nutritional status, particularly essential micronutrient adequacy, has the potential to stabilize the stress response, reduce inflammation, and improve neuromuscular function. Supplementation with omega-3, magnesium, iron, and vitamin D during pregnancy is considered a rational complementary approach to reducing labor anxiety and pain in the primary care setting. Objective: To assess the effectiveness of these four supplementation approaches on maternal anxiety and first-stage pain intensity. Methods: This systematic review followed PRISMA, searching PubMed, Scopus, Web of Science, and Cochrane without language restrictions. Included designs included randomized trials, quasi-experimental studies, and cohorts that reported on anxiety (e.g., HADS-A/STAI) and/or labor pain (VAS/NRS). Risk of bias was assessed using RoB 2 or ROBINS-1; random effects meta-analyses were considered if homogenous. Results: Preliminary evidence suggests omega-3s reduce mild to moderate anxiety; magnesium has the potential to improve neuromuscular tension; iron supplementation reduces anemia factor associated with a lower pain threshold; vitamin D findings are heterogeneous. The quality of evidence varies from low to moderate, limited by sample size, duration, and instrument heterogeneity. Conclusion: Supplementation with certain micronutrients holds promise for reducing antenatal anxiety and possibly labor pain, but standardized randomized trials with adequate sample sizes are needed to strengthen clinical recommendations.