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ID Sukati Sarmin https://orcid.org/0000-0002-2395-0274
ID Restu Pangestuti https://orcid.org/0000-0002-9075-9728
ID Fifi Ratna Aminati

Abstract

Background: Anemia in pregnancy remains a major public health concern, with prevalence exceeding 20% in Indonesia. This condition is commonly associated with hemodilution and inadequate iron intake.


Objective: This study aims to analyze the effect of red guava–red spinach juice combined with iron (Fe) tablet fortification on the hemoglobin (Hb) levels of third‑trimester pregnant women.


Methods: A quasi‑experimental pretest–posttest design with a control group was implemented involving 60 pregnant women. Participants were divided into control (Fe tablets only) and intervention groups (Fe tablets + 200 mL red guava–red spinach juice daily for 14 days). Hemoglobin was measured using a calibrated digital hemoglobinometer. Paired and independent t‑tests were used.


Result: The control group showed an Hb increase from 9.21 ± 0.18 g/dL to 12.10 ± 0.27 g/dL (mean difference 2.89 g/dL, p < 0.001). The intervention group increased from 8.41 ± 1.12 g/dL to 13.00 ± 0.90 g/dL (mean difference 4.59 g/dL, p < 0.001). An independent t‑test revealed significant differences in post‑test Hb levels between groups (t = −20.4, p = 0.01). Effect size (Cohen’s d = 1.21) indicated strong clinical significance.


Conclusion: Red guava–red spinach juice combined with Fe tablets is more effective in increasing Hb levels than Fe tablets alone. This intervention can be recommended as a complementary non‑pharmacological strategy for anemia prevention programs.

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How to Cite
Sarmin, S., Pangestuti, R., & Aminati, F. R. (2025). THE EFFECT OF RED GUAVA-RED SPINACH JUICE COMBINED WITH IRON SUPPLEMENTATION ON HEMOGLOBIN LEVELS IN PREGNANT WOMEN. Nurse and Holistic Care, 5(3), 232–243. https://doi.org/10.33086/nhc.v5i3.8062
Section
Articles
Fe Tablets, Red Guava, Red Spinach, Pregnant Women, Hemoglobin Levels

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Sukati Sarmin, Bachelor of Midwifery Study Program, College of Health Sciences of Husada Jombang

Restu Pangestuti, Diploma of Midwifery Study Program, Faculty of Medicine and Health Sciences, Alma Ata University Yogyakarta, Indonesia

Fifi Ratna Aminati, Diploma Program of Midwifery, College of Health Sciences of Husada Jombang, Indonesia