Parity and Risk of Low Birth Weight Infant in Full Term Pregnancy

Latar belakang: Berat badan lahir rendah meningkatkan morbiditas dan mortalitas pada bayi baru lahir. Hasil Riskesdas 2010 dan 2013 menunjukkan penurunan angka prevalensi berat badan lahir rendah dari 11,1% menjadi 10,2%. Tujuan penelitian ini adalah mengidentifikasi faktor risiko yang berkaitan dengan kejadian berat badan lahir rendah pada kehamilan cukup bulan. Metode: Penelitian potong lintang di dua rumah sakit di Jakarta dengan menggunakan data sekunder. Data rekam medik wanita yang melahirkan pada periode 1 Januari sampai 31 Desember 2011 dipilih secara purposif. Berat badan lahir rendah adalah berat badan kurang dari 2500g pada bayi baru lahir. Analisis data dilakukan dengan menggunakan regresi logistik. Hasil: Pada analisis ini didapatkan 2242 subyek yang memenuhi kriteria, dari 4191 subyek. Proporsi berat badan lahir rendah adalah 9,5%. Jika dibandingkan dengan primipara, wanita nullipara memiliki risiko melahirkan bayi dengan berat badan lahir rendah 46% lebih tinggi [adjusted odds ratio (ORa) = 1.46; P=0.030]. Selanjutnya, jika dibandingkan dengan bayi laki-laki, bayi perempuan memiliki risiko 42% lebih tinggi mengalami berat lahir rendah (ORa = 1.42; P=0.017) Kesimpulan: Bayi berat badan lahir rendah pada kehamilan cukup bulan lebih sering ditemukan pada wanita nullipara dan bayi perempuan. Kata kunci: paritas, jenis kelamin bayi, berat badan lahir rendahBackground: Low birth weight infants tend to increase the occurence of early infant mortality and morbidity. The survey in Indonesia suggested that the prevalence of low birth weight declined from 11.1% in 2010 to 10.2% in 2013. This study aims to identify the risk factors of low birth weight infant in full term pregnancy. Methods: This was a cross-sectional study using secondary data from two hospitals in Jakarta. The data was obtained from medical records of pregnant women who gave birth during the period of January 1 to December 31, 2011. Multivariat logistic regression model with stepwise method was used to analyze the risks of low birth weight. Results: The sample size in this study was 4191 subjects. Out of them 2242 subjects met the inclusion criteria. The proportion of low birth weight was 9.5%. Compared with primipara, nullipara had 46 % increased risk to have LBW infant (ORa = 1.46; P=0.030), meanwhile primipara and nullipara did not have significant difference for having LBW infants (ORa = 0.90; P=0.614). In term of sex of infants, female infant had 42% higher risk of having LBW infant compared with male infant (ORa = 1.42; P=0.017). Conclusion : Low birth weight infants in full term pregnancies are more common in nullipara and most of the LBW infants are femal

Maternal Education, Prematurity and the Risk of Birth Asphyxia in Selected Hospitals in Jakarta

Background: Birth asphyxia can causes hypoxic ischemic organ damage in neonates. According toadvanced Indonesian Basic Health Research 2007, asphyxia was the second highest cause of infant deathafter infection (13.8%). This study aimed to identify several risk factors associated with birth asphyxia.Methods: This study was carried out in one government and one private hospitals in Jakarta. All medicalrecords of pregnant women who gave birth between January 1 to December 31 of 2011 were included.Birth asphyxia was defined as an Apgar score less then seven at one minute after birth. Logistic regressionwas used to analyze the risk factors related to birth asphyxia.Results: As many as 2777 samples out of 4191 were included for this analysis. The proportion of asphyxiain newborn babies was 6.5%. Compared with those who had high educated mothers, those who had loweducation level had 4.3-fold higher risk to have an asphyxiated baby [adjusted odds ratio (ORa) = 4.31;P=0.000]. Meanwhile middle educated mothers had 3.3-fold higher risk to have birth asphyxia (ORa=3.31;P=0.000). In terms of gestasional age at birth, compared with those who had full term birth, those who hadpreterm birth had 3.1-fold higher risk to have birth asphyxia (ORa=3.07; P=0.000). Meanwhile, althoughnot significant, those who had postterm birth had 63% more risk (P=0.118) to have birth asphyxia.Conclusion: The mother who had lower and middle education levels as well as preterm babies had higherrisk for having birth asphyxia baby. (Health Science Journal of Indonesia 2015;6:111-5

Parity, Education Level and Risk for (Pre-) Eclampsia in Selected Hospitals in Jakarta

Background:(Pre-)eclampsia is a common complication in pregnancy associated with high morbidity and mortality in maternal and perinatal. This study aimed to investigate the risk factors for (pre-)eclampsia in selected hospitals in Jakarta.Methods:This cross-sectional study design was conducted in two selected hospitals in Jakarta during the period of January 1 to December 31, 2011. The collected data came from medical records among women who delivered in the hospitals. The Cox regression with constant time was used to analyze the risks for (pre-)eclampsia.Results:The 4191 samples were collected from all pregnant woman who delivery in two hospitals. Subjects who did not have complete data (no age, marital status, parity, education, occupations, and funding sources) were excluded, leaving 1685 samples were available for the analysis. The proportion of (pre-)eclampsia in two hospitals was 11.5%. Nulliparous women had 78% greater risk of (pre-)eclampsia compared to primiparous women [adjusted relative risk (RRa) = 1.78; P = 0.000]. Furthermore, women with low education level had 86% greater risk of (pre-)eclampsia (RRa=1.86, P=0.005), while middle education level had 72% greater risk of (pre-)eclampsia (RRa=1.72; P=0.007) compared to high education level.Conclusion: Nulliparous and low educated women had higher risk of (pre-)eclampsia in selected hospitals in Jakarta. (Health Science Indones 2014;1:35-9

Young Mothers, Parity and the Risks of Anemia in the Third Trimester of Pregnancy

Background: Anemia during pregnancy remains a major health problem in Indonesia. According to theIndonesian basic health research in 2007-2013, the prevalence of anemia in pregnancy tends to increase.This paper aimed to assess the risk factors related to anemia in the third trimester of gestation.Methods: This cross-sectional study was carried out in one government hospital and one private hospitalin Jakarta. All medical records of pregnant women who gave birth between January 1 to December 31 of2011 were included. The Cox regression with constant time was used to analyze the risks of anemia.Results: This study collected 4191 samples in two hospitals. Eligible samples for analysis were 1202while the remainings were excluded due to incomplete data records. The prevalence of anemia amongpregnant women in the third trimester was 33.7%. Compared to women in the 21-35 year age group,those with aged 16-20 years had 56% higher risk to be anemic [adjusted relative risk (RRa) = 1.56; P= 0.014], however, those with aged 36-46 years had the same risk to be anemic (P = 0.350). In term ofparity, compared with nulliparous, multiparous women had 58% higher risk to be anemic (RRa = 1.58; P= 0.000), however, primiparous women had moderately higher risk to be anemic (RRa = 1.15; P = 0.201).Conclusion: Anemia in the third trimester of pregnancy were more common among young and multiparousmothers. (Health Science Journal of Indonesia 2015;6:7-11

The Use of Antibiotics in Hospitalized Adult Typhoid Patients in an Indonesian Hospital

Background: Typhoid fever was the third ranked disease among the top 10 diseases in hospitalized patients in Indonesia in 2011. There were increased drug resistance, increased number of carrier, and number of relapse cases. This study aimed to analyze the use of antibiotics in hospitalized adult typhoid patients in a hospital in Indonesia. Methods: The data were extracted from medical records of drug use in adult typhoid patients hospitalized in the Indonesian Red Cross Hospital in Bogor (West Java) during the period of July to December 2012. The analysis for typhoid was qualitatively (DU90%) and quantitatively (DDD /hbd) using ATC/DDD method.Results: From 459 typhoid patients, the total use of antibiotics in hospitalized adult typhoid patients during the period of July to December 2012 was6.35 DDD/hbd. The use of ceftriaxone had the highest DDD/hbd which was equal to 4.10 DDD/hbd. This meant out of 100 typhoid patients, 4 patients received 2 g ceftriaxone per day. Ceftriaxone was given in injection form. Furthermore, there were more drugs in segment 10% than 90% segment. From 26 types of antibiotics, 7 were included in the DU 90% segment which were ceftriaxone (64.54%); levofloxacin (13.90%); ciprofloxacin (3.57%); meropenem (2.80%); metronidazole (2.52%); ampicillin-sulbactam (1.65%); cefditoren pivoxil (1.60%).Conclusion: Ceftriaxone was the most widely used antibiotics in the treatment of hospitalized adult typhoid patients in a hospital in Indonesia. (Health Science Indones 2014;1:40-3

Proporsi Seksio Sesarea dan Faktor yang Berhubungan dengan Seksio Sesarea di Jakarta

The incidence of caesarean sections (c-section) in Indonesia have been increased in government and private hospitals. To identify c-section proportion and associated factors in the government hospitals and one private hospital in Jakarta during the period January 1st to December 31 , 2011. The study design was cross -sectional. Data retrieved from the medical records of patients who gave birth in a hospital caesarean government and the private hospitals during the period 1 January to 31December 2011. The data were analyzed with chi square test and logistic regression. The proportion of c-section 59.2 %. The proportion of c-section in the RS government 56.5 % and 62.7 % in private hospitals. The related factors c-section were baby indication is fetal distress (ORadj 11.95 ; 95 % CI 1.31 to 108.94 ), maternal indication is prelabor rupture of membranes (ORadj 4.18 ; 95 % CI 1.06 to 16 , 50 ) and hypertension (ORadj 7.13 ; 95 % CI 2.38 to 21.32). The proportion of c-section in a government hospital and a private hospital in Jakarta is quite high 59.2 %. Prelabor rupture of membranes, hypertension and fetal distress were determinant factor c-section in this hospital.Keywords : Caesarean section, baby indication, maternal indicationAbstrakAngka kejadian persalinan seksio sesarea di Indonesia terus meningkat baik di rumah sakit pemerintah maupun swasta. Mendapatkan proporsi seksio sesarea dan berbagai faktor yang berhubungan denganpersalinan SS di satu RS pemerintah dan satu RS swasta di Jakarta selama periode 1 Januari-31 Desember 2011. Disain penelitian ini adalah cross sectional. Data diambil dari catatan medik pasien yang melahirkan sesarea di satu RS pemerintah dan satu RS swasta selama periode 1 Januari-31 Desember 2011. Data dianalisis dengan uji chi square dan regresi logistik. Proporsi persalinan SS sebesar 59,2%. Proporsi SS di RS pemerintah 56,5% dan di RS swasta 62,7%. Faktor yang berhubungan dengan persalinan SS adalah indikasi bayi yaitu gawat janin (ORadj 11,95; 95% CI 1,31-108,94), indikasi ibu yaitu Ketuban pecah dini (ORadj 4,18; 95%CI 1,06-16,50) dan Pre-eklamsi/eklamsi (ORadj 7,13; 95% CI 2,38-21,32). Proporsi persalinan SS di satu RS pemerintah dan satu RSswasta di Jakarta cukup tinggi 59,2%. Ketuban pecah dini, hipertensi dan gawat janin merupakan faktor yang berhubungan untuk terjadinya persalinan sesarea di rumah sakit tersebutKata kunci : Seksio sesarea, indikasi bayi, indikasi ibu