Pengaruh Kenaikan Berat Badan Rata – Rata Per Minggu pada Kehamilan Trimester II dan III terhadap Risiko Berat Bayi Lahir Rendah

Background: Low pregnancy weight gain is one of the risk factor of low birth weight (LBW). Weight gain rate per week can be used gain during pregnancy. However, some studies show differences in cut-off point weight gain in pregnancy of second and third trimester to minimize the risk of LBW.Objective: To identify changes of weight gain rate per week in the second and third trimester of pregnancy in relation to the risk of LBW.Method: The study was observational study using case control design. The study population was women giving birth at Ulin Hospital of Banjarmasin during the period of November 2006 – August 2007. Subject of the study was having LBW infants 98 mothers as case group and giving birth to infants >2500 grams 245 mothers as control group. Data medical record of obstetric and gynecology unit, mother and child health monitoring books, so did the direct interview. Chi square and double logistic regression methods were used to analyse the relationship between the objective variabels.Result: Weight gain 2500 grams. Other variables having risks of LBW were gestational age (<37 weeks), hypertensive disorder during pregnancy, parity, having history of preterm delivery and prenatal care < 5 times

Riwayat KEK dan anemia pada ibu hamil tidak berhubungan dengan kejadian stunting pada anak usia 6-23 bulan di Kecamatan Sedayu, Bantul, Yogyakarta

ABSTRACTBackground: Quality of human resource was built since human being was in the womb. Pregnant mother’s health had signifi cant impact on fetus. Pregnant mother’s with anemia and CED would surely have significant impact on the fetus in their womb because it would make low birth weight. If a child with low birth weight can not catch up grow, it was highly possible that they would suffer from stunting. Objectives: The aim of this study was to identify the relationship between nutritional status of pregnant mother with stunting in children 6-23 age month in Sedayu, Bantul, Yogyakarta.Methods: It was observational study with case-control design. The number of samples were 252 children aged 6-23 months. All of stunting children aged 6-23 months in Sedayu subdistrict were selected as samples. Cases and controls samples were matching based on age. Data were collected using structured questionnaire to fi nd out the identity of the children aged 6-23 month, identity of respondents, the nutritional status of the children aged 6-23 month, the history of nutritional status of the pregnant mothers’ and sociodemographic. Anthropometric measurement used microtoise to fi nd out parent’s height, infantometer to find out children length, semi-quantitative food frequency questionnaire (SQ-FFQ) and food models were used as instrument. The data was analyzed using univariate analysis, bivariate analysis with chisquaretest, and multivariate analysis with multiple logistic regression.Results: The bivariate analysis showed that anemic history during pregnancy was the risk factor of stunting, but it was not statistically signifi cant (p=0.13, OR:1.5, 95% CI:0.85-2.73). The CED history during pregnancy was not the risk factor of the stunting incident (p=0.23, OR:0.7, 95% CI:0.37-1.31). Other factors related to the stunting incidence were mother’s height (p=0.01, OR:2.04, 95% CI:1.14-3.65), the history of low birth weight (p=0.03, OR:3.03, 95% CI:1.09-8.33), and food insecurity (p=0.04, OR:2.7, 95% CI:1.04-7.00). The multivariate analysis showed that mother’s height was correlated with the stunting incidence in Sedayu subdistrict.Conclusion: Factors that influence the incidence of stunting in children aged 6-23 month were pregnant mother with anemia, history of low birth weight, food insecurity, and stunted mother. Stunted mother was associated with the incidence of stunting. KEYWORDS: anemia, CED, growth disorder, pregnant women, risk factorsABSTRAKLatar belakang: Kualitas sumber daya manusia terbentuk sejak dalam kandungan. Kesehatan ibu saat hamil akan sangat mempengaruhi kesehatan janin yang dikandungnya. Ibu hamil yang anemia dan menderita kekurangan energi kronis (KEK) tentu akan mempengaruhi kesehatan janin yang dikandungnya, karena akan menyebabkan bayi lahir dengan berat yang rendah. Bila tidak bisa tumbuh kejar, bayi BBLR kemungkinan besar akan menderita stunting. Tujuan: Untuk mengetahui hubungan antara status gizi ibu saat hamil dengan kejadian stunting pada anak usia 6-23 bulan di Kecamatan Sedayu, Kabupaten Bantul.Metode: Penelitian ini merupakan penelitian observasional dengan desain case-control. Jumlah sampel penelitian sebanyak 252 anak berusia 6-23 bulan yang berasal dari 4 desa di Kecamatan Sedayu. Semua anak stunting usia 6-23 bulan diambil sebagai sampel, dengan matching umur kasus dan kontrol. Pengambilan data menggunakan kuesioner terstruktur untuk mengetahui identitas anak usia 6-23 bulan, identitas responden, status gizi anak usia 6-23 bulan, riwayat status gizi ibu saat hamil, dan data sosiodemografi. Pengukuran antropometri terhadap tinggi badan orang tua dengan microtoise dan panjang badan anak dengan infantometer serta untuk SQ-FFQ menggunakan food model. Data dianalisis dengan menggunakan analisis univariat (deskriptif), bivariat (chi-square), dan multivariat (regresi logistik).Hasil: Hasil bivariat menunjukkan riwayat anemia saat hamil merupakan faktor risiko terjadinya stunting tetapi secara statistik tidak signifikan (p=0,13, OR=1,5, 95%CI=0,85-2,73). Riwayat KEK saat hamil bukan faktor risiko terhadap kejadian stunting (p=0,23, OR=0,7, 95% CI=0,37-1,31). Faktor lain yang berhubungandengan kejadian stunting adalah tinggi badan ibu (p=0,01, OR=2,04, 95% CI=1,14-3,65), riwayat BBLR (p=0,03, OR=3,03, 95% CI=1,09-8,33), dan rawan pangan (p=0,04, OR=2,7, 95% CI=1,04-7,00). Hasil analisis multivariat adalah tinggi badan ibu berhubungan dengan kejadian stunting di Kecamatan Sedayu, Bantul, Yogyakarta.Kesimpulan: Faktor yang mempengaruhi kejadian stunting adalah ibu hamil yang menderita anemia, mempunyai riwayat BBLR, rumah tangga rawan pangan dan tinggi badan ibu yang kurang. Pada analisis multivariat yang berhubungan dengan kejadian stunting adalah tinggi badan ibu yang kurang. KATA KUNCI: anemia, KEK, stunting, ibu hamil, faktor risik

Development process of the preconception education booklet

Background: Healthy preconception is very essential to prepare for pregnancy, childbirth, and healthy babies. However, many women still lack of knowledge on having healthy preconceptions. Effective education requires relevant and standardized material and educational media. The objective of this study aimed to explain the process of developing a preconception education booklet.Methods: We have developed a preconception education booklet. The method to develop this booklet involved five main stages: literature review, interviews with preconception women and health care workers in primary health care, focus group discussions with the lecturer of midwifery, nutrition, and health promotion, expert review, and measure response test from women of reproductive age.Results: Our literature review has come out with a summary of the preconception educational materials consist of 15 topics that have been present. By using In-depth interviews, we observed and then developed materials that were required by women of reproductive age and health workers and they consisted of 10 topics. Our Focus Group Discussion has come out with the need to grouping the materials into 4 groups (pillars). We then validated our booklet material by using Expert review. Finally, our response test showed that 96% of respondents agree that booklet material is easy to understand, 90% of respondents agree that booklets are interesting to read, 93% of respondents agree that booklet material is relevant to their condition, 90% of respondents agree that the material in the booklet is the material it needs, 86% of respondents agree that the material in this booklet can help with their health problems, 80% of respondents agree that the choice of words in the booklet is easy to understand, 90% of respondents agree that the cover of the booklet is very interesting, 100 respondents agree that the font of the letters in the booklet is easy to read, 80% of respondents agreed that the illustrations relevant with the materials. Booklets were positively appreciated by 87% (26 out of 30 respondents) of reproductive-age women.Conclusions: Our preconception booklet can be used by health care workers to provide pregnancy preparation counselling for women of reproductive age

Health-related quality of life of the elderly after natural disasters: a scoping review

Every nation on earth is experiencing an increase in the number and proportion of elderly people. This vulnerable population may experience a decline in health-related quality of life (HRQOL) following a natural disaster. This scoping review aimed to have a better understanding on the elderly’s HRQOL following natural disasters, its influencing factors, and the state of the research on this topic. A literature search was conducted using four databases (PubMed/MEDLINE, Cochrane Library, Science Direct, and ProQuest) for the last 10 years (2013–2022). The summary of the selected relevant articles and analysis data were used to present the findings. There were seven articles included in our review. One article was about floodsand the rest was about earthquake.Two out of the six earthquake articles involved tsunamis. All of the studies were conducted during the recovery phase and revealed that the elderly had poor HRQOL after natural disasters. Several aspects, including demographics, physical, psychological, social, and environmental factors, were identified as having impacts on the elderly‘s HRQOL following a disaster. The relocation had a significant negative impact on the mental health of the elderly, with a mean difference of -3.69 (-5.60, -1.77). In conclusion, the HRQOL of the elderly after a natural disaster is low and affected by several factors. To improve it, a stronger research agenda and disaster management programs that take these factors into account are required

Pendekatan Multilevel Sebagai Upaya Meningkatkan Pemberian ASI Eksklusif

Increasing exclusive breastfeeding effort was continued in Jember district. Local government collaborates with USAID to increase breastfeeding promotion program. Health promotion program used multilevel approach. This study aimed to evaluate exclusive breastfeeding program and impact program to increasing breastfeeding in Jember district. This study method used cross sectional study in two population with mix method approach (qualitative and quantitative). Collecting qualitative data was using participative observation, indepth interview and focus group discussion to describing program. Collecting quantitative data was using questionare to evaluate impact program in two populations (120 respondent program and 125 respondent non program). Data was analyzed by open code in qualitative data. To analyzed quantitative data was used chi square.  The research result shows that Health promotion program increased exclusive breastfeeding was using multilevel approach. In top level, implementation of the program was regulation government policy number 17, 2013 about save childbirth, initiation breastfeeding and exclusive breastfeeding. In the middle level implementing program by Jember health department and local government clinic through peer breastfeeding support, mother pregnant class and promote by midwife. Lower level evaluation result was that two population program and non program have different significant. Population who give program have 2,4 higher OR value in exclusive breastfeeding than population not give the program. Based on this research it can be concluded that multilevel approach can used to increasing exclusive breastfeeding until six month. Government support was needed to successful program

The influence of iron supplementation in pregnant women to the occurrence of low birth weight (LBW) babies in Palu, Central Sulawesi

Low birth weight (LBW) babies remains a major problem world wide as it causes a high rate ofneonatal morbidity and mortality. One effort to reduce the prevalence of LBW babies is byproviding iron supplementation to the pregnant women. The aim of this study was to examinethe relationship between iron supplementation program and prevalence of LBW babies in Palu,Central Sulawesi. This was an observational study with case control design. Subjects were allLBW babies from mothers that had accepted iron supplementation during pregnancy. Samplesize in this study was 87 for case and 87 for control. Bivariate analysis showed that ironsupplementation that not comply the program had a significant correlation with prevalence ofLBW babies (p=0.01). Other significant factors include abnormal hemoglobin level (p=0.01),body mass index (BMI) (p=0.02), educational level (p=0.02), multiparity (p=0.03), andgestational age (prematurity) (p=0.03). Multivariate analysis revealed that the strongest riskfactor for the occurrence of LBW babies was iron supplementation that not comply the program(OR= 3.82; 95% CI: 1.77- 8.22). Other risk factors were hemoglobin level (OR= 3.45; 95% CI:1.59-7.49), BMI (OR= 2.27; 95% CI: 1.05-4.91), gestational age (OR= 3.11; 95% CI: 1.45-6.67), multiparity (OR= 2.98, 95% CI: 1.36-6.51), and educational level (OR= 2.38, 95% CI:1.12-5.03). Based on the analysis, the strongest risk factors that affected the prevalence of LBWwas iron supplementation, abnormal hemoglobin level, gestational age, multiparity and educationlevel. In conclusion, iron supplementation during pregnancy that not comply with the programwas the strongest risk factor of LBW babies. The prevalence of LBW babies can be reduced bycontrolling of iron supplementation, hemoglobin level, BMI, gestational age, parity and education

Hubungan kepatuhan antenatal care dengan pemilihan penolong persalinan di Kabupaten Natuna

Compliance of antenatal care and election of birth helpers in NatunaPurposeThis study aimed to determine the association of ANC (Antenatal care) compliance with birth attendant choice in Natuna.MethodsThis study used a cross-sectional method. The subjects of the research were mothers in Natuna regency 2014. The variables were: independent variable (ANC compliance), the dependent variable (the birth attendant choice), and the control variables (age, maternal education, distance to the health facilities, parity). Data collection used questionnaires and interviews. The data analysis used descriptive and inferential analysis. The bivariable analysis used the chi-square test and multivariable analysis used logistic regression test with 95% of confidence interval (CI) and a significance level of p 2 had a chance 1.9 times greater of choosing the TBA as birth attendant than women with parity ≤2.ConclusionsThere needs to be a control program from the health department working with community health workers to socialize awareness of the importance of the ANC. There needs to be the addition of TBA who are trained and partnered especially in remote areas because it cannot be denied there are still many people who choose TBA as a birth helper. Latar Belakang: Persalinan ditolong oleh tenaga kesehatan mempunyai peran penting untuk mencegah kematian ibu. Cakupan ANC di Kabupaten Natuna terus meningkat, namun persalinan oleh tenaga kesehatan masih di bawah strandar nasional. Penelitian ini bertujuan untuk mengetahui hubungan  kepatuhan ANC dengan pemilihan penolong persalinan di  Kabupaten Natuna.Metode: Metode penelitian cross sectional. Subjek penelitian yaitu ibu bersalin normal di Kabupaten Natuna tahun 2014. Variabel bebas (kepatuhan ANC), variabel terikat (pemilihan penolong persalinan), variabel kontrol (umur, pendidikan ibu, jarak kepasilitas kesehatan, paritas). Pengumpulan data menggunakan kuesioner tertutup dan wawancara . Analisis  data menggunakan analisis deskriftif dan inferensial yang meliputi analisis bivariabel dengan menggunakan uji chi-square dan analisis multivariabel dengan menggunakan uji regresi logistik dengan 95% confidence interval (CI) dan taraf signifikan p2 berpeluang 1.9 kali lebih besar memilih dukun sebagai penolong persalinan dari pada ibu dengan paritas ≤2, RP=1.99 (95% CI= 1.11-3.55). Hasil wawancara, ibu yang memeriksakan kehamilan oleh dukun akan memilih dukun sebagai penolong persalinan, alasan ketidakpatuhan dalam perawatan antenatal adalah keadaan kehamilan dan kurngnya dukungan keluarga dan alasan  pemilihan dukun sebagai penolong persalinan yakni  tradisi keluarga, biaya, terbatasnya pelayan kesehatan dan kurangnya tenaga kesehatan.Kesimpulan: Kepatuhan ibu dalam antenatal care, pendidikan ibu dan paritas memiliki hubungan yang bermakna dengan pemilihan penolong persalinan

Vitamin D receptor gene polymorphism in Madura pregnant women with hypertension: a case control study

Background: Genetic factors are important considerations in the etiology of preeclampsia and gestational hypertension. Several previous studies have shown an association of Vitamin D receptor (VDR) gene polymorphisms with hypertension in pregnancy. However, the number of studies is still very limited and the results difer from one another. Aim of the study: This study aimed to analyze the polymorphisms of rs2228570 and rs731236 of the VDR gene in subjects with hypertension and non-hypertension in pregnancy in Madura ethnicity. Subjects and methods: The researchers conducted tests for two polymorphisms in the VDR gene among 210 subjects consisting of 105 pregnant women with hypertension and 105 non-hypertension pregnant women from Madura ethnicity. The rs2228570 (T>C) and rs731236 (C>T) polymorphisms were detected by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism. All data were analyzed by T-tests and Chi-Square tests. Results: The TT genotype frequency of rs2228570 (15.2%) in the hypertension group was higher than in the control group (6.7%) (p = 0.047). Subjects with the TT genotype at rs2228570 showed a 3.048 times greater risk of developing hypertension than the CC genotype (OR = 3.048: 1.135–8.183, p = 0.023). The T allele frequency of rs2228570 (40.5%) in the hypertension group was higher than in the control group (30.5%) (p = 0.032). Subjects with the T allele had 1.551 times greater risk of developing hypertension. There was no signiicant diference in genotype and allele of rs731236 between hypertension subjects and controls. Conclusion: The TT genotype and T allele of rs2228570 in the hypertension group were risk factors for hypertension in this study. While the TT genotype and T allele at rs731236 were not risk factors for hypertension in pregnancy. Genotyping of VDR gene polymorphisms in pregnant women is expected to be useful in strategies for treating hypertension in pregnancy

Pengaruh Pemberian Parasetamol Intravena untuk Mengurangi Nyeri Persalinan Kala 1 Fase Aktif

Background: Labor was a physiological process, labor pain appeared from regularly uterine contraction, cervix distention and pressure to pelvic floor that stimulate free end nerves. Pain labor can influenced the mother, fetus and the progress of labor. There are various of effort to decrease pain labor by pharmacological or non pharmacological. The best therapy must be safe, effective, and minimal adverse effect to mother and fetus.Objective: To evaluate the effect of paracetamol intraveneous for pain relief in active labor versus saline water.Methods: In randomized controlled trial, with single blinded, 66 primigravid in active labor at RSUD Hj. ANNA LASMANAH Banjarnegara and RSUD Banyumas from November 2016 to January 2017. Sampels divided in two groups, paracetamol group (n=33) and normal saline group (n=33). The primary  outcome was the efficacy of paracetamol to relief pain. Intensity of the pain measure by VAS (visual analogue scale), pain measured before drug administration, after 30 minutes, at 1, 2, 3, and 4 hours in both groups. The secondary outcomes include the adverse effect to the mother and baby in both group.Results: The reduction in pain score was significantly greater in paracetamol group than normal saline after 30 minutes, 1, 2, 3, and 4 hours after adiministration of the drug (p<0.05). There was no adverse effect to mother and baby in both groups.Conclusion: Paracetamol intravenous statistically significant decreasing mean pain score than normal saline and safe in active labor.Keywords: Paracetamol, analgesia, active phase in labo

Dampak Konseling Individu dan Konseling Berpasangan terhadap Penggunaan Kontrasepsi Pascasalin: Randomized Controlled Trials (RCT)

Background: The achievement of Contraceptive Prevalence Rate (CPR) is 57.9%, which indicates that the Family Planning has not run optimally one of which concerns the utilization of family planning counseling as an attempt to avoid an unplanned pregnancy. The postpartum period is a period appropriate in using contraception. Some studies suggest that the counseling given by health workers will increase the interest of potential acceptors of contraception.Objective:The objective of this research is to increase the utilization of postpartum contraception counseling.Method: This research used Randomised Controlled Trial (RCT) method to provide counseling to couples and individuals. The subject of this study were the final trimester pregnant women with Simple Random Sampling and technique then were randomized to determine the intervention and control groups. Bivariable analysis use statistical test Chi Square with CI 95 % and P value <0.05 and binomial logistic regression multivariable analysis.Result and Discussion:The proportion of postpartum contraceptive utilization in the intervention group compared with the control group was 86% the percentage difference. Variable wife age and information have a significant influence on the utilization of contraception postpartum.Conclusion:The use of counseling in pairs in pregnant women effectively increases the utilization of postpartum contraception. Keywords: Counseling, postpartum contraceptio