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All Journal Paediatrica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia eJournal Kedokteran Indonesia
Marsubrin, Putri Maharani Tristanita
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The role of early aggressive nutrition on growth of very preterm or very low birth weight infants Insani, Nadia Dwi; Rohsiswatmo, Rinawati; Sjarif, Damayanti Rusli; Marsubrin, Putri Maharani Tristanita; Yuliarti, Klara; Gultom, Lanny Christine
Paediatrica Indonesiana Vol 64 No 4 (2024): July 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.4.2024.318-24

Abstract

Background Very preterm infants (<32 weeks gestational age) are at high risk of poor neurodevelopmental outcomes. Early aggressive parenteral nutrition (protein ³ 2g/kg/day) can reduce the incidence of malnutrition in very preterm infants. At present, Fatmawati General Hospital does not have a standard nutritional protocol for preterm infant. Objective To determine the difference in growth (days to regain birth weight and growth velocity) of very preterm (<32 weeks gestational age) or very low birth weight (VLBW) (<1500g) infants who were born and hospitalized in the Neonatal Unit of Fatmawati General Hospital, Jakarta, before and after applying early aggressive parenteral nutrition using a nutrition protocol from Cipto Mangunkusumo Hospital, Jakarta. Methods A quasi-experimental study was conducted on 23 very preterm or VLBW infants in the Neonatal Unit of Fatmawati General Hospital, from July to November 2019. Control group data were taken from medical records of very preterm or VLBW babies discharged from our unit from January 2018 – to June 2019 and compared to those of the intervention group. Results The intervention group regained their birth weight significantly faster than the control group [mean 7.43 (SD 3.5) vs. 16.73 (SD 5.1) days, respectively; (P=0.00)]. Mean growth velocity was also significantly higher in the intervention group than in the control group [14.6 (SD 6.0) vs. 8.9 (SD 6.9) gram/kg/day, respectively; (P=0.002)]. Conclusion Provision of early aggressive parenteral nutrition reduces the time to regain birth weight and leads to higher growth velocity in very preterm/VLBW infants.
Sindrom Refeeding pada Neonatus Marsubrin, Putri Maharani Tristanita; Sugiyarto, Kanya Lalitya Jayanimitta; Widjaja, Marcella Amadea
eJournal Kedokteran Indonesia Vol. 12 No. 2 (2024): Vol. 12 No. 2 - Agustus 2024
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Refeeding syndrome (SR) adalah sekelompok gejala yang terjadi setelah pemberian nutrisi enteral atau parenteral pada pasien kekurangan gizi. Angka kejadian SR bervariasi yaitu hipofosfatemia 20–90%, hipokalemia 8,8–66,7%, dan hipomagnesemia 1–8,3%. Faktor risiko SR meliputi neonatus dengan kecil masa kehamilan (KMK), pertumbuhan janin terhambat (PJT), bayi berat lahir sangat rendah (BBLSR), prematur ekstrim, umbilical artery resistency index (UARI) tinggi, atau berat badan menurut panjang badan berdasarkan z-score <-2 standar deviasi (SD). Pemberian asam amino tinggi pada awal kehidupan secara bermakna dapat meningkatkan risiko SR termasuk hipofosfatemia berat pada BBLASR. SR dapat dicegah dengan melengkapi pemberian elektrolit (khususnya fosfat) pada awal pemberian nutrisi.
Penggunaan Kafein Sitrat pada Bayi Prematur Marsubrin, Putri Maharani Tristanita; Sugiyarto, Kanya Lalitya Jayanimitta
Majalah Kedokteran Indonesia Vol 74 No 4 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.4-2024-1427

Abstract

Apnea is a manifestation of immature breathing and frequently occurs in preterm infants treated in the Neonatal Intensive Care Unit. Apnea of prematurity (AOP) is characterized by episodes of apnea (cessation of breathing) lasting 15–20 seconds or more, or shorter episodes accompanied by bradycardia and/or desaturation. The incidence of AOP is inversely related to gestational age (GA) and birth weight. Caffeine is one of the pharmacological treatments for managing AOP. Caffeine belongs to the methylxanthine class, like theophylline and aminophylline. Caffeine has been used as a therapy of choice for AOP in developed countries since the 1970s. Meanwhile, in developing countries, aminophylline remains the most commonly used drug for AOP management. Compared to aminophylline and theophylline, caffeine has better therapeutic effects and absorption, a longer half-life, and fewer side effects. Therefore, caffeine is the first-line therapy for AOP management.
Skrining pada Bayi Prematur Sejak di Unit Perawatan Intensif Neonatal Marsubrin, Putri Maharani Tristanita; Sugiyarto, Kanya Lalitya Jayanimitta
Majalah Kedokteran Indonesia Vol 74 No 5 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.5-2024-1703

Abstract

Premature infants have a higher risk of mortality and morbidity compared to full-term infants. Therefore, screening in the neonatal unit is necessary to detect these conditions, allowing for timely intervention to be implemented. This article discusses various screening procedures for premature infants, such as head ultrasounds for intraventricular hemorrhage, eye exams for retinopathy of prematurity, hearing tests, heart evaluations, and others. Early identification can reduce morbidity and improve long-term outcomes for premature infants.
Gut dysbiosis as a risk factor of neonatal sepsis among preterm infants Marsubrin, Putri Maharani Tristanita; Hikmahrachim, Hardya Gustada; Rohsiswatmo, Rinawati; Yulindhini, Maya; Firmansyah, Agus
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.96-102

Abstract

Background Preterm infants are at high risk of developing sepsis. An imbalance between the normal gut and pathogenic microbiomes, known as dysbiosis, has been proposed as a condition that leads to neonatal sepsis. Objective To assess for an association between gut dysbiosis and neonatal sepsis. Methods A prospective cohort study was conducted involving very preterm or very low birth weight infants admitted to the Neonatal Unit, Cipto Mangunkusumo Hospital, Jakarta, from November 2019 to January 2021. The primary outcome was proven and/or clinical neonatal sepsis. The independent variable was gut dysbiosis, defined as a ratio of normal-to-pathogenic gut microbiome <1.0. Gut microbiome analysis was performed using a polymerase chain reaction test from a fecal specimen. Multivariate analysis using multiple logistic regression was conducted with adjustments for potential confounders. Results Forty-three infants were recruited during the study period, with a median gestational age of 30 (range 25-36) weeks and birth weight of 1,170 (range 630-1855) grams. Among them, 28 (65.1%) infants had dysbiosis and 25 (58.2%) developed sepsis. The incidence of sepsis was higher among infants with dysbiosis (20 infants; 71.4%) than those without dysbiosis (5 infants; 33.3%). Dysbiosis and hemodynamically significant patent ductus arteriosus increased the risk of sepsis, with aOR 6.93 (95%CI 1.04 to 46.14; P=0.045) and aOR 22.7 (95%CI 1.45 to 355.29; P=0.026), respectively, after adjusting for sex, birthweight, maternal and infant morbidities, as well as maternal and infant vitamin D status. Conclusion Gut dysbiosis is a risk factor for neonatal sepsis. Maintaining the balance of the gut microbiome is essential from the first day of life.
Predictors of pediatric Henoch-Schönlein purpura recurrence Santoso, Dara Ninggar; Kurniati, Nia; Hendarto, Aryono; Chozie, Novie Amelia; Prawira, Yogi; Marsubrin, Putri Maharani Tristanita
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.307-15

Abstract

Background Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children and is usually self-limited with a favorable prognosis. However, recurrence in children is associated with a poorer prognosis, i.e., a higher risk of progressing to chronic kidney disease (CKD) as a long-term complication. In Indonesia, the recurrence rate of HSP and its predictors in children have not been well established . Objective To estimate the incidence of recurrent HSP and determine its predictors in children at Dr. Cipto Mangunkusumo National General Hospital (RSCM). Methods A retrospective cohort review of medical records followed children aged <18 years at RSCM for 6 months after HSP diagnosis based on the the European League Against Rheumatism (EULAR)/ Paediatric Rheumatology European Society (PRESS)/Paediatric Rheumatology International Trials Organization (PRINTO) criteria. Multivariate, Cox logistic regression, and Kaplan-Meier analyses were performed. Results This study included 116 children aged 2–17 years with HSP. Twenty-six (22.4%) of the subjects experienced recurrence, with an incidence of 3.56 per 100,000 person-years. The only statistically significant predictor for recurrence was  the presence of infection after the first episode of HSP (HR 11.301; 95%CI 4.327 to 29.519; P<0.001). The cumulative survival of subjects with infection for recurrence over 6 months  was  51%, with mean 5.3 months survival duration (95%CI 4.76 to 5.99; P< 0.0001). Chronic kidney disease, a long-term complication of HSP, was noted in 22 (19%) participants. Conclusion Recurrence of HSP was  observed in 22.4% of our subjects within 6 months follow up. However, subjects with a history of infection after their first episode of HSP resolution should be notified about the possibility of recurrence. Chronic kidney disease occurred in 22 participants (19%), possibly becoming a long-term complication of HSP.
Co-Authors Agus Firmansyah Aryono Hendarto Damayanti Rusli Sjarif Gultom, Lanny Christine Hikmahrachim, Hardya Gustada Insani, Nadia Dwi Nia Kurniati Novie Amelia Chozie Rinawati Rohsiswatmo Santoso, Dara Ninggar Sugiyarto, Kanya Lalitya Jayanimitta Widjaja, Marcella Amadea Yogi Prawira, Yogi Yuliarti, Klara Yulindhini, Maya