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Marsubrin, Putri Maharani Tristanita
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Health Professions Medicine & Pharmacology

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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.
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.
Luaran Bayi Prematur dengan Pertumbuhan Janin Terhambat: Sebuah Penelitian Deskriptif Sugiyarto, Kanya Lalitya Jayanimitta; Oswari, Jessica Sylvania; Sjahrullah, Muhamad Azharry Rully; Marsubrin, Putri Maharani Tristanita
Sari Pediatri Vol 26, No 4 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.4.2024.244-8

Abstract

Latar belakang. Pertumbuhan janin terhambat (PJT) adalah masalah kesehatan global yang kompleks, berkontribusi terhadap peningkatan morbiditas dan mortalitas pada neonatus. Ketidakmampuan janin untuk mencapai potensi pertumbuhan genetiknya, yang sering kali disebabkan oleh disfungsi plasenta menjadi penanda PJT. Kriteria diagnostik meliputi berat janin atau lingkar perut di bawah persentil ke-10, perlambatan trajektori pertumbuhan, dan sering disertai oligohidramnion. Prevalensi PJT pada neonatus berkisar antara 7-15%, meningkat menjadi 30% di negara berkembang. Bayi dengan PJT berisiko hipoglikemia, komplikasi respiratorik, dan masalah jangka panjang, seperti penyakit kardiovaskular dan gangguan metabolik.Tujuan. Penelitian ini bertujuan untuk memaparkan luaran klinis bayi prematur dengan PJT.Metode. Penelitian ini adalah studi kohort retrospektif yang mengamati luaran bayi prematur dengan PJT, mengumpulkan data rekam medis di RSUP Nasional Dr. Cipto Mangunkusumo dari Januari hingga Desember 2023. Kriteria eksklusi mencakup intra uterine fetal death (IUFD) dan rekam medis tidak lengkap. Variabel independen dalam penelitian ini adalah bayi prematur dengan PJT, sedangkan variabel dependen adalah mortalitas dan morbiditas bayi prematur.Hasil. Pada periode Januari hingga Desember 2023, terdapat 664 persalinan prematur, 79 di antaranya dieksklusi. Penelitian ini melibatkan 585 bayi prematur dengan prevalensi PJT sebesar 29,2%. Angka kejadian distres pernapasan dan kebutuhan dukungan respirasi non-invasif lebih tinggi pada kelompok PJT, masing-masing sebesar 81,4% vs 63,4% dan 62,9% vs 45,8%. Angka mortalitas dan morbiditas lainnya tidak berbeda signifikan antara kelompok PJT dengan non-PJT. Kesimpulan. Luaran pada bayi prematur dengan atau tanpa PJT tidak berbeda bermakna. Namun, bayi prematur dengan PJT lebih berisiko mengalami distres pernapasan saat lahir sehingga membutuhkan dukungan ventilasi lebih dibandingkan kelompok non-PJT.
Prosedur Menunda Minum saat Transfusi Sel Darah Merah dan Kejadian Enterokolitis Nekrotikans pada Bayi Prematur Mardhotillah, Afiffa; Marsubrin, Putri Maharani Tristanita
Sari Pediatri Vol 25, No 5 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.5.2024.341-8

Abstract

Bayi prematur memiliki risiko menderita komplikasi akibat prematuritas dan luarannya sangat berhubungan dengan usia gestasi. Di antara berbagai komplikasi, enterekolitis nekrotikans merupakan komplikasi yang perlu diwaspadai pada bayi prematur. Patogenesis terjadinya  masih belum dipahami secara penuh. Prematuritas menjadi satu-satunya faktor risiko yang konsisten ditemukan dalam studi mengenai enterekolitis nekrotikans, tetapi diyakini bahwa etiologinya bersifat multifaktorial. Saat ini, mulai banyak penelitian yang juga mengaitkan enterekolitis nekrotikans dengan transfusi sel darah merah atau dikenal sebagai transfusion associated necrotizing enterocolitis. Berbagai upaya untuk mencegah terjadinya enterekolitis nekrotikans dilakukan, salah satunya dengan melakukan prosedur menunda minum saat transfusi sel darah merah. Tujuan dari telaah ini adalah untuk memaparkan berbagai pandangan dan penelitian terkait penerapan prosedur menunda minum saat transfusi sel darah merah dan kaitannya dengan angka kejadian enterekolitis nekrotikans.
Early detection of meconium peritonitis in term neonate: a case report Marsubrin, Putri Maharani Tristanita; Iskandar, Stephen Diah; Wulandari, Haryanti Fauzia; Bermanshah, Evita Kariani; Rahayatri, Tri Hening; Roeslani, Rosalina Dewi
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.443-6

Abstract

Meconium peritonitis (MP) is a very rare, sterile peritonitis that results from fetal gut perforation in utero. Late diagnosis and treatment may cause severe morbidity and mortality related to sepsis. Here we report a term, appropriate for gestational age (AGA) neonate with meconium peritonitis. A one-day-old baby was brought to our hospital with lethargy and progressive abdominal distention for the last 12 hours and hypovolemic shock on admission. The diagnosis of meconium peritonitis was established based on physical examination, supported by abdominal X-ray and ultrasound. A sigmoid colon perforation was found during emergency surgery and a sigmoid colostomy was done. The infant was discharged on the 20th post-operative day with good enteral feeding tolerance.
Co-Authors Agus Firmansyah Aryono Hendarto Bermanshah, Evita Kariani Damayanti Rusli Sjarif Gultom, Lanny Christine Hikmahrachim, Hardya Gustada Insani, Nadia Dwi Iskandar, Stephen Diah Mardhotillah, Afiffa Nia Kurniati Novie Amelia Chozie Oswari, Jessica Sylvania Rahayatri, Tri Hening Rinawati Rohsiswatmo Rosalina Dewi Roeslani, Rosalina Dewi Santoso, Dara Ninggar Sjahrullah, Muhamad Azharry Rully Sugiyarto, Kanya Lalitya Jayanimitta Widjaja, Marcella Amadea Wulandari, Haryanti Fauzia Yogi Prawira Yuliarti, Klara Yulindhini, Maya