Nunik Kusumawardani
Pusat Teknologi Intervensi Kesehatan Masyarakat, Badan Litbangkes, Kemenkes RI, Jl. Percetakan Negara No. 29 Jakarta, Indonesia

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FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP RISIKO KEHAMILAN “4 TERLALU (4-T)” PADA WANITA USIA 10-59 TAHUN (ANALISIS RISKESDAS 2010) H, Puti Sari; Hapsari, Dwi; Dharmayanti, Ika; Kusumawardani, Nunik
Media Penelitian dan Pengembangan Kesehatan Vol 24, No 3 Sep (2014)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (284.165 KB)

Abstract

Abstrak Tujuan penulisan ini adalah mengidentifikasi faktor-faktor tidak langsung yang dapat mempengaruhi risiko kehamilan. Desain penelitian cross sectional. Data yang dianalisis merupakan data hasil Riset Kesehatan Dasar (Riskesdas) tahun 2010 yang telah dilaksanakan oleh Badan Litbangkes. Unit analisis adalah ibu atau wanita usia subur (WUS) yang pernah melahirkan minimal 1 anak dalam kurun waktu 5 tahun terakhir sampai dengan saat wawancara. Analisis dilakukan dengan menggunakan metode logistik regresi untuk mengetahui faktor yang paling dominan. Berdasarkan hasil analisis ditemukan bahwa variabel yang paling dominan dalam hubungan antara faktor tidak langsung dengan kejadian fisiko kehamilan 4-T (terlalu tua, terlalu muda, terlalu banyak dan terlalu dekat) adalah variabel tempat tinggal  (desa/kota),  tingkat  pendidikan,  status  ekonomi,  dan  keinginan  hamil.  Ibu  yang  tinggal  di perdesaan berpeluang 1,1 kali berisiko kehamilan 4T, sementara ibu yang berpendidikan rendah (SD ke bawah) berpeluang 1,4 kali untuk mengalami risiko kehamilan. Ibu dari keluarga miskin berpeluang 1,3 kali mengalami risiko kehamilan, sedangkan ibu yang sulit akses ke pelayanan kesehatan berpeluang 1,9 kali berisiko hamil dengan kondisi 4-T, dan ibu yang tidak/belum ingin hamil berpeluang 4,9 kali mengalami risiko kehamilan. Masalah risiko kehamilan lebih mungkin terjadi pada kelompok ibu yang tinggal di perdesaan, dengan tingkat pendidikan dan ekonomi rendah, dan kesulitan akses ke fasilitas kesehatan serta belum atau tidak menginginkan kehamilannya. Oleh sebab itu diperlukan pemerataan program jamkesmas agar keluarga tidak mampu dan yang tinggal di perdesaan semakin mudah untuk mendapat  pelayanan  kesehatan.  Selain  itu  memprioritaskan  pembangunan  fasilitas  kesehatan  dan penyediaan tenaga kesehatan di perdesaan, dan juga penyuluhan tentang cara mengatur kehamilan yang sehat.Kata kunci : risiko kehamilan, WUS, 4-TAbstract The purpose of this paper is to identify factors that may indirectly affect the risk of pregnancy. Crosssectional study design. The data is from the Basic Health Research (Riskesdas) in 2010 which has been implemented by the National Health Research, Ministry of Health. The unit of analysis is the mothers or women of childbearing age (WUS) who had delivered at least one child within a period of 5 years up to the time of the interview. The analysis was performed by using logistic regression to determine the most dominant factor. Based on the analysis found the most dominant variable in the relationship between the indirect factors associated with the incidence of pregnancy risk 4-T (too old, too young, too many and too often) is variable residency (rural/urban), level of education, economic status, access to health facility and desire of pregnancy. Mothers who live in rural areas are likely 1.1 times have the chance of pregnancy risk, while mothers with low education (elementary school and below) 1.4 times as likely to experience a pregnancy risk. Then, mothers of poor families having a chance to experience 1.3 times the risk of pregnancy, whereas mothers who have difficult access to health services were likely 1.9 times at risk of pregnancy with 4-T conditions, and women who did not want to get pregnant were likely to experience 4.9 times the risk of pregnancy. Risk of pregnancy problems is more likely to occur in the group of women who live in rural areas, with low levels of education and the economy, and the difficulty of access to health facilities and does not want her pregnancy. Therefore, it requires health insurance or “jamkesmas”in order to provide an equal health services for poor people and those who living in rural areas. In addition to prioritize the provision of health facilities and health workers in rural areas, as well as counseling on how to manage a healthy pregnancy.Keywords : risk of pregnancy, fertility.
Central obesity increases the risk of type 2 diabetes mellitus among urban adults Pradono, Julianty; Kusumawardani, Nunik; Delima, Delima
Universa Medicina Vol 34, No 3 (2015)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2015.v34.187-196

Abstract

BackgroundIn Indonesia the number of persons with type 2 diabetes mellitus (T2DM) was 8.5 million in 2013, and is estimated to be 11.8 million in 2030. The aim of this study was to determine the major risk factors associated with T2DM prevalence in urban aged >15 years.MethodsAn observational study with cross-sectional design was used with the data from Riskesdas 2007 and 2013 on population aged >15 years. Total respondents were 294,352 (2007) and 368,281 (2013). Data were collected by trained personnel through interviews, blood pressure and anthropometry measurements, and blood glucose and lipid tests. Odds ratio (OR) was used to test the relationship between T2DM and a number of other variables. Multiple logistic regression analysis was obtained to determine the main risk factor associated with T2DM prevalence.ResultsType 2 diabetes mellitus prevalence increased from 2.3% (2007) to 2.5% (2013). T2DM tended to be increased in the younger age groups. Low education, middle-to-high economic status, less physical activity, smoking >200 cigarettes, and high risk blood lipid levels were strongly associated with T2DM prevalence. The main risk factors were inadequate physical activity (2007: OR 1.9;95% CI:1.16–2.98 and 2013: OR 2.44;95% CI: 1.57-3.78) and central obesity (2007: OR 1.8;95% CI:0.99–3.10, and 2013:OR 3.84; 95% CI: 2.49-5.93) after controlling for age, gender, employment and economic status.ConclusionsType 2 diabetes mellitus prevalence in the population aged >15 years increased within 5 years. Lack of physical activity and central obesity were the major risk factors of T2DM prevalence in urban adults.
Determinants of diabetes comorbidities in Indonesia: a cohort study of non-communicable disease risk factor Kristanti, Dewi; Rahajeng, Ekowati; Sulistiowati, Eva; Kusumawardani, Nunik; Dany, Frans
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.3-13

Abstract

BackgroundType 2 diabetes mellitus (DM) is a non-communicable disease that constitutes a huge health burden, with the presence of comorbidities of DM adding to it. This study aimed to obtain the main determinants of the combined incidence of DM and its main comorbidities in adults.MethodsThis was a further analysis of the Non-Communicable Disease Risk Factor Cohort Study 2011 – 2018 involving 3730 subjects. Data of diabetes-free respondents at baseline were followed up every 2 years for 6 years. Data collection was carried out through interviews and health examinations. All subjects were assayed for blood glucose and lipid parameters. Chi-square test and Cox regression were implemented for data analysis.ResultsDuring 6 years of follow-up, DM incidence occurred in 567 (15.2%) subjects. The most common comorbidities were increased low density lipoprotein (LDL), central obesity, increased total cholesterol, obesity and hypertension. Most of the comorbidities occurred before the diagnosis of DM incidence. The determinants of the combined DM incidence–increased LDL are obesity, hypertension, and a family history of DM. The determinants of the combined DM incidence–central obesity are increased triglycerides, hypertension, male gender, and family history of DM. While the determinants of the combined DM incidence–hypertension are obesity and increased triglycerides.CONCLUSIONThis study demonstrated a high burden of diabetes incidence with comorbidities among adults. Knowledge of the magnitude of the diabetescomorbidity determinants emphasizes the role of non pharmacological intervention such as weight reduction and dietary modification.