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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Keperawatan Jiwa (JKJ): Persatuan Perawat Nasional Indonesia Sari Pediatri Paediatrica Indonesiana Jurnal Kesehatan Reproduksi Berita Kedokteran Masyarakat

Ekawaty Lutfia Haksari

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran, Keperawatan, Dan Kesehatan Masyarakat Universitas Gadjah Mada/RSUP. Dr. Sardjito, Yogyakarta

Author-ID : 3211938

Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

Published : 17 Documents Claim Missing Document

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Articles

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Risk factors for hearing loss in neonates Ni Luh Putu Maharani; Ekawaty Lutfia Haksari; I Wayan Dharma Artana
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects) and without hearing loss (control group of 50 subjects). The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040). There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.

Developmental delay in 3-month-old low birth weight infants with hyperbilirubinemia Wiradharma Wiradharma; I Gusti Ayu Trisna Windiani; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Backgrourui Developmental delay may be due to a variety offactors occurring during the prenatal, perinatal, or postnatalperiods, one of which is hyperbilirubinemia.Objective To evaluate the impact ofhyperbilirubinemia on infantdevelopmental delay.Methods A prospective cohort study was conducted from March toJuly 2011. Subjects were low birth weight infants with and withouthyperbilirubinemia. Developmental delay was measured using theMullen Scales of Early Learning. Data was analyzed by Chi squaretest and relative risks were calculated. Logistic regression analysiswas performed to assess factors associated with developmentaldelay. Differences were considered statistically significant for Pvalues < 0.05.Results Forty-six low birth weight infants were enrolledin this study, 23 with hyperbilirubinemia and 23 withouthyperbilirubinemia. The relative risk (RR) for developmentaldelay in the hyperbilirubinemia group was 2.08 (95%CI 0.51 to8 .40). Multivariate analysis revealed that hyperbilirubinemia didnot significantly influence developmental delay (RR 1.45; 95%CI0.29 to 7.31). However, small for gestational age with or withouthyperbilirubinemia significantly influenced developmental delay(RR 12.13; 95%CI 2.43 to 60.56).Conclusion Hyperbilirubinemia in low birth weight infants isn ot a risk factor for developmental delay at the age of 3 months.However, being small for gestational age with or withouthyperbilirubinemia significantly influences the likelihood ofdevelopmental delay.

Relationship between bottle feeding in supine position in infants and the presence of asthma among preschoolers Pertiwi Febriana Chandrawati; Roni Naning; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Asthma is a common chronic respiratory disease.The risk factors of asthma are allergic factors, familial atopy,race, gender, and smoking during pregnancy. Other risk factorsare gastroesophageal reflux and micro-aspiration which causebronchospasm and bronchial hyperreactivity due to repeatedairway irritation.Objective To determine the association between bottle feedinggiven in supine position before sleep time in the first year of lifewith asthma in 4 to 7 years old.Methods A case control study was conducted on pediatricpatients from Sardjito Hospital and Muhammadiyah kindergarten, Yogyakarta. Two structured questionnaires were used; the first identified the case group (asthma) and control group (nonasthma), whereas the second one identified whether the subjects had bottle feeding in supine position in the first year of life or not.Results 122 subjects were studied, 62 subjects in asthma groupand 60 in control group. In asthma group, feeding in supineposition before sleep time in the first year had OR of 2.45 (95%CI 1.21 to 6.93), whereas regurgitation when bottle-feeding insupine position had OR of 4.53 (95% CI 1.54 to 13.16). Suddencry when bottle-feeding in supine position had OR of 5.02 (95%CI 1.69 to 15.71). Asthma in the family increased risk of asthma[OR 3.12 (95% CI 1.16 to 6.50)] and atopicfamily has OR 3.25(95% CI 1.01 to 6.27).Conclusion Bottle feeding in supine position before sleep timeduring first year oflife is associated with occurrence of asthma inpreschool children.

Association between neutropenia and death rate of bacterial neonatal sepsis Elly Noer Rochmah; Ekawaty Lutfia Haksari; Sri Mulatsih
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Background Neonatal sepsis remains a crucial problem with highmorbidity and mortality. Not less than four million neonates dieevery year, 99% of which occur in developing countries withinfection as the main cause (36%) of death. The prognosticfactors of bacterial neonatal sepsis vary. However the death ratein neonatal sepsis with neutropenia is suspected to be higher thanthat in non-neutropenic condition.Objectives The purpose of this study was to identify whetherneutropenia would increase the death risk of bacterial neonatalsepsis.Methods We conducted a retrospective cohort study. Subjectswere neonates at Instalasi Maternal Perinatal (IMP) of Dr. SardjitoHospital in Yogyakarta who met the eligibility criteria. Duringthe five-year period Qanuary 2002- January 2007), out of 1821cases of suspected neonatal sepsis, 365 (16.7%) were found tohave bacterial cause in the culture of body's fluid (blood, urine,and cerebrospinal). Out of these 16.7% patients suffering fromneutropenia, 39.6% patients died, whereas 9.1 o/o patients weresurvive [RR 4.72, (95% CI: 2.49 to 8.93), P < 0.01].Conclusion Neonates suffering bacterial sepsis with neutropeniahad death risk 4.7 times higher than those who did not haveneutropenia.

Lactate clearance as a predictor of mortality in neonatal sepsis Felix Nathan Trisnadi; Ekawaty Lutfia Haksari; Tunjung Wibowo
Paediatrica Indonesiana Vol 56 No 4 (2016): July 2016
Publisher : Indonesian Pediatric Society

Background Neonatal sepsis remains the leading cause of neonatal deaths. Therefore, efforts should be made to reduce its mortality. Lactate clearance can be used as a marker of onset of hypoxia and microcirculation disorders, as well as to predict patient outcomes.Objective To assess the use of lactate clearance to predict mortality from neonatal sepsis.Methods We conducted a prospective cohort study in the levels 2 and 3 of neonatal care unit, Department of Child Health, Dr. Sardjito General Hospital, Yogyakarta, from October to November 2011. We enrolled 40 neonatal sepsis patients, who were divided into either the high or low lactate clearance groups. All neonates were followed up until they were discharged from the hospital, as to whether they survived or died. We performed blood lactate measurements early on following their diagnosis of sepsis, and after the subsequent six hours following the first antibiotic administration. Logistic regression for the multivariate analysis and ROC curves for the accurate analysis of predictive outcome factors were performed.Results More deaths occurred in neonates with low lactate clearance at six hours (48%) than in those in the high lactate clearance group (7%). Low lactate clearance at six hours was a significant predictor of mortality (RR 15.1; 95%CI 1.7 to 133), whereas the ROC analysis showed moderate accuracy.Conclusion Lactate clearance at six hours may be used as a predictor of mortality in infants with neonatal sepsis.

Predictors of early growth failure in preterm, very low birth weight infants during hospitalization Noviyani Leksomono; Retno Sutomo; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Background Preterm, very low birth weight (VLBW) infants experience intrauterine nutritional deficits and perinatal comorbidities that may impair early growth parameters. Early growth failure has detrimental effects on later growth and neurodevelopment in childhood. Objective To analyze predictors of early growth failure in preterm, VLBW infants and differences in early growth parameters between small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants. Methods This retrospective cohort study was conducted at Dr. Sardjito Hospital, Yogyakarta from 2011 to 2016. Subjects were preterm infants, with birth weights of 1,000-1,499 g. Twins, those who died during hospitalization, were discharged against medical advice, or had incomplete medical records were excluded. Adequate intrauterine growth was determined by the Lubchenco table criteria. Growth parameters and perinatal comorbidities were collected from medical records. Growth failure was defined as discharge weight less than 10th percentile of the Fenton growth curve. Bivariate and multivariate analysis were used to analyze potential predictive factors of early growth failure. Results Of 646 preterm, VLBW infants during the study period, 398 were excluded. Respiratory distress and SGA were predictors of early growth failure (AOR 6.94; 95%CI 2.93 to 16.42 and AOR 34.44; 95%CI 7.79 to 152.4, respectively). Mean weight velocities in SGA and AGA infants were not significantly different [16.5 (SD 5.9) and 17.5 (SD 5.3) g/kg/day, respectively; (P=0.25)]. Median time to regain, time to reach full feeding, and time to reach 120 kcal/kg/day were also not significantly different between SGA and AGA infants. Conclusions SGA and respiratory distress are predictors of early growth failure in preterm, VLBW infants during hospitalization. The SGA infants grow slower than AGA infants.

Umbilical cord blood interleukin-6 level as a predictor of early-onset neonatal sepsis Arya Adnan Fadilah; Ekawaty Lutfia Haksari; Setya Wandita
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.304-10

Background Neonatal sepsis is a global health problem contributing significantly to neonatal morbidity and mortality. It is difficult to clinically distinguish neonates with and without sepsis. Interleukin-6 (IL-6) concentration in neonates has high sensitivity and specificity to predict neonatal sepsis in infants at risk. Objective To determine the utility of umbilical cord blood IL-6 as a predictor of early-onset neonatal sepsis. Methods This prospective cohort study was conducted in neonates born to mothers with sepsis risk factors from December 2020 to January 2021. We measured IL-6 from umbilical cord blood taken after placental expulsion. IL-6 ³16.4 pg/ml was considered to be elevated. Subjects were monitored for signs of clinical sepsis until 72 hours after birth. We also recorded the presence of other maternal and infant risk factors of sepsis and assessed association between IL-6 and other risk factors with the occurrence of sepsis, expressed as relative risk (RR) with 95% confidence interval (95%CI). Results During the study period, 40 neonates were born to mothers with sepsis risk factors; 13 (32.5%) developed clinical sepsis. Significantly more infants with elevated IL-6 developed neonatal sepsis (55.5%) than those with normal IL-6 (13.6%). After multivariate analysis incorporating other significant variables, the risk factors predictive of clinical early-onset neonatal sepsis were IL-6 [RR 5.54 (95%CI 1.68-18.25); P=0.016], prematurity [RR 4.92 (95%CI 1.66-14.59); P=0.014], and initial Apgar score [RR 3.38 (95%CI 1.34-3.38); P=0.046]. Conclusion In neonates with maternal risk factors, an IL-6 level of ³16.4 pg/ml is associated with an increased risk of early-onset neonatal sepsis.

Co-Authors Alifah Anggraini Ariadne Tiara Hapsari Arya Adnan Fadilah Catur Yulinawati Dewi Hartaty Dewi Rokhanawati Dewi Rokhanawaty Djauhar Ismail Djauhar Ismail Elly Noer Rochmah Elysa Nur Safrida Felix Nathan Trisnadi I Gusti Agung Trisna Windiani I Nyoman Sujana I Wayan Dharma Artana MM. Tri Widiyati Ni Luh Putu Maharani Noormanto Noormanto Noviyani Leksomono Pertiwi Febriana Chandrawati Retno Sutomo Rizka Adela Fatsena Roni Naning Setya Wandita Setya Wandita Setya Wandita Setya Wandita Setya Wandita Tunjung Wibowo Tunjung Wibowo Tunjung Wibowo Tunjung Wibowo Tunjung Wibowo Wiradharma Wiradharma

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