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

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (102.474 KB) | DOI: 10.14238/pi48.5.2008.284-7

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.592 KB) | DOI: 10.14238/pi56.4.2016.193-8

Abstract

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.
Aplikasi SI DITA Berbasis Android terhadap Peningkatan Motivasi Orangtua Melakukan Stimulasi Deteksi Dini Tumbuh Kembang Rizka Adela Fatsena; Djauhar Ismail; Ekawaty Lutfia Haksari; Dewi Rokhanawati
JURNAL KESEHATAN REPRODUKSI Vol 8, No 3 (2021)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.56746

Abstract

Background: Every parent needs to have the skills to carry out monitoring and stimulate the development of infants and children. Technology-based Early Detection and Growth Stimulation is an innovative pathway to providing health informationObjective: To determine the effect of the Android-based Si DITA application to increase parental motivation to stimulate early detection of growth and development in Az-Zahra Early Childhood Education at Sleman RegencyMethod: Quasi Experiment with pretest-post test control group design design patterns. The sample uses the Lemeshow formula with purposive sampling of 15 respondents in each groupResults and Discussion: Obtained p value = 0.001, states that the Android-based Si DITA application to increase parental motivation to stimulate early detection of growth has a meaningful or influential value. The confounding variables that influence are only prior information, while education and income variables have no effectConclusion: Android-based applications can increase parental motivation to stimulate and detect early growth and development
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (255.487 KB) | DOI: 10.14238/pi59.1.2019.44-50

Abstract

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.
Pengaruh Perawatan Bayi Lekat Terhadap Pencapaian Pertumbuhan Bayi Berat Lahir Rendah Di RS DR. Sardjito Yogyakarta Lely Lusmilasari, Achmad Surjono dan Ekawaty Lutfia Haksari
Berita Kedokteran Masyarakat (BKM) Vol 20, No 2 (2004)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.3704

Abstract

Background: In conventional care method, a low birth weight infants (LBWi) needs an incubator or even radiant heater to prevent hypothermic and improves its general condition, but both devices are so costly that a new way of nursing called kangaroo mother care (KMC) is developed. Objective: To determine the influence of KMC and the difference in growth achievement between LBWi nursed with KMC and the others with conventional method up to the age of three months. Methods: The study was a quasi experiment with Non-Equivalent Control Group design, carried out at DR Sardjito Hospital Yogyakarta. The sample consists of pairs of Mother-LBWi, chosen using consecutive sampling were divided into two groups of treatment group and control group. Data analysis was conducted by using SPSS program. Results: The mean z score of weight for age was – 1,193 ± 0,600 (treatment group) and – 1,308 ± 0,586 (control group), (mean difference: 0, 1159; CI 95% = –0.123 to +0.355; p=0,339). The mean z score of height for age was – 2, 20 ± 1,158 (treatment group) and-2, 52 ± 0,956 (control group), (mean difference: 0, 325; CI 95%= –0,103 to +0,753; p=0,136). The mean head circumference for age was 39, 19 ± 3, 04 (treatment group) and 38, 54 ± 1.95 (control group), (mean difference of 0, 65; CI 95% =-1.381 to +1.685; P=0.213). Conclusion: The mean z score of weight for age and height for age, head circumference for age in treatment group were higher than that control group, there were no significant differences between the two groups. Keywords: Kangaroo Mother Care; low birth weight infants (LBWi); Growth
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

Abstract

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.
Lama Pemberian Air Susu Ibu pada Bayi Kurang Bulan dan Faktor yang Memengaruhi Tunjung Wibowo; Alifah Anggraini; Elysa Nur Safrida; Setya Wandita; Ekawaty Lutfia Haksari
Sari Pediatri Vol 24, No 5 (2023)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp24.5.2023.294-8

Abstract

Latar belakang. Air susu ibu (ASI) merupakan nutrisi yang penting untuk bayi kurang bulan. Pemberian ASI pada bayi kurang bulan mempunyai banyak kendala yang akan memengaruhi keberhasilan pemberian ASI. Tujuan. Mengetahui durasi pemberian ASI pada bayi yang lahir kurang bulan dan faktor-faktor yang memengaruhiMetode. Rancang bangun penelitian adalah potong lintang. Data diambil dari registri bayi kurang bulan yang dirawat di bangsal Perinatologi RSUP Dr. Sardjito, yang lahir antara 1 Januari 2018 – Desember 2018. Bayi yang tidak mendapatkan ASI karena alasan medis, misal ibu menderita HIV, ibu mendapatkan kemoterapi atau karena ibu meninggal dunia dikeluarkan dari penelitian ini. Analisis simple dan multiple linear regression dilakukan untuk mengetahui hubungan variabel bebas terhadap lama pemberian ASI. Hasil. Sebanyak 79 bayi kurang bulan yang memenuhi kriteria inklusi dan eksklusi direkrut ke dalam penelitian. Rerata ± SD lama pemberian ASI pada bayi kurang bulan adalah 10,8±8,1 bulan dengan median 7 bulan. Bayi yang mendapatkan ASI sampai usia 2 bulan adalah 96,2%, usia 4 bulan 89,9%, 6 bulan 81%, 8 bulan 45,6 %, 10 bulan 34,2%. Hasil analisis regresi linear berganda menunjukkan bahwa variabel yang secara independent terbukti bermakna memengaruhi lama menyusui adalah usia pertama kali bayi diberikan susu formula (?=0,66; p=<0,001) dengan adjusted R2= 0,34.Kesimpulan. Waktu pertama kali diberikan susu formula memengaruhi lama pemberian ASI. Semakin akhir pemberian susu formula akan semakin lama pemberian ASI.