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All Journal Medical Journal of Indonesia Sari Pediatri Paediatrica Indonesiana Belitung Nursing Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Journal of Maternal and Child Health Jurnal Epidemiologi Kesehatan Indonesia Amerta Nutrition Jurnal Ilmu Kefarmasian Indonesia

Rinawati Rohsiswatmo

Departemen Ilmu Kesehatan Anak FKUI RSCM

Author-ID : 3212854

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Retinopathy of prematurity: Prevalence and risk factors Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 45 No 6 (2005): November 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.6.2005.270-4

Background Retinopathy of prematurity (ROP) is one of the ma-jor causes of infant blindness. There are several factors known asrisk factors for ROP. Recent studies show ROP as a disease ofmultifactorial origin.Objective To report the prevalence of ROP in Cipto MangunkusumoHospital, Jakarta and its relation to several risk factors.Methods A cross-sectional descriptive study was conducted fromDecember 2003-May 2005. All infants with birth weight 2500 gramsor less, or gestational age 37 weeks or less, were enrolled con-secutively and underwent the screening of ROP at 4 to 6 weeks ofchronological age or 31 to 33 weeks of postconceptional age.Result Of 73 infant who met the inclusion criteria, 26% (19 out of73 infant) had ROP in various degrees. About 36.8% (7 out of 19infants) were in stage III or more/threshold ROP. No ROP wasnoted in infants born >35 weeks of gestational age, and birth weight>2100 grams. No severe ROP was found in gestational age >34weeks and birth weight >1600 grams. None of full-term, small forgestational age infants experienced ROP. Birth weight, sepsis,apneu, asphyxia, multiple blood transfusions, and oxygen therapyfor more than 7 days were statistically significant with the develop-ment of ROP. However, using multivariate analysis, only asphyxia,multiple blood transfusions, and oxygen therapy for more than 7days were statistically significant with the development of ROP.Conclusion Screening of ROP should be performed in infantsborn 34 weeks of gestational age and/or birth weight <1600 grams.Infants with birth weight from 1600-<2100 grams need to bescreened only if supplemental oxygen is necessary or with clini-cally severe illness

Focused group discussion with health care staff improves breastfeeding rates in hospitalized infants Agnes Yunie Purwita Sari; Rosalina Dewi Roeslani; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 57 No 4 (2017): July 2017
Publisher : Indonesian Pediatric Society

Background Improving breastfeeding in sick infants is essential. During the neonatal care, health care staff play an important role in promoting breastfeeding. Therefore, it is important to study in depth how healthcare staff can improve breastfeeding practice in sick neonates.Objective To compare breastfeeding rates in sick infants before and after a focused group discussion (FGD) of health care staff on how to improve breastfeeding.Methods This study was an operational study using FGD and in-depth interviews as an intervention. A fish bone diagram was used to assess problems that may prevent mothers from breastfeeding their sick infants. Breastfeeding achievement was compared before and after the FGD.Results Of 257 sick infants, 177 subjects were in the before FGD group and 80 subjects were in the after FGD group. Significantly more after FGD subjects were breastfed during hospitalization than before FGD subjects [97.5% vs. 82.9%, respectively; (x2 =9.43; P=0.002)]. Breastfeeding initiation within 0-4 hours of birth was also significantly higher in the after FGD group [10 (12.5%) vs. 6 (3.5%), respectively; (x2 = 52.5; P<0.001)]. The solutions for breastfeeding problems were: 1) support of hospital management, 2) support of healthcare workers for breastfeeding mothers, 3) support of husbands and families for breastfeeding mothers, 4) financial support, 5) other factors such as level of care and consistent FGD events, and 6) a prospective cohort study.Conclusion The FGD with health care staff significantly increases breastfeeding achievement during infant hospitalization, and accelerated breastfeeding initiation. A fish bone diagram is used to effectively assess the problems with breastfeeding programs for sick babies.

Efficacy of oral erythromycin to enhance feeding tolerance in preterm infants Made Sukmawati; Rinawati Rohsiswatmo; Rulina Suradi; Pramita Gayatri
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

Background Feeding intolerance is a common condition that affects preterm infants. Erythromycin is a prokinetic agent used to treat feeding intolerance, but its efficacy remains inconclusive.Objective To evaluate the effectiveness of oral erythromycin to enhance feeding tolerance in preterm infants.Methods This prospective, randomized controlled trial in preterm infants was conducted at Sanglah Hospital, Denpasar, Bali, from June 2015 to January 2016. Eligible infants were randomized to receive either 12.5 mg/kg/dose oral erythromycin or a placebo, every 8 hours. The primary outcome was the time to establish full enteral feeding. The secondary outcomes were body weight at full enteral feeding and length of hospital stay.Results Of 62 initial subjects, 3 infants dropped out of the study. Thirty infants were given erythromycin and 29 infants were given placebo. The baseline characteristics of the two groups were similar, with mean of gestational ages of 31.4 (SD 1.7) weeks in the erythromycin group and 32.4 (SD 2.2) weeks in the placebo group. The median times to reach full enteral feeding did not significantly differ between the two groups, with 10 (SD 5.3) days in the erythromycin group vs. 8 (SD 6.5) days in the placebo group (P=0.345). Also, median body weights at full enteral feeding and lengths of hospital stay were not significantly different between the two groups.Conclusion Erythromycin of 12.5 mg/kg/dose every 8 hours as prophylactic treatment does not significantly enhance feeding tolerance in preterm infants. Median body weights at full enteral feeding and length of hospital stay are not significantly different between the erythromycin and placebo groups.

Intravenous paracetamol and patent ductus arteriosus closure in preterm infants Rizky Adriansyah; Nikmah S. Idris; Mulyadi M. Djer; Sukman T. Putra; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 57 No 4 (2017): July 2017
Publisher : Indonesian Pediatric Society

Background Indomethacin and ibuprofen are the drugs of choice for closure of patent ductus arteriosus (PDA) in preterm infants. However, intravenous preparations are of limited availability in Indonesia. Circumstantial evidence has shown that intravenous paracetamol may be an alternative therapy for PDA closure in premature infants.Objective To evaluate the effect of intravenous paracetamol on PDA closure in preterm infants.Methods A before-and-after study was conducted between May and August 2014 in Cipto Mangunkusumo General Hospital, Jakarta in preterm infants with hemodynamically significant PDAs, as established by echocardiography using the following criteria: duct diameter >1.4 mm/kg, left atrium to aorta ratio >1.4, and mean velocity in the left pulmonary artery >0.42 m/s or mean diastolic velocity in the left pulmonary artery >0.2 m/s. Subjects, aged 2 and 7 days, received intravenous paracetamol (15 mg/kg every six hours) for 3 days. Paired T-test was used to compare pre-intervention PDA diameter to those assessed at 24 hours after the intervention and at 14 days of life.Results Twenty-nine subjects had a mean gestational age of 30.8 weeks and mean birth weight of 1,347 grams. Nineteen (65.5%) patients had closed PDAs at the day 14 evaluation, 1 experienced PDA reopening, and 9 had failed PDA closure. No liver toxicity was identified. Mean duct diameters before, 24 hours after the intervention, and at 14 days of life were 3.0, 0.9, and 0.6 mm, respectively (P<0.0001).Conclusion Intravenous paracetamol seems to be reasonably effective for PDA closure in preterm infants.

Factors Affecting Low Birth Weight Incidence at Cipto Mangunkusumo Hospital, Jakarta Rachma F. Boedjang; Rinawati Rohsiswatmo; Titi S Sularyo; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 38 No 11-12 (1998): November - December 1998
Publisher : Indonesian Pediatric Society

A case-control study was conducted during the period of April-July 1997 to determine factors affecting the incidence of low birth weight infants born at Cipto Mangunkusumo Hospital, Jakarta. Of the 300 singleton infants (150 LBW and 150 non-LBW) studied, five risk factors were determined: (1) maternal education (p = 0,027), (2) maternal weight gain during pregnancy (p < 0,001), (3) interval between regnancy intervals (p = 0,041), (4) history of previous LBW (p = 0,004), and (5) maternal health condition during pregnancy (p < 0,0001). The mean anthropometric measurements of male non-LBW were significantly greater than female non-LBW infants.

Oxidative stress in neonates with hyperbilirubinemia before and after phototherapy: malondialdehyde and catalase activity Putu Junara Putra; Rinawati Rohsiswatmo; Pustika Amalia Wahidiyat
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Phototherapy is used to treat neonatal hyperbilirubinemia, but is currently thought to cause photodynamic stress and can induce lipid peroxidation. There is increasing evidence that many severe diseases of the neonates are caused by oxidative injury and lipid peroxidation. In the present communique, we review the oxidative succeptibility of the neonate and the evidence now available that phototherapy induces oxidative stress. Malondialdehyde (MDA) is a metabolic product of free radicals. Catalase is a antioxidant that binds free radicals. Objective To compare the levels of oxidants and antioxidants before and after phototherapy in neonates with hyperbilirubinemia. Methods This pretest-posttest control group study was conducted in Sanglah Hospital, Bali from November 2016 to April 2017. Thirty babies with gestational age â‰¥35 weeks and hyperbilirubinemia with total bilirubin levels requiring phototherapy were included in this study. The MDA levels and catalase activity were measured before and after 24 hours of phototherapy. Results Comparative analysis using paired T-test showed a significant increase of malondialdehyde level, with mean MDA 23.73 (SD 8.20) nmol/mL before and 53.05 (SD 10.18) nmol/mL after phototherapy (P<0.001). However, catalase activity significantly decreased from of 72.33 (SD 10.63) kU/L before phototherapy to 44.85 (SD 14.79) kU/L after phototherapy (P<0.001). The MDA level had a significant, negative association with catalase activity after phototherapy (r =-0.4; P=0.028). Conclusion Neonates with hyperbilirubinemia are found to have increased oxidative stress after phototherapy, as indicated by increased MDA levels and decreased CAT activity after 24 hours of phototherapy.

Sepsis calculator to support antibiotic stewardship in early-onset neonatal sepsis: a meta-analysis Rinawati Rohsiswatmo; Hardya Gustada Hikmahrachim; Dinarda Ulf Nadobudskaya; Sonia Miyajima Anjani; Albert You
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Establishing a diagnosis of neonatal sepsis is difficult. As such, appropriate timing of antibiotic therapy remains the biggest challenge. As a consequence of non-definitive diagnoses, inappropriate antibiotic administration is common. Recently, a sepsis calculator to estimate risk of early-onset sepsis (EOS) based on both maternal risk factors and infants' clinical presentation was established. Objective To determine the impact of the sepsis calculator in daily clinical settings, especially with regards to antibiotic usage. Methods A literature search of Pubmed, EBSCO, Embase, and Scopus database from January 2011 (after sepsis calculator was established) to June 2018 was performed. We included observational studies that compared the sepsis calculator to recent neonatal sepsis guidelines in terms of antibiotic administration, blood culture, and admission to the neonatal intensive care unit (NICU). The literature search, validation study, and assessment risk of bias were done independently by our four authors, while the first author did the statistical analysis. Results Of the 35 studies identified, 5 cohort studies met the criteria, with a total sample size of 18,352 infants from various countries. We developed a fixed-effect meta analysis of the data. The use of the sepsis calculator significantly reduced inappropriate use of antibiotics [RR 0.46; 95%CI 0.41 to 0.51; z=13.57; P<0.001], blood culture sampling [RR 0.46; 95%CI 0.40 to 0.52; z=12.11; P<0.001), and higher neonatal care level admissions [RR 0.68; 95%CI 0.59 to 0.78); z=5.47; P<0.001). No safety issues were reported from studies using the sepsis calculator. Conclusion The new EOS risk estimation using a neonatal sepsis calculator is an easy, effective, and safe tool to improve appropriate antibiotic use and outcomes. This calculator is ready to be implemented in all levels of neonatal care units.

UGT1A1 gene polymorphisms and jaundice in Indonesian neonates Rinawati Rohsiswatmo; Radhian Amandito; Andiani Wanda Putri; Nilam Sartika; Amarila Malik
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Background Uridine diphospho-glucuronocyltransferase 1A1 (UGT1A1) polymorphisms are a risk factor for unconjugated hyperbilirubinemia in neonates. UGT1A1 polymorphisms decrease bilirubin conjugation, thus causing hyperbilirubinemia. A variety of polymorphisms have been reported, with UGT1A1*60 and UGT1A1*6 especially prominent in the Asian population. Hyperbilirubinemia polymorphism studies are lacking in Indonesian populations. Objective To identify UGT1A1*60 and UGT1A1*6 profiles in Indonesian populations of heterogeneous ethnicity. Methods We enrolled 42 jaundiced neonates who were born from January to April 2017 and treated in the Neonatal Intensive Care Unit of our national referral center, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Genetic mutations *60 of exon 1 and *6 of the promoter region were analyzed by polymerase chain reaction â€“ restriction fragment length polymorphism methods, with DraI and AvaII as restriction enzymes, respectively. Clinical data including total serum bilirubin and racial information were obtained by medical records and interviews with parents. Results There were no homozygous mutations of UGT1A1*6, but 4.8% of subjects were heterozygous. As for UGT1A1*60, 4.8% were heterozygous and 95.2% were homozygous. Racial variations were not observed for UGT1A1*60, while Betawi descendents were found to have many heteroygous forms of UGT1A1*6. Conclusion Polymorphisms of the UGT1A1 gene were found in Indonesian neonates. Some ethnicities also showed increased tendency towards its incidence, such as the heterozygous form of UGT1A1*6.

Preterm human milk composition and dietary intake of breastfeeding mothers in the Indonesian population Putri Maharani Tristanita Marsubrin; Rinawati Rohsiswatmo; Damayanti R. Sjarif
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.20-4

Background Human milk consumption is a protective factor against infection. However, the high variability of human milk composition makes it difficult for clinicians and researchers to assess the adequacy of nutritional intake. Objective To identify the nutritional profiles and composition of premature human milk and dietary intake of breastfeeding mother. Methods Human milk specimens were collected from mothers who gave birth to very premature and/or very low birth weight infants. Infants had been admitted to the Neonatology Unit of Dr. Cipto Mangunkusumo Hospital, Jakarta. The milk specimens were analyzed with a mid-infrared milk analyzerTM (MIRIS) for four weeks, and maternal dietary macronutrient intake was determined with food record questionnaires on food consumption frequency and food recall. Results Significant changes in nutritional composition of human milk were observed, with the fat concentration and calories increasing with time, and protein concentration decreasing with time. There were no significant differences observed in carbohydrate concentration of milk over the four weeks (P=0.447). Maternal intake of protein, carbohydrates, fat and calories was lower than the recommended values for breastfeeding women. Conclusion The macronutrient (protein and fat) and energy contents of human milk change weekly. Dietary intake of breastfeeding women are lower than recommended values.

Vitamin D and T- regulator cells are not independent factors for RDS in premature neonates Putri Maharani Tristanita Marsubrin; Agus Firmansyah; Rinawati Rohsiswatmo; Yuditiya Purwosunu; Zakiudin Munasir; Tetty Yuniati
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.192-7

Background The high morbidity and mortality of premature neonates remain significant problem in Indonesia with respiratory distress syndrome (RDS) as one of the most common problem. Vitamin D plays an important role in lung maturity. Vitamin D deficiency causes epithelial cell inflammation, leading to a higher risk of RDS. Previous studies suggest that T regulatory cells (Treg) in inflammatory diseases, such as RDS in neonates, are possibly linked to vitamin D deficiency. Objective To determine the role of vitamin D on RDS and Treg cells in very premature or very low birth weight neonates. Methods A prospective cohort study conducted on premature neonates in Neonatology Division, Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Umbilical cord blood samples were collected to evaluate total vitamin D 25-OH levels and Treg cells. Subjects with RDS were evaluated until the end of the observation period. Results The mean umbilical cord vitamin D level was 15.79 (SD 6.9) ng/mL, and 53% of the subjects were found to be deficient. As much as 65.1% of neonates had RDS. The mean Treg level was 11.38 (SD 2.45)%. No significant correlation was observed between vitamin D level and the occurrence of RDS (RR 0.87; 95%CI 0.56 to 1.34; P=0.53); vitamin D level and the dysregulation of Treg cells (RR 1.30; 95%CI 0.76 to 2.21; P=0.31) as well as between Treg dysregulation and RDS (RR 1.11; 95%CI 0.70 to 1.75; P=0.64). However, we found that RDS group had a lower gestational age and higher presentation of dysregulation Treg. Conclusion In very premature or very low birth weight neonates, no association between occurence of RDS and vitamin D deficiency as well as Treg cell dysregulation.

Co-Authors Abdurahman Sukadi Agnes Yunie Purwita Sari Agus Firmansyah Agus Firmansyah Ahmad Kautsar Ahmad Kautsar Albert You Amarila Malik Andiani Wanda Putri Angelina Arifin Anita Halim Aria Wibawa Aryono Hendarto Asril Aminullah Audesia Alvianita Sutrisno Badriul Hegar Bambang Tridjaja AAP, Bambang Tridjaja Benedica M. Suwita Bernie Endyami Budiman, Jenica Xaviera Christopher S. Suwita Damayanti R. Sjarif Damayanti Rusli Sjarif Darlan Darwis Darmawan B Setyanto Desiana Dharmayani Diah Mulyawati Utari Dian Artanti Dina Indah Mulyani Dinarda Ulf Nadobudskaya Dion Darius Samsudin Djajadiman Gatot Djajadiman Gatot Djajadiman Gatot Dwi Hidayah Dyah Dwi Astuti Ellya Marliah Endang Windiastuti Enty Tjoa Enty, Enty Evita Karianni Bermanshah Fatima Safira Alatas, Fatima Safira Felix F. Widjaja Firmansha Dilmy, Mohammad Adya Gultom, Lanny Christine Hanifah Oswari Hardiono Pusponegoro Hardya Gustada Hikmahrachim Hardya Gustada Hikmahrachim Hardya Gustada Hikmahrachim Hikmahrachim, Hardya Gustada Hindra Irawan Satari Ifran, Evita Karianni B. Imral Chair Ina Susianti Timan Insani, Nadia Dwi Intan Alita Putri Tumbelaka Irawan Mangunatmadja Iskandar, Stephen Diah Islamah, Rachelya Nurfirdausi Isman Jafar James Thimoty Laila Laila Larashintya Rulita Lily Rundjan Lucky H. Moehario Lucky H. Moehario Made Sukmawati Marianna Yesy Marsubrin, Putri Maharani Tristanita Mulyadi M. Djer Mulyadi M. Djer Mustarim Mustarim Nadjib Advani Najib Advani Naomi Esthemita Dewanto Ni Ketut Prami Rukmini Nieta Hardiyanti Nikmah S. Idris Nila Kusumasari Nilam Sartika Noroyono Wibowo Nusarintowati Ramadhina Peter Graham Davis Pramita Gayatri Purwosunu, Yuditiya Pustika Amalia Wahidiyat Putri M.T Marsubrin, Putri M.T Putri Maharani Tristanita Marsubrin Putri Maharani Tristanita Marsubrin Putri, Atikah Sayogo Putu Junara Putra Rachma F. Boedjang Radhian Amandito Radhian Amandito Ramadhika, Muhammad Reni Fahriani Rima Irwinda, Rima Risma Karina Kaban Rismala Dewi Rizalya Dewi Rizky Adriansyah Ronny Suwento, Ronny Rosalina D. Roeslani Rosalina Dewi Roeslani Rosalina Dewi Roeslani Rubiana Sukardi Rudolf Tuhusula Rulina Suradi Rumondang, Amanda Safarina G. Malik Saleha Sungkar Salsabila Putri, Cut Tisya Santoso, Dewi Irawati Soeria Sarah R. Nursyirwan Sarah Rafika Sarah Rafika, Sarah Saroyo, Yudianto Budi Soedjatmiko Soedjatmiko Sonia Miyajima Anjani Stanislaus Djokomuljanto Sudarto Ronoatmodjo Sudigdo Sastroasmoro Sudjatmiko Sudjatmiko Sukman T. Putra Sukman T. Putra Sukman Tulus Putra Susanti, Yurika Elizabeth Teny Tjitra Tetty Yuniarti Tetty Yuniati Titi S Sularyo Wanda , Dessie Wijaya, Marcella Amadea Wresti Indriatmi Yapiy, Ivana Yuditiya Purwosunu Yuliarti, Klara Yulidar Hafidh Yulindhini, Maya Yuni Astria Yuyun Lisnawati Yvan Vandenplas Zakiudin Munasir Zakiudin Munasir Zakiudin Munasir

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