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Relationship between Age, Parity and Body Mass Index in Pregnant Women with the Incidence of Preeclampsia at Prof. Dr. Margono Soekardjo Hospital Purwokerto Simanjuntak, Josua; Priyanto, Edy; Zulvayanti, Zulvayanti
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.676

Background: Preeclampsia is a crucial problem in developing country and contributes 9% of maternal mortality in Asia. Moreover it has been the second main cause of maternal death in Indonesia and the leading cause of maternal death in Central Java since 2019.Objective: This study aims to determine the relationship between age, parity and BMI in pregnant women with the incidence of preeclampsia.Methods: This study is a retrospective analytic observational study with a case control design. The research subjects were all cases of vaginal delivery and cesarean section from July to December 2022.Results: There were 200 women as subjects consisting of 100 women with preeclampsia and 100 women without preeclampsia. Most of the research subjects were aged <35 years (71.5%). It was found that preeclampsia was significantly associated with age ≥35 years (p=0.019), BMI ≥30 (p=0.008) and primiparity (p=0.006). On bivariate analysis, women with age ≥35 years (OR 2.1; 95% CI; 1.12-3.97), BMI ≥30 (OR 2.4; 95% CI; 1.25-4.87) and primiparity (OR 2.2; 95% CI; 1.2- 3.92) are at increased risk of developing preeclampsia.Conclusion: The results of this study indicate that age ≥ 35 years, BMI ≥30 and primiparity are associated with the occurrence of preeclampsia.Hubungan Usia, Paritas dan Indeks Masa Tubuh pada Ibu Hamil dengan Kejadian Preeklamsia di RSUD Prof. Dr. Margono Soekardjo PurwokertoAbstrak Pendahuluan: Preeklamsia masih menjadi masalah kesehatan ibu yang krusial di negara berkembang dan berkontribusi sebanyak 9% mortalitas maternal di Asia. Preeklamsia menempati urutan ke-2 kematian ibu di Indonesia dan menjadi penyebab utama kematian ibu di Jawa Tengah sejak tahun 2019.Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara usia, paritas, dan IMT pada ibu hamil dengan kejadian preeklamsia.Metode: Penelitian ini merupakan penelitian observasional analitik retrospektif dengan desain case control. Subjek penelitian adalah seluruh kasus persalinan pervaginam dan seksio sesarea pada bulan Juli sampai Desember 2022.Hasil: Diperoleh subjek sebanyak 200 wanita yang terdiri atas 100 wanita dengan preeklampsia dan 100 wanita tanpa preeklampsia. Sebagian besar subjek penelitian berusia <35 tahun (71.5%). Ditemukan bahwa preeklamsia secara signifikan berhubungan dengan usia ≥35 tahun (p=0.019), IMT ≥30 (p=0.008) dan primiparitas (p=0.006). Pada analisis bivariat, wanita dengan usia ≥35 tahun (OR 2.1; 95%CI; 1.12 - 3.97), IMT ≥30 (OR 2.4; 95%CI; 1.25 - 4.87) dan primipara (OR 2.2; 95%CI; 1.2 - 3.92) berada dalam peningkatan risiko terjadi preeklamsia. Kesimpulan: Hasil penelitian ini menunjukkan bahwa usia ≥35 tahun, IMT ≥30 dan primiparitas berhubungan dengan terjadinya preeklampsia.Kata kunci: preeklamsia, usia, paritas, indeks masa tubuh

IMPACT OF MATERNAL WEIGHT GAIN AND INFLAMMATORY MARKERS ON NEONATAL IRON DEFICIENCY: A CROSS-SECTIONAL STUDY FROM A PEDIATRIC PERSPECTIVE Santosa, Qodri; Oliviany, Windy; Hafiidhaturrahmah, Hafiidhaturrahmah; Pratidina, Wening Gelar; Hapsari, Ariadne Tiara; Priyanto, Edy; Muntafiah, Alfi
Medical and Health Journal Vol 4 No 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2025.4.2.14481

Background: Maternal health during pregnancy is crucial for neonatal outcomes, particularly regarding iron status. This study investigates the impact of maternal weight gain and inflammatory markers on neonatal iron deficiency in a cohort of mothers and their newborns. Methods: A cross-sectional study was conducted involving spontaneously delivered infants from single, full-term pregnancies, with Apgar scores ≥7 at the first minute and normal birth weights (≥2,500 to <4,000 grams). Maternal weight gain was categorized as "appropriate" or "inappropriate" based on the 2009 Institute of Medicine (IOM) recommendations. Maternal blood samples were collected during the third trimester, and infant iron status was assessed through hematological parameters and serum iron levels. Statistical analyses included the Mann-Whitney test and independent t-tests, with significance set at p < 0.05. Results: A total of 59.5% of mothers did not achieve appropriate weight gain, and 57.1% exhibited positive CRP levels, indicating inflammation. Infants born to mothers with appropriate weight gain had significantly better hematological parameters, including higher erythrocyte counts, hemoglobin, and hematocrit levels (p < 0.05). Conversely, infants of mothers with positive CRP levels demonstrated lower erythrocyte counts and hemoglobin levels, indicating a potential negative impact of maternal inflammation on iron transfer (p < 0.05). No significant differences in neonatal iron status were observed between infants born to anemic and non-anemic mothers. Discussion: The findings underscore the importance of monitoring maternal nutritional status and inflammatory markers during pregnancy. Adequate weight gain according to IOM guidelines is associated with improved neonatal iron status, while maternal inflammation negatively impacts iron transfer to the fetus. These results highlight the need for targeted interventions, including nutritional education and management of inflammatory conditions, to enhance maternal and neonatal health outcomes. Conclusion: This study contributes to the understanding of the relationships between maternal weight gain, inflammatory markers, and neonatal iron status. By addressing these factors, healthcare providers can improve outcomes for mothers and their newborns, ultimately promoting healthier populations.

Correlation of Maternal Comorbidities and Neonatal Outcomes in Patients With Non-Reassuring Fetal Status Undergoing Caesarean Section Nasrudin, Nasrudin; Priyanto, Edy; Suardi, Dodi
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.854

Objective: Non-reassuring fetal status (NRFS) is an obstetric emergency characterized by abnormal fetal heart rate patterns requiring immediate intervention, often through cesarean section. Maternal comorbidities such as obesity, hypertension, and anemia are suspected to increase the risk of NRFS and adversely affect neonatal outcomes, particularly in developing countries. This study aimed to evaluate the relationship between maternal comorbidities and neonatal outcomes, including low birth weight (LBW), APGAR scores, and the need for Neonatal Intensive Care Unit (NICU) admission, in NRFS cases undergoing cesarean section at Prof. Dr. Margono Soekarjo Hospital, Purwokerto, from September 2023 to April 2024.Methods: A cross-sectional study used secondary (medical) data with total sampling. Bivariate and multivariate logistic regression analyses reported odds ratios (ORs) and 95% confidence intervals (CIs). A p-value of <0.05 was considered statistically significant.Result: Maternal obesity, hypertension, and anemia were significantly associated with LBW, low APGAR scores, and NICU admission. All comorbidities showed ORs <1, indicating increased risk for adverse neonatal outcomes.Conclusion: There was a significant correlation between maternal comorbidities and poor neonatal outcomes in NRFS cases delivered via cesarean section.Hubungan antara Komorbiditas Maternal dan Luaran Neonatus pada Pasien dengan Non-Reassuring Fetal Status yang Menjalani Seksio SesareaAbstrak Tujuan: Non-reassuring fetal status (NRFS) adalah kondisi kegawatdaruratan obstetri yang ditandai oleh pola detak jantung janin abnormal dan membutuhkan intervensi segera, sering berupa seksio sesarea. Komorbiditas maternal seperti obesitas, hipertensi, dan anemia diduga berperan dalam meningkatkan risiko NRFS dan memengaruhi luaran neonatal, terutama di negara berkembang. Penelitian ini bertujuan mengevaluasi hubungan antara komorbiditas maternal dan berat badan lahir rendah (BBLR), skor APGAR, dan kebutuhan perawatan Neonatal Intensive Care Unit (NICU) pada pasien NRFS yang menjalani seksio sesarea di RSUD Prof. Dr. Margono Sokearjo Purwokerto dari September 2023 hingga April 2024.Metode: Penelitian potong lintang ini menggunakan data (rekam medis) dengan teknik total sampling. Analisis bivariat dan multivariat dilakukan menggunakan regresi logistik dengan odds ratio (OR) dan interval kepercayaan 95%. Nilai p <0,05 dianggap signifikan.Hasil: Obesitas, hipertensi, dan anemia maternal secara signifikan berhubungan dengan BBLR, skor APGAR rendah, dan kebutuhan NICU. Semua komorbiditas menunjukkan odd ratio <1, mengindikasikan peningkatan risiko terhadap luaran neonatal yang merugikan.Kesimpulan: Terdapat hubungan signifikan antara komorbiditas maternal dan luaran neonatal yang buruk pada pasien NRFS yang menjalani seksio sesarea.

Iron Given, Iron Denied: Neonatal Hematologic Alterations in Obese Pregnancies Despite Universal Supplementation Santosa, Qodri; Priyanto, Edy; Muntafiah, Alfi
Medical and Health Journal Vol 5 No 1 (2025): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2025.5.1.17102

Background: Maternal obesity, a pro-inflammatory state now highly prevalent among women of reproductive age in Indonesia, may undermine the effectiveness of antenatal iron supplementation. Neonatal iron deficiency remains a public health concern, with maternal inflammation potentially disrupting fetal iron transfer. Objective: To investigate the association between maternal third-trimester Body Mass Index (BMI) and neonatal hematologic and iron parameters, within the context of standardized antenatal iron supplementation. Methods: This hospital-based cross-sectional study in Central Java, Indonesia, enrolled84 full-term neonates whose mothers received iron supplementation. Subjects were stratified by maternal BMI into non-obese (<25 kg/m²) and obese (≥25 kg/m²) groups. Cord blood was analyzed for hematologic indices (hemoglobin, Mean Corpuscular Volume [MCV], Mentzer Index) and iron biomarkers (ferritin and hepcidin). Results: Neonates from obese pregnancies exhibited significantly higher MCV (103.4 ± 5.1 fL vs. 100.1 ± 4.9 fL, p=0.004) and Mentzer Index (21.8 ± 4.7 vs. 21.3 ± 2.9, p=0.040) compared to the non-obese group. These findings suggest macrocytic shifts and possible ineffective erythropoiesis. No significantdifferences were observed in hemoglobin, ferritin, or hepcidin levels between groups. Conclusion: Maternal obesity during late pregnancy is associated with altered neonatal hematologic profiles, despite standardized iron supplementation. These results underscore a potential inflammation-mediated disruption in placental iron transfer and erythropoiesis, reinforcing the need for tailored antenatal strategies that incorporate maternal metabolic screening and functional hematologic monitoring for atrisk infants.

Correlation of Early-Onset and Late-Onset Preeclampsia with Increased Lactic Dehydrogenase Serum Levels Kezia Sitorus, Lois Tabitha; Priyanto, Edy; Zulvayanti, Zulvayanti
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.711

Introduction: Preeclampsia is a hypertensive disorder during pregnancy that is associated with 2-8% of pregnancy-related complications worldwide. Lactate Dehydrogenase (LDH) is a dominant intracellular cytoplasmic enzyme of anaerobic glycolysis and is released into the general circulation during cell death. This enzyme is increased in preeclampsia due to glycolysis and chronic anoxemia due to placental ischemia. The effect of LDH on pregnancy-related complications, such as preeclampsia, is now gaining attention. This study aims to assess the difference in LDH serum levels in early- and late-onset preeclampsia. Methods: This is an analytical observational study with a retrospective approach and cross-sectional design. The sample consists of 106 patients with early- and late-onset preeclampsia at RSUD Prof Dr. Margono Soekarjo from July to December 2022. Data analyzed in this study was collected from medical records.Results: This study found that 65.09% of the subjects were less than 35-years-old, 76.42% were multiparous, 64.15% had term birth, and 77.01% had a BMI >30. The mean LDH level in early-onset preeclampsia was 292.38 + 255.05 (141–1507), while the mean in late-onset preeclampsia was 181.60 + 43.13 (103–319). The cut-off value for LDH levels in preeclampsia patients was 185.5 U/L. A significant correlation was found between mean BMI and LDH levels (p=0.0001) and between mean maternal age and LDH levels (p=0.0001).Conclusion: There was a significant relationship between the onset of preeclampsia, mean BMI, and mean maternal age and LDH levels.Hubungan antara Kejadian Preeklamsia Awitan Dini dan Lanjut dengan Peningkatan Serum Laktat DehidrogenaseAbstrakPendahuluan: Preeklamsia adalah kelainan hipertensi pada kehamilan yang berhubungan dengan 2 – 8% komplikasi terkait kehamilan di seluruh dunia. Laktat dehidrogenase (LDH) adalah enzim sitoplasma intraseluler dominan dari glikolisis anaerobik dan dilepaskan ke sirkulasi umum selama kematian sel. Enzim ini meningkat pada preeklamsia akibat glikolisis dan anoksemia kronis akibat iskemia plasenta. Pengaruh LDH terhadap komplikasi terkait kehamilan seperti preeklamsia kini mulai mendapat perhatian. Studi ini bertujuan untuk menilai perbedaan kadar serum LDH pada preeklamsia awitan dini dan lanjut.Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan retrospektif dan desain potong lintang. Sampel terdiri atas 106 pasien dengan preeklamsia awitan dini dan lanjut di RSUD Prof Dr. Margono Soekarjo periode Juli-Desember 2022. Data diperoleh dari rekam medis.Hasil: Ditemukan bahwa 65,09% subjek berusia kurang dari 35 tahun, sebanyak 76,42% subjek multipara, sebanyak 64,15% subjek mengalami kelahiran aterm, sebanyak 77,01% subjek memiliki IMT >30. Rerata kadar LDH pada preeklamsia awitan dini ditemukan 292,38 + 255,05 (141–1507), sedangkan rerata pada preeklamsia awitan lanjut adalah 181,60 + 43,13 (103–319). Nilai cut off kadar LDH pada pasien preeklamsia ditemukan 185,5 U/L. Hubungan signifikan ditemukan antara rerata IMT dengan kadar LDH (p=0,0001) dan rerata usia ibu dengan kadar LDH (p=0,0001).Kesimpulan: Terdapat hubungan signifikan antara awitan preeklamsia, rerata IMT dan rerata usia ibu dengan kadar LDH.Kata kunci: preeklamsia, lactic dehydrogenase, preeklamsia awitan dini, preeklamsia awitan lanjut

The Surgical Approach for Adenomyosis in Nulligravid Women: A Case Report Diputri, Marlina Jaya; Triastuti, Prastika Candra; Priyanto, Edy
Indonesian Journal of Obstetrics & Gynecology Science Volume 9 Number 1 March 2026
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v9i1.913

Introduction: Adenomyosis is a benign uterine condition characterized by endometrial tissue invasion into the myometrium. This often leading to chronic pelvic pain, dysmenorrhea, and infertility. A meta-analysis in 2025 reported prevalence ranging from 5.9% to 46.0%, with a mean of 20.7%. The Osada triple-flap technique was developed to remove adenomyotic tissue while preserving uterine function, serving as an alternative to total hysterectomy. However, intraoperative findings may require surgical adjustment.Case Report: A 32-year-old woman presented with severe abnormal uterine bleeding. Married for 11 years without children, she had a history of recurrent bleeding, multiple hospitalizations, blood transfusions, and myomectomy. Ultrasound showed an enlarged, globular, and heterogenous uterus with asymmetrical thickening. An exploratory laparotomy was performed with the intention of using the Osada technique, but, due to deep cul-de-sac adhesions and suspected malignancy, the surgery proceeded to total abdominal hysterectomy.Conclusions: Adenomyosis significantlyaffects fertility and uterus-preserving techniques like the Osada method may benefit selected patients. However, in cases with extensive adhesions, distorted anatomy, or suspected malignancy, hysterectomy remains the safest and most definitive treatment. AbstrakPendahuluan: Adenomiosis adalah kelainan jinak pada uterus akibat invasi endometrium ke miometrium. Kondisi ini sering menimbulkan nyeri panggul, dismenore, dan infertilitas. Meta-analisis tahun 2025 melaporkan bahwa prevalensi 5,9% hingga 46,0% (rata-rata 20,7%). Teknik Osada triple-flap dikembangkan untuk mengangkat jaringan adenomyosis sambil mempertahankan fungsi uterus, sebagai alternatif histerektomi total. Namun, temuan intra-operatif dapat mengubah rencana tindakan. Laporan Kasus: Perempuan 32 tahun datang dengan perdarahan uterus abnormal berat. Menikah 11 tahun tanpa anak, riwayat perdarahan berulang, beberapa kali rawat inap, transfusi darah, dan miomektomi. Ultrasonografi menunjukkan uterus membesar dan heterogen. Laparatomi eksplorasi direncanakan dengan teknik Osada (triple-flap), namun karena adanya adhesi dalam dan kecurigaan keganasan, dilakukan histerektomi total. Kesimpulan: Adenomiosis dapat mengganggu kesuburan. Metode preservasi uterus seperti metode Osada bermanfaat pada kasus terpilih, tetapi histerektomi total tetap menjadi pilihan paling aman dan efektif pada kasus kompleks dengan adhesi dan kecurigaan keganasan.

RISK FACTORS FOR PREECLAMPSIA INCIDENTS AT PROF. DR. MARGONO SOEKARJO HOSPITAL AUGUST 2023 – JULY 2024 Syahrinto, Keysa Putra; Wibowo, Yudhi; Priyanto, Edy; Sumawan, Herman; Muhaimin, Amalia
Mandala Of Health Vol 19 No 1 (2026): Mandala of Health: A Scientific Journal
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mandala.2026.19.1.19682

Background: Preeclampsia is the leading cause of maternal death in Central Java in 2023. Preeclampsia is known to be associated with risk factors such as gemelli, maternal age, gravida, parity, diabetes mellitus (DM), and maternal nutritional status before pregnancy, although there are still differences in the relationship values in several research center. Therefore, research is needed to determine the relationship of preeclampsia risk factors with the incidence of preeclampsia at RSUD Prof. Dr. Margono Soekarjo. Objective: This study aims to determine the relationship between maternal nutritional status before pregnancy, DM, maternal age, gravida, parity, and gemelli with the incidence of preeclampsia at RSUD Prof. Dr. Margono Soekarjo August 2023 – July 2024. Methodology: This study was conducted using a cross-sectional study design with a sample of 392 pregnant women. The independent variables in this study were gemelli, maternal age, gravida, parity, DM, and maternal nutritional status before pregnancy, the dependent variable was the diagnosis of preeclampsia, and the potential confounding variable controlled was bacteriuria. Results: The results of multivariate analysis showed that gemelli (p= 0.008), age <20 years (p= 0.009), age >35 years (p<0.001), overweight (p<0.001), obesity (p<0.001), chronic energy defficient (p<0.001), nulliparous (p<0.001), and multiparous or grandemultiparous (p<0.001) were significantly associated with the incidence of preeclampsia at RSUD Prof. Dr. Margono Soekarjo in August 2023 – July 2024. Conclusion: Gemelli were the risk factor that most influenced the incidence of preeclampsia at RSUD Prof. Dr. Margono Soekarjo in August 2023 – July 2024.

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