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All Journal Jurnal Kesehatan Reproduksi Jurnal Kesehatan Reproduksi Jurnal Kreativitas PKM 2-TRIK: TUNAS-TUNAS RISET KESEHATAN Journal of Midwifery Care Moluccas Health Journal Jurnal Keperawatan Karya Kesehatan Siwalima
Magdalena Paunno
Fakultas Kesehatan Universitas Kristen Indonesia Maluku
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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PENGARUH IBU HAMIL PEROKOK PASIF TERHADAP KEJADIAN LAHIR MATI DI KOTA AMBON Magdalena Paunno; Ova Emilia; Abdul Wahab
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.12647

Abstract

PENGARUH IBU HAMIL PEROKOK PASIF TERHADAPKEJADIAN LAHIR MATI DI KOTA AMBONMagdalena Paunno1, Ova Emillia2, Abdul Wahab3ABSTRACTBackground: Intervention in the care for pregnant women can reduce antenatal mortality until 75%.Antenatal Care (ANC) in Ambon municipality is categorized good if compared from the mean rate ofnational level, that is, Visit 1 (89%) and Visit 4 (87.76%); however, the incidence of stillbirths in Ambonis still considered high. Data about the incidence of stillbirths in three hospitals of Ambon showed thatthere were 44.2 stillbirths per 1000 live births while national data in 2003 showed that there were only9.6 stillbirths per 1000 live births. The direct cause of stillbirth is hypoxia, that is, the lack of oxygenin a pregnant woman’s body due to the exposure of cigarette smoke. In Ambon municipality, 65% ofhouseholds have 1 active smoker and almost all of the smokers (90%) smoke inside the house. This rateof course exceeds the national rate. In addition, other factors causing stillbirth are the quality of antenatalcare, age, parity, anemia and women’s educational level.Objective: To study whether passive smoking during pregnancy is a risk factor of the incidence of stillbirths.Method: This was an observational study with case-control study design. Study sites were in three hospitalsof Ambon municipality, namely Dr. M. Haulussy District Hospital, Al-Fatah Hospital, and Sumber HidupHospital. Subjects were divided into two groups which were case and control with comparison of 1:1 (69stillbirths as case and 69 live births as control) from January to December 2007. Samples were taken usingnon probability sampling which was determined with quota sample. The analysis of quantitative dataused univariable analysis, bivariable analysis with chi-square test (χ²) and stratification, and multivariableanalysis with logistic regression.Result and Discussion: There was a significant relationship between passive smoking during pregnancyand the incidence of stillbirth based on bivariable analysis with OR=3.36 (95% CI=1.20-5.41) while basedon multivariable analysis with OR=2.8 (1.01-7.94). Other risk factors that affected the incidence of stillbirthwere the quality of antenatal care with OR=3.2 (95% CI=1.39-7.52) and anemia during pregnancy withOR=2.3 (95% CI=1.20-5.41). Meanwhile, stratification analysis showed that non anemic women duringpregnancy was significantly related to stillbirths with OR=5.7 (95% CI 1.10-55.22). However, age, parity andeducation were not the risk factors of the incidence of stillbirth in Ambon.Conclusion: Passive smoking during pregnancy was a risk factor of the incidence of stillbirth in Ambonmunicipality. Other factors that caused the incidence of stillbirths were the quality of antenatal care andanemia. However, age, and parity were not the risk factors of the incidence of stillbirths in Ambon.Keywords: pregnant woman, passive smoking, stillbirthINTISARILatar belakang: Intervensi pada perawatan ibu hamil dapat menurunkan kematian perinatal hingga 75%.ANC di Kota Ambon dikategorikan baik, bila dilihat angka rata-rata secara nasional yaitu K1 89%, K4 87,76%namun, kejadian lahir mati sangat tinggi dibanding angka nasional. Salah satu penyebab langsung lahirmati adalah hypokxia yaitu kekurangan oksigen dalam tubuh ibu, akibat dari ibu hamil terpapar asaprokok. Di Kota Ambon, 65% rumah tangga mempunyai 1 orang perokok, dan hampir semua perokok (90%)merokok di rumah. Angka ini lebih tinggi dari angka nasional. Faktor lain menyebabkan lahir mati adalahkualitas antenatal care, umur, paritas anemia ibu selama hamil, pendidikan ibu yang rendah.Tujuan: Penelitian ini untuk mengetahui apakah ibu hamil perokok pasif merupakan faktor risiko kejadianlahir mati.Metode: Penelitian observasional dengan rancangan kasus-kontrol. Lokasi penelitian pada 3 RS di KotaAmbon yaitu: RSUD dr. M. Haulussy, RS. Al-Fatah, RS. Sumber Hidup. Subjek penelitian 1:1 69 lahir mati(kasus) dan 69 lahir hidup (kontrol) pada bulan Januari sampai dengan bulan Desember 2007. Pengambilansampel dengan cara non probability sampling, ditentukan secara quota sample . Analisis data terdiridari analisis univariabel, analisis bivariabel menggunakan uji chi-square (χ²), stratifikasi serta analisismultivariabel menggunakan regresi logistik.Hasil dan Pembahasan: Ada hubungan yang bermakna antara ibu hamil perokok pasif dengan kejadianlahir mati. Analisis bivariabel OR=3,36 (95% CI=1,20-5,41) analisis multivariabel OR=2,8 (1,01-7,94). Faktorrisiko lain yang mempengaruhi kejadian lahir mati adalah: Kualitas antenatal care mempunyai nilai OR=3,2(95% CI=1,39-7,52), ibu hamil anemia OR=2,3 (95% CI=1,20-5,41) dan pendidikan OR=2,42 ( 1,15-5,10).Saat analisis strativikasi, ibu tidak anemia mempunyai hubungan bermakna dengan lahir mati OR=5,7 (95%CI 1,10-55,22). Umur, paritas dan pendidikan bukan merupakan faktor risiko lahir mati di Kota Ambon.Kesimpulan : Ibu hamil perokok pasif merupakan faktor risiko terhadap kejadian lahir mati di Kota Ambon.Faktor lain yang menyebabkan lahir mati adalah kualitas antenatal care dan anemia ibu hamil.Kata kunci: ibu hamil, perokok pasif, lahir mati.1 Air Selobar Community Health Center, Ambon Health Office, Maluku Province2 Obstetric and Gynecology Division, Faculty of Medicine,Gadjah Mada University, Yogyakarta3 Maternal and Child Health-Reproductive Health, Graduate Program,Faculty of Medicine, Gadjah Mada University, Yogyakarta
PENGARUH PERAWATAN KEHAMILAN DAN PERSALINAN DENGAN KEJADIAN KEMATIAN NEONATAL. Magdalena Lena Paunno
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.61550

Abstract

AbstractBackground: Maternal care interventions (ANC) can reduce perinatal mortality by up to 75%. Neonatal mortality is closely related to the first 100 days of life starting from conception, the intra-uterine period, or in the womb for 230 days. Neonatal mortality can also be caused by various factors based on the cause, namely: Direct causes related to complications during the newborn and indirect causes related to the mother are hypertension, anemia in pregnancy, quality of care during pregnancy and/or delivery, and maternal mortality. Maternal mortality has some characteristics, such as Condition 4 is categorized as too much (namely too young; too old; too close range; and too much), while Condition 3 is categorized as delay, (being late to recognize the danger signs of childbirth; being late in making decisions; being late in handling by health workers in health facilities). Neonatal mortality refers to death in the 1st 28 days of life. Neonatal deaths are divided into two types, such as early neonatal mortality refers to death before 7 days or 0-6 days, and late neonatal mortality to death on days 7-28. The highest rate of neonatal deaths is perinatal mortality, where intrauterine fetal death occurs from 28 weeks of gestation to the 1st 7 days of life.Objective: This study was to determine the risk of neonatal death associated with prenatal care and delivery, as well as other factors.Research Methods: This type of observational research with a quantitative approach is a case-control research design. In this study, the case was neonatal mortality and the exposure was pregnancy care and delivery care. Calculation of the case-control sample size without matching by considering previous studies with a minimal sample studied for 1:1 control cases. Thus, the total number of samples is 86 people. By taking non-probability sampling, it is determined by quota sample.Results and Discussion: There is a relationship between Neonatal mortality with a P-value of 0.3150, which means being late in recognizing danger signs has a risk of 3.150 times The Asymptotic Significance (2-sided) value shows a P-value = 0.011 which means that <0.05 then the OR value declared significant or meaningful. While 95% CI showed a value of 1.306-7.600. There is a relationship between age and Neonatal mortality with the Odds value of Haenszel's Mantel Ratio indicated by the Estimate value, which is 3,496, which means that age in the risk category <25 years and >35 years has a risk of 3.496 times that of the age with no risk category 25-35 years. The Asymptotic Significance (2-sided) value shows a P-value = 0.006 which means that <0.05, the OR value is declared significant or significant. While the 95% CI showed a value of 1.438-8.498. There is a relationship between danger signs and Neonatal Mortality, the Odds value of the Haenszel Coat Ratio is indicated by the Estimate value, which is 3.150, which means that the variable late recognizes danger signs has a risk of 3.150 times that of not recognizing danger signs late. The Asymptotic Significance (2-sided) value shows a P-value = 0.011, which means that <0.05, the OR value is declared significant or significant. While 95% CI showed a value of 1.306-7.600.Conclusion: Pregnancy care and other factors, such as age and danger signs, have a risk of neonatal death compared to delivery care. Pregnant women of reproductive age have a higher risk than the group of live neonates. In the stillbirth group, pregnant women who were late in recognizing danger signs were higher than in the live neonates group. Keywords: Neonatal Death; Pregnancy and Delivery Care; RSUD dr. Haulussy Ambon.AbstrakLatar Belakang Intervensi perawatan ibu hamil (ANC) dapat menurunkan kematian perinatal hingga 75%. Kematian neonatal berkaitan erat dengan100 hari pertama kehidupan yang dimulai sejak konsepsi, masa intra uteri atau dalam kandungan selama 230 hari. Kematian neonatal juga dapat disebabkan oleh berbagai faktor berdasarkan penyebab yaitu: Penyebab langsung berhubungan dengan komplikasi saat bayi baru lahir dan penyebab tidak langsung berhubungan dengan ibu adalah hipertensi, anemia dalam kehamilan, kualitas perawatan selama hamil, persalinan dan karakteristik ibu meliputi keadaan 4 terlalu (terlalu: muda; tua; jarak dekat; banyak) dan keadaan 3 terlambat yaitu terlambat mengenal: tanda bahaya; mengambil keputusan; terlambat ditolong. Kematian Neonatal adalah kematian terjadi saat bayi baru lahir sampai 28 hari. Kematian neonatal dibagi menjadi 2, yaitu kematian neonatal dini yang terjadi selama minggu pertama kehidupan umur 0-6 hari setelah lahir dan kematian neonatal lanjut yang terjadi umur 7-28 hari setelah lahi. Penyumbang kematian neonatal adalah kematian perinatal perinatal dimana tefjadi kematian janin intra uteri mulai dari kehamilan 28 minggu sampai 7 hari pertama kehidupan.Tujuan: Penelitian ini untuk  mengetahui  risiko kematian  neonatal yang berhubungan dengan  perawatan kehamilan dan persalinan, serta faktor lainnya.Metode :Jenis penelitian observasional dengan pendekatan kuantitatif adalah rancangan penelitian Kasus-Kontrol. Dalam penelitian  ini sebagai kasus adalah kematian neonatal dan paparan adalah perawatan kehamilan dan perawatan persalian. Perhitungan besar sampel kasus kontrol tanpa matching dengan mempertimbangkan penelitian sebelumnya dengan sampel minimal yang diteliti untuk kasus kontrol 1:1. sehingga jumlah sampel total adalah 86 orang. Dengan Cara pengambilan non probability sampling, ditentukan secara quota sample.Hasil dan Pembahasan: Adanya hubungan antara kematian Neonatal dengan nilai Pvalue 0,3150 yang artinya terlambat mengenal tanda bahaya mempunyai risiko sebesar 3,150 kali lipat Nilai Asymptotic Significance (2-sided) menunjukkan nilai Pvalue=0,011 yang berarti bahwa <0,05 maka nilai OR dinyatakan signifikan atau bermakna. Sedangkan 95% CI menunjukkan nilai 1,306-7,600. Ada hubungan antara umur dengan kematian Neonatal dengan atas nilai Odds Rasio Mantel Haenszel ditunjukkan dengan nilai Estimate yaitu 3,496 yang artinya umur dengan kategori beresiko <25 tahun dan >35 tahun mempunyai resiko sebesar 3,496 kali lipat dari pada umur dengan kategori tidak beresiko 25-35 tahun. Nilai Asymptotic Significance (2-sided) menunjukkan nilai Pvalue=0,006 yang berarti bahwa <0,05 maka nilai OR dinyatakan signifikan atau bermakna. Sedangkan 95% CI menunjukkan nilai 1,438-8,498. Ada hubungan tanda bahaya dengan Kematian Neonatal nilai Odds Rasio Mantel Haenszel ditunjukkan dengan nilai Estimate yaitu 3,150 yang artinya variabel terlambat mengenal tanda bahaya mempunyai resiko sebesar 3,150 kali lipat dari tidak terlambat mengenal tanda bahaya. Nilai Asymptotic Significance (2-sided) menunjukkan nilai Pvalue=0,011 yang berarti bahwa <0,05 maka nilai OR dinyatakan signifikan atau bermakna. Sedangkan 95% CI menunjukkan nilai 1,306-7,600.Kesimpulan: perawatan kehamilan serta faktor lainnya yaitu umur dan tanda bahaya memiliki risiko 1kali beriko terhadap kematian Neonatal dibandingkan dengan perawatan Persalinan.  lebih besar ibu hamil umur reproduksi beresiko di bandingkan dengan kelompok neonatal hidup.Pada kelompok lahir mati lebih besar ibu hamil yang terlambat mengenal tanda bahaya di banding kelompok neonatal hidup. Kata kunci: Kematian Neonatal; Perawatan kehamilan dan persalinan; RSUD dr. Haulussy Ambon.
Co-Authors Abdul Wahab Alfanay, Yunus Andrias, Nova Djurumana, Yohana Kofit, Aprillia Solfina Kowa, Mersi Olivia Lambiombir, Dian Miryam Lea Mediatrix Janwarin Lekiohapy, Reimon Leunupun, Trixie Louk, Karmalita Luturmas, Delila Afarik Mamuly, Wilma Fransisca Matulessy, Elizabeth Olivia Talahatu Ova Emilia Parinussa, Nenny Pelatta, Chendy Sofianty Ralahalu, Hermina P Siahaya, Alisye Titarsole, Clara Wilma Fransisca Mamuly Wutuwensa, Roy H