FAKTOR IBU, JANIN DAN RIWAYAT PENYAKIT SEBAGAI RISIKO PREEKLAMPSIA DI ASIA DAN AFRIKA: SUATU META-ANALISIS - Miranda Ayunani; Annisa Nurrachmawati; Rahmi Susanti (Puslitbang Upaya Kesehatan Masyarakat, 2019)
Abstract Background: Preeclampsia accounts for nearly 10 percent of maternal deaths in Asia and Africa. Therefore, it is important to detect signs and symptoms early on by knowing the factors that are at risk for a mother experiencing preeclampsia. Objective: To determine the risk factors for preeclampsia in Asia and Africa through the application of meta-analysis. Method: A systematic review was carried out on 26 case-control and cohort studies related to risk factors for preeclampsia from four databases (PubMed, BioMed Central, ProQuest, and Google Scholar). The pooled odds ratio was calculated with the fixed-effect and random-effect model using Review Manager 5.3. Result: A total of 20 studies consisting of 2,954,769 women were included in the meta-analysis. Risk factors for preeclampsia based on maternal factors were chronic hypertension=9.74(95% CI 1.69-56.04), gestational diabetes=9.28(95% CI 4, 49-19.19), pre-pregnancy body mass index=2.70(95% CI 2.08-3.50), maternal age during pregnancy=2.37(95% CI 2.29-2.46) and nulliparity=2.08(95% CI 1.44-3.01). The fetal factor was multiple pregnancy=4.24(95% CI 3.14-5.73). Four disease history factors were family history of preeclampsia=13.99(95% CI 6.91-28.33), history of chronic hypertension=8.28(95% CI 5.92- 11.59), history of preeclampsia=OR 6.90(95% CI 3.58-13.31) and family history of hypertension=2.81(95% CI 1.75-4.50). Conclusion: The results of a meta-analysis of 10 risk factors for preeclampsia could be used as a screening tool to determine the magnitude of risk and early diagnosis of preeclampsia that allows timely intervention. Key words: Maternal Factors, Chronic Hypertension, Preeclampsia, Meta-Analysis. Abstrak Latar belakang: Preeklampsia menyumbang hampir 10 persen dari kematian ibu di Asia dan Afrika. Oleh karena itu, penting untuk menemukan tanda dan gejala sejak dini dengan mengetahui faktor-faktor yang berisiko untuk seorang ibu mengalami preeklampsia. Tujuan: Mengetahui faktor risiko preeklampsia di Asia dan Afrika melalui penerapan meta-analisis. Metode: Tinjauan sistematis dilakukan pada 26 studi kasus kontrol dan kohort terkait faktor risiko preeklampsia di empat database, yaitu PubMed, BioMed Central, ProQuest, dan Google Scholar. Pooled Odds Ratio dihitung dengan model fixed-effect dan random effect menggunakan Review Manager 5.3. Hasil: Sebanyak 20 penelitian yang terdiri dari 2.954.769 wanita masuk dalam meta-analisis. Faktor risiko preeklampsia berdasarkan faktor ibu adalah hipertensi kronis=9,74(95% CI 1,69-56,04), diabetes gestasional=9,28(95% CI 4,49-19,19), indeks massa tubuh prakehamilan=2,70(95% CI 2,08-3,50), usia ibu saat kehamilan=2,37(95% CI 2,29-2,46) dan nuliparitas=2,08 (95% CI 1,44-3,01). Faktor janin yaitu kehamilan multipel=4,24(95% CI 3,14-5,73). Empat faktor riwayat penyakit yaitu riwayat keluarga preeklampsia=13,99(95% CI 6,91-28,33), riwayat hipertensi kronis=8,28(95% CI 5,92-11,59), riwayat preeklampsia= (95% CI 3,58-13,31) dan riwayat keluarga hipertensi=2,81(95% CI 1,75-4,50). Kesimpulan: Hasil meta-analisis dari 10 faktor risiko preeklampsia dapat digunakan sebagai alat skrining untuk mengetahui besarnya risiko dan diagnosis dini preeklampsia, yang memungkinkan intervensi tepat waktu. Kata kunci: Faktor Ibu, Hipertensi Kronis, Preeklampsia, Meta-analisis