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INDONESIA
Paediatrica Indonesiana
Published by Ikatan Dokter Anak Indonesia
ISSN : 00309311     EISSN : 2338476X     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of health practice throughout the world.
Arjuna Subject : -
Articles 2,118 Documents
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Maternal and neonatal risk factors associated with necrotizing enterocolitis in neonates Quispe Castañeda, Claudia Vanessa; Segura-Fernández, Emma Mariela; Alva-Vargas, Marcela Sofía; Meregildo-Rodríguez, Edinson Dante; Vásquez-Tirado, Gustavo Adolfo
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.410-5

Abstract

Background Necrotizing enterocolitis (NEC) remains a leading cause of morbidity in hospitalized neonates—particularly preterm infants—yet its multifactorial etiology and the relative roles of maternal versus neonatal factors are not fully defined. We assessed whether prematurity, neonatal sepsis, and maternal conditions, including preeclampsia, are independently associated with NEC. Objective To evaluate for associations between maternal and neonatal risk factors and the development of necrotizing enterocolitis (NEC) in hospitalized neonates. Methods This case-control study with a retrospective analytical observational design included 235 neonates hospitalized in the Neonatology Unit of the Víctor Lazarte Echegaray Hospital (HVLE) from 2016 to 2023. Clinical records were randomly selected. Seventy-eight neonates with a confirmed diagnosis of NEC comprised the case group, while 157 neonates without NEC comprised the control group. Various maternal and neonatal factors present in this population were analyzed for potential associations with NEC.The influence of potential confounding variables was also considered. Data collection was carried out through a review of neonatal medical records. Results Multivariate analysis identified three factors significantly associated with NEC. Prematurity (P< 0.05) emerged as the main neonatal risk factor, followed by neonatal sepsis (P<0.05). Among maternal factors, preeclampsia showed a significant association with NEC (P<0.05). These variables were considered independent risk factors for NEC. On the other hand, no statistically significant association was found between NEC and other maternal conditions analyzed in this study, such as maternal obesity, sepsis, gestational diabetes, or chronic hypertension (P>0.05). Conclusion Prematurity and neonatal sepsis are neonatal factors significantly associated with a higher risk of NEC. Likewise, preeclampsia emerged as a significant maternal risk factor associated with NEC.
Impact of Brain Gym® on health outcomes of toddlers born with low birth weight: a randomized trial Setiawan, Cahyo; Kartini, Apoina; Winarni, Sri; Darundiati, Yusniar Hanani
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.399-409

Abstract

Background Low birth weight (LBW) children are at risk of developmental delay, including impaired motor skills, cognitive function, and stress regulation. Brain Gym® activities have been shown to improve motor coordination, attention span, and fine motor skills in preschool and primary school-aged children. Evidence for the use of Brain Gym® is limited for infants and toddlers with medical vulnerabilities such as low birth weight (LBW), who are at increased risk of developmental delay and heightened stress sensitivity. Objective To evaluate the impact of Brain Gym® exercises on cognitive function, motor skills (fine and gross motor), and cortisol levels in children aged 12–23 months with a history of LBW compared to a control group. Methods  A randomized controlled trial (RCT) was conducted in Sragen, Indonesia, involving 80 low birth weight (LBW) children aged 12 to 23 months. Participants were randomly allocated into two groups: an experimental group receiving Brain Gym® intervention and a control group.The experimental group received Brain Gym® exercises combined with routine baby massage, while the control group received only baby massage. Cognitive and motor development were assessed using the Denver Developmental Screening Test (DDST), while stress biomarkers were measured through salivary cortisol levels using enzyme-linked immunosorbent assay (ELISA). Assessments were conducted at baseline (pre-intervention) and after the 8-week intervention period. The evaluators who administered the DDST and laboratory staff analyzing cortisol were blinded to group allocation. Results The primary outcomes of this study were motor skills, cortisol levels, and cognitive function. At baseline, there were no significant differences between the Brain Gym® group and the control group in fine motor, gross motor, or cognitive function scores, as assessed by the DDST. After the intervention, between-group comparisons revealed no statistically significant differences in gross motor, fine motor, cortisol, or cognitive function outcomes. Within-group analysis showed that gross motor scores in the Brain Gym® group significantly increased after the intervention (P = 0.038), while fine motor scores demonstrated a non-significant trend toward improvement (P = 0.110). Cortisol levels in the Brain Gym® group significantly decreased (P = 0.009), whereas the control group exhibited no significant changes in gross motor (P = 0.548), fine motor, or cortisol levels (P = 0.118). Cognitive function scores remained statistically unchanged in both groups. Conclusion Our findings suggest that Brain Gym® exercises can improve gross motor function and reduce stress in LBW children. These findings highlight the potential of early interventions in enhancing development, but should be interpreted cautiously due to the modest sample size and short intervention period. Future studies should focus on the long-term effects and the mechanisms underlying these improvements.
Hemodynamically significant patent ductus arteriosus and tissue oxygenation in preterm infants Amaliah, Lissaberti; Indrayady, Indrayady; Ramadanti, Afifa; Nova, Ria; Akbari, Atika
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.364-72

Abstract

Background  One of the most common side effects of preterm birth is hemodynamically significant patent ductus arteriosus (hsPDA), with a prevalence of approximately 70% among preterm infants. The clinical consequences of hsPDA are impaired tissue perfusion and oxygenation to organs. Near-infrared spectroscopy (NIRS), a validated non-invasive method for determining regional oxygen saturation (rSO2), can identify early changes in organ perfusion and oxygenation.  Cerebral and renal tissues as these vital organs are highly susceptible to systemic hypoperfusion caused by hsPDA, which can lead to serious complications such as brain injury and renal insufficiency.  We used (NIRS to clarify the impact of hsPDA on regional oxygenation in the brains and kidneys of preterm infants. Objective To compare oxygenation of cerebral and renal regional tissues in preterm infants with and without hsPDA Methods A cross-sectional study was conducted at Mohammad Hoesin Hospital. Forty preterm infants (gestational age <37 weeks), born between November 2023 and September 2024, who were diagnosed with PDA and had a chronological age >24 hours and <7 days, were enrolled. Infants with multiple congenital anomalies, ductal-dependent cyanotic congenital heart disease, early-onset sepsis, or without parental consent were excluded. Cerebral and renal oxygenation were assessed using NIRS monitoring. Statistical analysis was performed with unpaired T-test. Results Based on echocardiographic criteria, 22 of the 40 infants had hsPDA, while 18 had non-hsPDA. The mean cerebral rSO2 values in the hsPDA and non-hsPDA groups were 79.5 (SD 12.1)% and 80.9 (SD 4.3)%, respectively. The mean renal rSO2 values were 70.4 (SD 17.8)% and 77.8 (SD 6.4)%, respectively. The mean cerebral fractional tissue oxygen extraction (FTOE) values of the hspda and non-hsPDA groups were 0.2 (0.1 to 0.21). The mean renal FTOE values were 0.3 (SD 0.19) and 0.2 (SD 0.07), respectively. There were no significant differences between the two groups in renal and cerebral rSO2 and FTOE. Conclusion Preterm infants’ cerebral and renal tissue oxygenation is  were not significantly different in those with and without hsPDA.  
Kidney dysfunction in children with thalassemia Lestari, Hertanti Indah; Rahmawati, Eka; Ayu, Dewi Rosariah; Fitriana, Eka Intan; Sari, Dian Puspita
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.337-45

Abstract

Background Children with thalassemia are at risk for kidney dysfunction due to chronic anemia, frequent blood transfusions, iron retention, and use of iron chelating agents. Cystatin C, an endogenous marker for assessing estimated glomerular filtration rate (eGFR), a novel biomarker for the early detection of kidney failure, has been reported to be potentially superior to the commonly used serum creatinine. Objective To evaluate various creatinine- and cystatin C-based formulas for eGFR to detect kidney dysfunction in children with thalassemia. Methods This was a cross-sectional study on children (age <18 years) with thalassemia. Kidney dysfunction was defined as eGFR <90 mL/minute/1.73 m2. Hyperfiltration was defined as eGFR >150 ml/minute/1.73 m2. This study compared the proportion of kidney dysfunction as determined using various creatinine- and cystatin C-based eGFR formulas, comprising the creatinine-based Schwartz formula, the cystatin C-based Filler formula, the creatinine-cystatin C-based New CKID formula, and the creatinine-cystatin C-based Schwartz formula. Results The median age of the 152 study subjects was 11.0 (range 2.0-18.0) years. When using the creatinine-based Schwartz formula, none of the subjects had kidney dysfunction. Kidney dysfunction was found in 21.7% of subjects when using the cystatin C-based Filler formula, in 26.3% of subjects when using the creatinine-cystatin C-based (New CKID) formula, and 59.9% of subjects using the creatinine-cystatin C-based Schwartz formula. When using the creatinine-based Schwartz formula, 38.2% subjects experienced hyperfiltration no hyperfiltration was found by when using other eGFR formulas. There was low correlation between creatinine and cystatin C (r=0.195; P=0.016). There was only mild agreement in eGFR between the creatinine-based Schwartz formula and the cystatin C-based Filler formula (k=0.195; P<0.001). Conclusion The proportion of kidney dysfunction in children with thalassemia based on eGFR calculation using cystatin C- and creatinine-cystatin C-based formulas ranged from 21.7% to  59.9%. No kidney dysfunction was found using a creatinine-only-based eGFR formula, whereas hyperfiltration was a common finding. Hence, more than one parameter should be considered for early detection of kidney dysfunction in thalassemia.
Early detection of meconium peritonitis in term neonate: a case report Marsubrin, Putri Maharani Tristanita; Iskandar, Stephen Diah; Wulandari, Haryanti Fauzia; Bermanshah, Evita Kariani; Rahayatri, Tri Hening; Roeslani, Rosalina Dewi
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.443-6

Abstract

Meconium peritonitis (MP) is a very rare, sterile peritonitis that results from fetal gut perforation in utero. Late diagnosis and treatment may cause severe morbidity and mortality related to sepsis. Here we report a term, appropriate for gestational age (AGA) neonate with meconium peritonitis. A one-day-old baby was brought to our hospital with lethargy and progressive abdominal distention for the last 12 hours and hypovolemic shock on admission. The diagnosis of meconium peritonitis was established based on physical examination, supported by abdominal X-ray and ultrasound. A sigmoid colon perforation was found during emergency surgery and a sigmoid colostomy was done. The infant was discharged on the 20th post-operative day with good enteral feeding tolerance.
Target height prediction in Indonesian children: a population-based and clinically relevant model Moelyo, Annang Giri; Ferdian, Hanum
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.416-21

Abstract

Background The traditional calculation of target height (TH) overlooks two important factors: the assortative mating correlation, which reflects the tendency for people of similar height to partner, and the parental–offspring correlation, which measures the strength of the relationship between parents’ and children’s heights. A more accurate model is needed for the Indonesian population.   Objective To develop a target height (TH) prediction model for Indonesian children and to compare its performance with traditional formulas. Methods This retrospective study used nationally representative data from the Indonesia Family Life Survey (IFLS). Adult height data from the IFLS-5 (2014) for 2,506 subjects and the corresponding parental height data from the IFLS-3 (2000) were analyzed. We used a new model, namely estimated target height (eTH), which combined the Hermanussen–Cole and van Dommelen methods, to estimate each participant’s TH. This new model was compared to traditional models which used Tanner (TTH) and modified Tanner (mTH) formulas.   Results The new eTH model yielded the following formulas: TH (boys) = 0.36 × father’s height + 0.43 × mother’s height + 42.77; and TH (girls) = 0.30 × father’s height + 0.36 × mother’s height + 50.47. Correlations with the observed adult height were highest for the new model (r = 0.528 for boys; r = 0.534 for girls), compared to traditional models. Conclusion This study provides a locally validated model for TH estimation in Indonesian children that demonstrates improved clinical applicability over traditional formulas.
Rate of administration of tuberculosis preventive treatment to pediatric household contacts and influencing factors Ridwan, Ivani; Sofiah, Fifi; Rismarini, Rismarini
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.422-30

Abstract

Background Providing tuberculosis preventive treatment (TPT) to household contacts is an important measure for preventing disease transmission. Various child-, parent-, and healthcare-related factors influence TPT provision. Objective To determine the rate of pediatric TPT administration in household contacts of pulmonary TB patients and its influencing factors. Methods An observational analytical study was conducted from May-August 2024 at primary healthcare facilities in Palembang, Indonesia. We included children in household contact with bacteriologically-positive pulmonary TB patients confirmed by molecular rapid diagnostic test  who were registered for treatment in community health centers in Palembang that had a TB treatment program. Results Among 364 household contacts of 114 TB cases, only 3.3% received TPT. The majority of parents or guardians were <35 years of age, were biological parents of the included children, had sub-minimum wage incomes, demonstrated good understanding of TPT, and had completed at least secondary education. The majority of children were female, over 5 years of age, and well-nourished according to parent or caregiver subjective perception. At the participating community health centers, healthcare workers in charge of the TB treatment programs were mostly paramedical staff and had good TPT knowledge, and drug availability was adequate. Children with caregivers aged ≥35 years were 12 times more likely not to receive TPT (aOR=12,093; 95%CI 1,544 to 94,713; P=0.018). Caregiver role in the family, economic status, knowledge level, education, travel distance, child factors, and health facility factors showed no significant association with TPT provision. Conclusion The rate of TPT provision in Palembang is low, far below the national target of 50-90%. Guardian age of ≤35 years was the only factor significantly associated with TPT provision.
Comparative diagnostic accuracy of ultrasound and chest radiography in ETT tip localization Widyaningtiar, Hapsari; Prawira, Yogi
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.431-7

Abstract

Background Endotracheal intubation is a life-saving intervention, and accurate placement of the endotracheal tube (ETT) is crucial in pediatric patients due to anatomical variability. Ultrasound offers a practical and safe alternative to chest X-ray (CXR) for verifying ETT placement. Objective To compare the diagnostic accuracy of ultrasound compared to CXR in localizing the ETT tip in pediatric patients. Methods A cross-sectional study was conducted from January to April 2025 in the Pediatric Intensive Care Unit and Cardiac Intensive Care Unit at Dr. Cipto Mangunkusumo Hospital. The study included children aged 1 month to 18 years intubated with either cuffed or uncuffed ETTs. A CXR was performed immediately after intubation, followed by ultrasound within 24 hours. ETT position was assessed based on CXR findings and tracheal ring alignment on ultrasound. Results A total of 89 patients were enrolled. Ultrasound demonstrated sensitivity of 88.6%, specificity of 73.7%, overall accuracy of 85.4%, positive predictive value (PPV) of 92.5%, and negative predictive value (NPV) of 63.6%. The area under the receiver operating characteristic curve (AUC) was 0.811. The positive likelihood ratio (LR+) was 3.37, and the negative likelihood ratio (LR–) was 0.16. Multivariate analysis identified ultrasound as a significant predictor of accurate ETT placement [odds ratio (OR) 7.75; 95%CI 1.29 to 4.74; P<0.001]. Conclusion Ultrasound is a feasible, reliable and accurate alternative to CXR for verifying ETT tip positioning in pediatric intensive care settings.

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