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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 2,147 Documents
 211   212   213   214   215 
Microbial profiles and antimicrobial resistance patterns in neonatal intensive care units: an analysis of the impact of the COVID-19 pandemic in Indonesia Santi, Theresia; Robertus, Thomas; Dewanto, Naomi Esthernita Fauzia; Hidayat, Feronica Kusuma; Hidayat, Ferry; Sungono, Veli; Jo, Juandy
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Abstract

Background Neonatal sepsis requires prompt antimicrobial treatment. A lack of information on patterns of antibiotic resistance among the bacteria across hospitals hinders the treatment. The COVID-19 pandemic contributed to changes in neonatal infection patterns and antimicrobial resistance.  Data describing these changes remain scarce in Indonesia. Objective To determine the spectrum of pathogens and their antibiotic resistance patterns among Indonesian neonates with sepsis, prior and during the COVID-19 pandemic. Methods This retrospective study  was done to examine patterns of pathogens and antibiotic resistance in neonates admitted to the neonatal intensive care units (NICUs) at Siloam Hospital Kebon Jeruk and Lippo Cikarang for 6 years, i.e., January 2018 to December 2020 (“Prior/Early COVID-19 Pandemic” or first phase) and January 2021 to December 2023 (“Mid/Late COVID-19 Pandemic” or second phase). The inclusion criteria were newborns with suspected or proven sepsis who underwent microbiological specimen collection for the assessment of antimicrobial resistance. We compared patterns of isolated pathogens and their antibiotic resistance of neonates with sepsis in two private hospitals, prior and during the COVID-19 pandemic. Results There were more participants in the first phase than in the second phase (44 vs. 33, respectively), resulting in more pathogenic isolates in the former than the latter phase (43 vs. 23, respectively). There were more Gram-negative bacteria detected than Gram-positive bacteria, although a reduction of several Gram-negative bacterial species from the order of Enterobacterales (including Klebsiella pneumoniae and Escherichia coli) was detected in the second phase. The resistance of Enterobacterales to gentamicin and third-generation cephalosporins was substantially increased in the second phase. Conclusion Despite an overall decline in isolate numbers, the observed increase in antibiotic resistance among Enterobacterales in the second phase may reflect suboptimal stewardship and indiscriminate use of broad-spectrum antibiotics during the COVID-19 pandemic. This highlights the growing challenge of antimicrobial resistance in neonatal sepsis management in Indonesia.
Changes in gross motor function in children with cerebral palsy and associated factors Hidayah, Nurul; Widodo, Dwi Putro; Mangunatmadja, Irawan; Handryastuti, Setyo
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Background Cerebral palsy (CP) is a condition characterized by abnormalities in movement, muscle tone, and posture caused by non-progressive damage to immature brain tissue. Gross motor function is associated with the quality of life and prognosis of children with CP. Objective To observe gross motor changes in cerebral palsy patients based on GMFCS from the time of initial diagnosis compared to the current GMFCS. Methods This was a cross-sectional study with subjects classified into two groups based on GMFCS at the time of CP diagnosis and at the time of the study (April 2018). Group 1 consisted of level I-III GMFCS and group I consisted of level IV-V GMFCS. Data were obtained from the results of two GMFCS measurements: at diagnosis by history-taking and at the time of this study by physical examination. Subjects were 100 children who met the inclusion criteria who were treated at the Child Neurology Polyclinic and the Medical Rehabilitation Polyclinic, FKUI-RSCM. Results The most common characteristics in our CP patients were male gender (61%), full term birth (75%), tetraplegia CP type (66%), abnormal CT findings (83.3%), abnormal head circumference (83%), and epilepsy (61%). There was a significant gross motor skill improvement between the time of initial diagnosis and current gross motor skills (P<0.001) and no subjects had deteriorated. This improvement was influenced by factors such as better outcomes in females compared to males, diplegia-type cerebral palsy compared to tetraplegia, and normal vs. abnormal CT findings. Conclusion Gross motor improvement in children with cerebral palsy varies significantly from initial diagnosis, with better outcomes observed in females, those with diplegia, and those with normal CT findings.
The effect of tongue-tie incision on infant weight gain: a systematic review Kadaristiana, Agustina; Nur Aini, Putri; Narendraswari, Prajnya Paramitha; Milenina, Nurul Syifa; Arifianto, Arifianto; Dwinanda, Novitria; Devy, Monica Sari
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Abstract

Background Tongue tie in breastfeeding infants may affect breast emptying, which may increase the likelihood of infant weight faltering. However, the benefits of tongue-tie incision on weight gain remain unclear. Objective To investigate the effect of tongue-tie incision on weight gain in breastfeeding infants by systematic review. Methods A systematic review was conducted by searching PubMed, Science Direct, EBSCO, Proquest, Wiley Online, the Cochrane Library, Scopus, and grey literature for published studies. Inclusion criteria for selecting articles were studies conducted on actively breastfed infants, articles with full texts, and randomized controlled trials, case-control studies, or cohort studies published within the last 10 years. The outcome assessed was weight gain. Risk of bias was assessed using the ROBINS-I V2 tools. Results Of the 382 articles screened, there were three pre-post cohort studies (one prospective and two retrospective) involving 419 infants who underwent tongue tie incision before the age of one year. No randomized controlled trials examined the effect of tongue-tie incision on weight gain. The studies reported an increase in weight gain and daily weight gain after tongue-tie incision. However, all studies had critical risks of bias due to a lack of controls and efforts to mitigate confounding risks. Conclusion There is insufficient evidence that tongue-tie incision could increase weight gain better than without incision.
Enhancing maternal self-efficacy through infant massage: A randomized clinical trial among mothers of preterm infants Pramitha, Dyan Ajeng; Hartanto, Fitri; Radityo, Adhie Nur; Sarosa, Gatot Irawan; Mellyana, Omega; Anam, Moh. Syarofil
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Abstract

Background: Preterm birth is a global health concern, often requiring Neonatal Intensive Care Unit (NICU) admission, which can lead to parent-infant separation. This separation may increase maternal stress and reduce caregiving confidence. Infant massage is a potential intervention to enhance maternal engagement and self-efficacy in caring for their premature infants. Objective: This study aims to evaluate the effect of infant massage on maternal self-efficacy in the care of preterm infants. Methods: This was a randomized controlled trial conducted at the NICU of Kariadi Hospital, Indonesia. A total of 56 mothers of preterm infants were randomly assigned to an intervention group (n=28) or a control group (n=28). Mothers in the intervention group were trained to perform infant massage for 5–10 minutes, twice daily, for seven consecutive days. The control group received standard care. Maternal self-efficacy was measured pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP S-E) questionnaire. Data were analyzed using the Wilcoxon signed-rank test. Result: The intervention group showed a statistically significant increase in self-efficacy across all four domains: caretaking procedures (p=0.010), evoking behavior (p<0.001), reading behavior or signaling (p<0.001), and situational beliefs (p=0.002). In contrast, the control group only demonstrated significant improvement in two domains (evoking behavior and reading Behavior). Conclusion: Infant massage performed by mothers is an effective intervention to significantly improve the self-efficacy of mothers with preterm infants in the NICU. This practice can be recommended to support maternal well-being and foster parent-infant bonding during hospitalization. Keyword: infant massage, maternal self-efficacy, preterm infant
Antibody-synthesizing lymphocytes (AS-LYMP) and reactive lymphocytes (RE-LYMP): novel predictors of severe dengue Saputra, I M Yullyantara; Gustawan, I Wayan; Utama, Made Gede Dwilingga; Lestari, AA Wiradewi; Adibrata, Antony Abel; Dewi, Eleonora Anindya Tiara
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Background Dengue fever is a major public health problem in Indonesia, where children are particularly at risk of severe disease. Early recognition of severe dengue is critical to reduce morbidity and mortality. Novel lymphocyte activation markers, such as antibody-synthesizing lymphocytes (AS-LYMP) and reactive lymphocytes (RE-LYMP), may improve risk stratification. Objective To evaluate antibody-synthesizing lymphocytes (AS-LYMP) and reactive lymphocytes (RE-LYMP) as potential diagnostic risk stratification markers for severe dengue fever. Methods This cohort retrospective study was conducted at Ngoerah General Hospital, Denpasar, Bali, and included children under 18 years with confirmed dengue infection. AS-LYMP and RE-LYMP counts were obtained using a Sysmex XN-3000 analyzer. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis, and optimal cut-off points were identified using the Youden index. Results Seventy-nine dengue patients were analyzed: 15 without warning signs, 39 with warning signs, and 25 with severe dengue. Both AS-LYMP and RE-LYMP counts were significantly elevated in severe dengue (P<0.001) compared to other two groups. The ROC analysis showed acceptable accuracy for AS-LYMP (AUC 0.749; cut-off 0.83 × 10³/μL; sensitivity 80.0%; specificity 63.0%) and RE-LYMP (AUC 0.729; cut-off 1.04 × 10³/μL; sensitivity 80.0%; specificity 59.3%). Hemoglobin level and leukocyte count demonstrated predictive value, but with lower accuracy. Conclusion AS-LYMP and RE-LYMP are promising biomarkers for early identification of severe dengue in children. Integration into routine hematology testing may support timely clinical decision-making.
Exclusive breastfeeding and reduced risk of type 1 diabetes mellitus in children Hsieh, Peter Prayogo; I Gusti Ayu Putu , Eka Pratiwi; I Made, Arimbawa; I Gusti, Lanang Sidiartha; Sindhughosa, Wega Upendra; I Made, Darma Yuda
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Background There was a 7-fold increase in the prevalence of type 1 diabetes mellitus (T1DM) in Indonesia from 3.88/100,000,000 in 2000 to 28.19/100,000,000 in 2010. Previous studies have shown small reductions in the risk of developing T1DM associated with exclusive breastfeeding. This topic has not been well explored in Indonesian children with T1DM. Objective  To assess for a possible association between T1DM and exclusively breastfeeding. Methods This matched, case-control study included children who visited clinics or were hospitalized from January-March 2025 (case group). The control group comprised children from a Catholic private school. The inclusion criteria for the case group were children aged >24 months to <18 years who had been diagnosed with TIDM by a doctor and had complete electronic medical records (EMR). The exclusion criterion was incomplete EMR. The inclusion criteria for the control group were children without T1DM who were aged >24 months to <18 years. Subjects’ characteristics and history of breastfeeding were obtained from the interview and questionnaire.  The association between T1DM and exclusively breastfeeding were analyzed using McNemar analysis and logistic regression was done for confounding factors. Results Of the 42 subjects in each group, 27 (64.3%) subjects with T1DM  and 16 (38.1%) subjects in the control group were not exclusively breastfed. McNemar analysis revealed a significant association between not exclusively breastfeeding and greater risk of T1DM (OR=3.99; 95%CI 1.44 to 11.04; P=0.008). Conclusion There is a significant association between exclusive breastfeeding and T1DM. Those who were not exclusively breastfed are 3.99 times more likely to develop T1DM.
Risk factors for bradycardia in magnetic resonance imaging and computed tomography-scan examinations of children under general sedation Cesilia, Citra; Ananda, Pratama; Shiddiq, Akbar; Febriani, Febriani; Wijaya, Dewi; Candra, Riky; Fahrizon, Ramadhanti A.; Djojosugito, Fauzia A.
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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Background Children often require general sedation to obtain high-quality magnetic resonance imaging (MRI) or computed tomography (CT) images, but sedation may cause complications such as respiratory depression. Identifying risk factors for sedation-related bradycardia, an indicator of severe sedation compromise, can improve patient safety during imaging. In pediatric patients, bradycardia can arise as a downstream consequence of hypoxia, airway obstruction, or inadequate ventilation, all of which represent key mechanisms of respiratory compromise during sedation. Objective To determine factors associated with bradycardia in pediatric patients undergoing MRI or CT scans under general sedation. Methods This retrospective, observational study included 328 children (<18 years of age) sedated for MRI or CT between 2022 and 2025 at Arifin Achmad Hospital. Data on age, sex, nutritional status, American Society of Anesthesiologists (ASA) status, comorbidities, number of sedative agents, sedation duration, and imaging modality were collected. Bivariate and multivariate binary logistic regression analyses were performed to identify factors associated with bradycardia. Results Bradycardia occurred in 3.0% of cases (10/328). No cases of overt respiratory depression were identified in this study. Nutritional status was significantly associated with bradycardia in bivariate (P=0.001) and multivariate (P=0.004) analyses. Children with severe malnutrition had a markedly higher risk of developing bradycardia [adjusted odds ratio/OR 6.91; 95%CI 1.84 to 25.93). Conclusion In sedated pediatric patients undergoing MRI or CT scans, severe malnutrition was the only significant predictor of bradycardia. These findings suggest that pre-sedation nutritional status assessments may help mitigate the risk of sedation-related respiratory complications.

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