Hubungan anemia dan resiko kejadian ketuban pecah dini di Kabupaten Purworejo

RITAWATI, Prof. dr. M. Hakimi, SpOG(K), Ph.D

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Ketuban pecah dini menimbulkan komplikasi morbiditas dan mortalitas maternal maupun perinatal. Anemia kehamilan dengan kadar hemoglobin <11 gr/dl diduga meningkatkan insiden ketuban pecah dini melalui mekanisme biologi dan mekanisme penyakit. Tujuan: Untuk mengetahui hubungan anemia pada trimester II dengan kejadian ketuban pecah dini. Metode penelitian: Penelitian ini menggunakan rancangan kohort retrospektif, di Kabupaten Purworejo, Jawa Tengah, menggunakan data sekunder Zibuvita (Zink-ibu dan Vitamin A) dari hasil survei longitudinal Laboratorium Penelitian Kesehatan dan Gizi Masyarakat (LPKGM) FK UGM tahun 1995-1999. Penelitian Zibuvita dilakukan untuk melihat hubungan Zink dan vitamin A dengan kesehatan reproduksi. Subjek penelitian adalah 608 ibu hamil. Uji hipotesis menggunakan Chi-square dengan p<0,05 dan interval kepercayaan 95 persen. Model Binary Log Regression digunakan untuk melihat variabel luar yang mempengaruhi hubungan anemia dengan kejadian KPD. Hasil: Insiden KPD sebesar 16,67 persen pada kelompok anemia. Anemia bermakna secara statistik terhadap kejadian KPD pada analisis bivariat maupun multivariat setelah mengontrol konsumsi tablet besi selama hamil (RR=1,94, IK 95%=1,08-3,48; RR=2,11, IK 95%=1,16-3,82). Analisis stratifikasi tidak menunjukkan pengaruh suplementasi zink dan vitamin A pada ibu hamil anemia terhadap risiko KPD (RR Crude=1,94; IK 95%=1,08-3,48, RR Mantel-Haenszel=1,91, IK 95%=1,06-3,44). Paritas, umur ibu, usia kehamilan, suplementasi Fe, suplementasi zink dan vitamin A, infeksi, tingkat pendidikan, status bekerja, dan status ekonomi keluarga tidak berhubungan dengan risiko kejadian KPD. Kesimpulan: Anemia pada trimester II terbukti meningkatkan kejadian KPD. Tidak ada perbedan risiko KPD pada variabel faktor bio-sosio demografi ibu selama kehamilan.

Background: Early amniotic ruptures cause maternal as well as perinatal morbidity and mortality. Anemia during pregnancy with hemoglobin level < 11 gr/dl is predicted to increase the prevalence of early amniotic rupture through biological and disease mechanism. Objective: To identify the association between anemia and the prevalence of early amniotic rupture. Method: The study used a retrospective cohort design and secondary data of zinc-mothers-vitamin A taken from the result of longitudinal survey carried out by Research Laboratory of Community Health and Nutrition, Faculty of Medicine Gadjah Mada University 1995-1999. The study was conducted at District of Purworejo Jawa Tengah to find out the association between zinc and vitamin A with reproductive health. The subject consisted of 608 pregnant mothers. The hypothetical test used chi square with p < 0.05 and CI95%. Binary Log Regression was used to identify external factors affecting the association between anemia and the prevalence of early amniotic ruptures. Result: The prevalence of early amniotic ruptures as much as 16.67% occurred to the anemic group. Anemia was statistically significant to the prevalence of early amniotic rupture based on both bivariate and multivariate analysis after the control of Fe tablet consumption during pregnancy (RR=1.94, CI95%=1.08-3.48; RR=2.11, CI95%=1.16-3.82). The result of stratification analysis showed no affect of zinc and vitamin A supply for anemic pregnant mothers to the prevalence of early amniotic rupture. (RR crude=1.94; CI95%=1.08–3.48, RR Mantel-Haenszel = 1,91, CI95%=1.06–3.44). Parity, age of mothers, education, occupational status, and economic status of the family had no association with risk for early amniotic rupture. Conclusion: Anemia in trimester II increased the prevalence of early amniotic rupture. There had no association in variable of biosociodemographic factors of mothers during pregnancy with early amniotic rupture.

Kata Kunci : Anemia Kehamilan,Ketuban pecah dini,suplementasi zink dan vitamin A,Studi kohort, early amniotic ruptures, cohort study, anemic pregnancy