HUBUNGAN ANTARA KADAR FERITIN SERUM IBU HAMIL ATERM DENGAN KADAR FERITIN SERUM BAYI USIA ENAM BULAN DI RS PKU MUHAMMADIYAH BANTUL

MARGARETA GIRI DOS SANTOS, Dr. dr. Tri Ratnaningsih, M.Kes., Sp.PK(K); Prof. dr. Budi Mulyono, Sp.PK(K), MM ; Dr. dr. Usi Sukorini, M.Kes., Sp.PK(K)

2018 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang: Anemia disebabkan oleh berbagai macam penyebab, namun hampir 50% kasus anemia disebabkan oleh defisiensi besi. Pada tahun 2011, WHO melaporkan, prevalensi anemia di Indonesia pada anak usia 6-59 bulan sebesar 32% dan ibu hamil sebesar 30%, keduanya termasuk dalam tingkat sedang signifikansi kesehatan publik. Pada anak usia 0-15 tahun terjadi pertumbuhan cepat sehingga menghabiskan simpanan besi yang telah terakumulasi selama masa kehamilan yang dapat mengarah pada defisiensi besi absolut. Pada ibu hamil, kebutuhan besi bertambah hingga 3 kali lipat karena ekspansi massa sel darah merah ibu dan pertumbuhan janin. Standar baku diagnosis ADB saat ini adalah aspirasi sumsum tulang, namun sangatlah invasif sehingga jarang digunakan. Pemeriksaan hematologi (hemoglobin) lebih sering digunakan karena lebih terjangkau dan tersedia hampir di seluruh fasilitas kesehatan di Indonesia. Pemeriksaan biokimia status besi juga diperlukan sebagai deteksi dini ADB. Feritin serum merupakan tes yang paling spesifik dan sensitif untuk identifikasi ADB. Tes feritin serum mampu mendeteksi defisiensi besi sebelum terjadinya onset sehingga dapat digunakan untuk mencegah anemia. Tujuan: Mengetahui adanya hubungan kadar feritin serum ibu hamil aterm dan kadar feritin serum bayi usia 6 bulan di RS PKU Muhammadiyah Bantul. Metode: Penelitian analitik dengan rancangan retrospektif. Data yang digunakan adalah data sekunder dengan subyek ibu hamil aterm dan bayi usia 6 bulan yang lahir di RS PKU Muhammadiyah Bantul. Analisis data menggunakan uji hipotesis parametrik Pearson’s Correlation Coefficient dengan SPSS versi 22. Variabel yang digunakan adalah kadar feritin ibu hamil aterm dan bayinya yang berusia 6 bulan, jenis kelamin, jenis persalinan, kondisi sakit, dan ASI eksklusif. Hasil: Sebanyak 16 subyek ibu hamil memiliki kadar feritin serum <15 ng/ml (43,24%). Sejumlah 24 subyek (24,32%) bayi usia enam bulan mempunyai kadar feritin serum <15 ng/ml. Rerata dan simpang baku kedua subyek tersebut secara berturut-turut yaitu 25,30 ± 26,41 ng/ml dan 40,29 ± 48,13 ng/ml. Tidak ditemukan hubungan antara feritin bayi 6 bulan dengan ASI eksklusif (p=0,403), kondisi sakit (p=0,786), jenis kelamin (p=0,255), dan jenis persalinan (p=0,404) . Hal tersebut serupa dengan hasil korelasi antara kadar feritin serum ibu hamil aterm dan feritin bayi enam bulan (p=0,494; r=0,116). Kesimpulan: Tidak ditemukan hubungan yang signifikan antara kadar feritin serum ibu hamil aterm dengan kadar feritin serum bayi usia enam bulan di RS PKU Muhammadiyah Bantul. Kata kunci: anemia defisiensi besi, hamil aterm, bayi 6 bulan, feritin

Background: Anemia is caused by various causes, but almost 50% of cases of anemia are caused by iron deficiency. In 2011, WHO reported, the prevalence of anemia in Indonesia in children aged 6-59 months by 32% and pregnant women by 30%, including in the medium level. In children aged 0-15 years there is rapid growth so as to save iron deposits that have accumulated during pregnancy that can increase iron deficiency absolute. In pregnant women, the need for iron increases up to 3-fold because of increased mass of maternal red blood cells and fetal growth. The current standard diagnostic standard is bone marrow aspiration, but a rarely invasive use. Hematologic examination (hemoglobin) is more commonly used because it is more affordable and available almost in all health facilities in Indonesia. An iron status biochemical examination is also required as a predecessor of IDA. Serum ferritin tests can overcome iron deficiency before onset can be used to treat anemia. Objective: To study the relationship between serum ferritin level in aterm pregnancy woman with serum ferritin level in her six months old infant in PKU Muhammadiyah Hospital Bantul. Methods: Analytical research with retrospective designed. The data used were secondary data with subjects of term pregnant women and six months old infants who were born in PKU Muhammadiyah Hospital Bantul. Data analysis used Pearson's Correlation Coefficient parametric hypothesis test with SPSS version 22. The variables used were ferritin levels of term pregnant women and her 6 month-old baby, gender, type of labor, illness condition, and exclusive breastfeeding. Results: Sixteen pregnant women had serum ferritin <15 ng/ml (43.24%). A total of 24 subjects (24.32%) infants aged six months with serum ferritin <15 ng/ml. The mean and standard deviatian of both subjects were 25.30 ± 26.41 ng/ml and 40.29 ± 48.13 ng/ml, respectively. There was no correlation between serum ferritin of six months old infant and exclusive breastfeeding (p = 0,403), sickness condition (p = 0,786), gender (p = 0,255), and labor type (p = 0,404). This is similar to the result of correlation between serum ferritin level of term pregnant women and ferritin of infant six months (p = 0,494; r = 0,116). Conclusions: No significant relationship was found between serum ferritin levels of pregnant women with serum ferritin levels of her six months old infants at PKU Muhammadiyah Hospital Bantul. Keywords: iron deficiency anemia, term pregnancy, 6 months infant, serum ferritin

Kata Kunci : anemia defisiensi besi, hamil aterm, bayi 6 bulan, feritin