HUBUNGAN IBU HAMIL PEROKOK PASIF DENGAN TERJADINYA ANEMIA DAN DEPRESI DALAM KEHAMILAN DI PUSKESMAS KOTA YOGYAKARTA

AGUSTINI LIVIANA D R, Widyawati, S.Kp., M.Kes., Ph.D;Elsi Dwi Hapsari, S.Kp., MS., DS

2021 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang: Bahaya asap rokok 75% didapat oleh perokok pasif. Ibu hamil paling rentan terpapar dari anggota keluarga lingkungan sekitar. Selama hamil terjadi peningkatan volume plasma darah dibandingkan volume sel darah merah dan massa haemoglobin (Hb), sehingga terjadi anemia fisiologis . Selain itu, ibu hamil mengalami perubahan hormon yang dapat mempengaruhi peubahan mood dan berdampak pada psikologis. Tujuan: Penelitian ini bertujuan untuk melihat hubungan perokok pasif dengan terjadinya anemia dan depresi pada wanita hamil dan gambaran paparan asap rokok pada terjadinya anemia dan depresi dalam kehamilan. Metode: Jenis penelitian ini deskriptif analitik dengan pendekatan cross sectional dan dilakukan pada bulan Februari-Maret 2021 di puskesmas Kota Yogyakarta. Peneliti menggunakan consecutive sampling dengan total sampel 93 ibu hamil. Lembar screening digunakan untuk menentukan ibu hamil perokok pasif, dan penetuan kotinin menggunakan cotinine urine test merk Oncoprobe. Tingkat akurasi Cotinine urine test sebesar 99%-100% dan 50% pada hasil di bawah cut off point (200 ng/m). Pengukuran kadar Hb menggunakan alat GCHb merk easy touch. Pengukuran depresi ibu hamil menggunakan Edinburgh Perinatal Depression Scale (EPDS). Kuesioner ini diadopsi dari Shresta et al 2016 dengan validitas 88,9%. Analisis data yang digunakan adalah uji Chi square. Hasil: Jumlah ibu hamil perokok pasif sebanyak 58,1%, ibu hamil yang mengalami anemia sebanyak 18,3%, dan ibu hamil depresi 53,8%. Hasil penelitian menunjukkan tidak ada hubungan yang bermakna secara statistik pada ibu hamil perokok pasif dengan anemia selama kehamilan (p= 0,119). Sedangkan pada ibu hamil perokok pasif dengan depresi menunjukkan ada hubungan namun tidak signifikan (p=0,003). Kesimpulan: Pemeriksaan kotinin pada ibu hamil dapat menjadi salah satu pemeriksaan yang terdapat di antenatal care melihat dampak yang terjadi pada ibu serta pada pelayanan pemeriksaan kehamilan ataupun pada buku kesehatan ibu dan anak, dapat diberikan penjelasan dampak ibu menjadi perokok pasif. Kata Kunci: Ibu hamil; Perokok Pasif; Anemia; Depresi; EPDS

Background: Passive smoking exposure presents more dangers for public health than the actual risk of harm experienced by people who smoke cigarettes. Pregnant women are the most susceptible to this dangerous exposure from family members smoking around them. During pregnancy, the volume of blood plasma increases compared to the volume of red blood cells and the mass of hemoglobin, resulting in physiological anemia. In addition, pregnant women experience hormonal changes that can cause mood changes and have a negative impact psychologically. Objective: This study aimed to examine the relationship between passive smoking with the occurrence of anemia and depression in pregnant women and describe the effect of cigarette smoke exposure on the occurrence of anemia and depression in pregnancy. Methods: This cross-sectional research used a descriptive analytic approach and was conducted in February-March 2021 at the Yogyakarta City Health Center. Researchers used consecutive sampling with a total sample of 93 pregnant women. A screening sheet was used to determine passive smoking exposure of pregnant women. The cotinine determination used the Oncoprobe urine test with an accuracy rate of 99%-100% and 50% at the results below the cut-off point (200 ng/m). Measurement of hemoglobin levels used an easy touch brand GCHb tool. Measurement of depression in pregnant women used the Edinburgh Perinatal Depression Scale (EPDS), which was adapted from the Shrestha et al. questionnaire with 88.9% validity. Analysis of the data used the Chi-square tests with significance set as p <0.05. Results: Pregnant women exposed to passive smoking were 58.1%, while those who experienced anemia were 18.3%, and those depressed were 53.8%. The results showed there was no statistically significant relationship between passive smoking in pregnant women and anemia during pregnancy (p=0.119). Meanwhile, passive smoking in pregnant women with depression was related but the result was not significant (p=0.003). Conclusion: Cotinine examination in pregnant women can be one of the examinations used in antenatal care to see the negative impacts that occur in mothers exposed to passive smoking. Results in the antenatal care services and in maternal and child health books can explain the impact of mothers exposed to passive smoking. Keywords: Pregnant women; Passive smokers; Anemia; Depression; EPDS

Kata Kunci : Ibu hamil,Perokok Pasif,Anemia,Depresi,EPDS,Pregnant women,Passive smokers,Anemia,Depression,EPDS