HUBUNGAN RIWAYAT KEHAMILAN DAN PERSALINAN DENGAN KEJADIAN PERSALINAN CAESAREAN SECTION DI KABUPATEN SLEMAN MENGGUNAKAN ANALISIS DATA HEALTH AND DEMOGRAPHIC SURVEILLANCE SYSTEM (HDSS) SLEMAN TAHUN 2015-2020

AYUSTINA DEWI, DR.dr. Cahyono Hadi., Sp.OG (K) dan dr. Rosalia Kurniawati Harisaputra, MPH

2023 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Angka Kematian Ibu (AKI) di Indonesia pada tahun 2020 mengalami peningkatan sebesar 4.627 kasus dibandingkan kematian ibu pada tahun 2019 sebesar 4.221 kasus. Proses persalinan merupakan salah satu faktor yang dapat mengakibatkan kematian pada ibu. Salah satunya pada persalinan caesarean section. Peningkatan persalinan caesarean section secara global di temukan data pada 150 negara mengalami peningkatan persalinan caesarean section sebanyak 18,6 %. Pada Tahun 2018 didapatkan jumlah persalinan caesarean section di Indonesia sebesar 17,6% dan di Daerah Istimewa Yogyakarta (DIY) sebesar 23,1%. Penelitian ini bertujuan mengetahui hubungan riwayat kehamilan dan persalinan (usia ibu, paritas, usia kehamilan, kehamilan gemelli, berat bayi lahir dan riwayat persalinan caesarean section) dengan kejadian persalinan caesarean section di Kabupaten Sleman menggunakan analisis data Health and Demographic Surveillance System (HDSS) Sleman tahun 2015-2020. Metode: Rancangan penelitian yang digunakan adalah rancangan longitudinal panel. Analisis univariabel, bivariabel dan multivariabel dengan menampilkan distribusi frekuensi, p-value, odds ratio, confidence interval. Analisis statistik menggunakan software STATA. Hasil: Distribusi responden yang bersalin secara caesarean section di Kabupaten Sleman sebesar 38,8%. Hasil analisis bivariabel didapatkan usia kehamilan, berat bayi lahir dan riwayat persalinan caesrean section berhubungan dengan kejadian persalinan caesarean section. Dari hasil analisis multivariabel didapatkan usia kehamilan � 42 minggu, Berat bayi lahir <2500 dan >4000 gram, dan responden yang memiliki riwayat persalinan caesrean section berhubungan dengan kejadian persalinan caesarean section. Kesimpulan: Berdasarkan hasil penelitian ada beberapa faktor yang berhubungan yaitu usia kehamilan, berat bayi lahir dan riwayat persalinan caesarean section. Dari hasil penelitian ini perlu diupayakan percobaan persalinan dengan induksi pada kehamilan lebih >42 minggu, mengatur pola makan dan aktivitas fisik untuk menjaga agar berat bayi lahir tidak >4000 gram dan upaya Vaginal Birth After Caesarean (VBAC) pada ibu dengan riwayat caesarean section.

Background: The Maternal Mortality Rate (MMR) in Indonesia in 2020 has increased by 4,627 cases compared to maternal deaths in 2019 of 4,221 cases. The delivery process is one of the factors that can cause death in the mother. One of them is caesarean section delivery. The increase in caesarean section deliveries globally found data in 150 countries experiencing an increase in caesarean section deliveries by 18.6%. In 2018, the number of caesarean section deliveries in Indonesia was 17.6% and in the Daerah Istimewa Yogyakarta (DIY) it was 23.1%. This study aims to determine the relationship between the history of pregnancy and childbirth (maternal age, parity, gestational age, gestational age, birth weight and history of caesarean section) with the incidence of caesarean section in Sleman Regency using data analysis from the Sleman Health and Demographic Surveillance System (HDSS). 2015-2020 years. Methods: The research design used is a longitudinal panel design. Univariable, bivariable and multivariable analysis by displaying the frequency distribution, p-value, odds ratio, confidence interval. Statistical analysis using STATA software. Results: The distribution of respondents who delivered by caesarean section in Sleman Regency was 38.8%. The results of the bivariable analysis showed that gestational age, birth weight and history of caesarean section delivery were associated with the incidence of caesarean section delivery. From the results of multivariable analysis, it was results that gestational age � 42 weeks, birth weight <2500 and >4000 grams, and respondents who had a history of caesarean section delivery were related to the incidence of caesarean section delivery. Conclusion: Based on the results of the study, there were several related factors, namely gestational age, birth weight and history of caesarean section delivery. From the results of this study, it is necessary to try induction of labor in pregnancies > 42 weeks, adjust diet and physical activity to keep the baby's birth weight not > 4000 grams and attempt Vaginal Birth After Caesarean (VBAC) in mothers with a history of caesarean section.

Kata Kunci : Caesarean section, Usia kehamilan, Berat Bayi Lahir, Paritas/ Caesarean section, Gestational age, Birth Weight, Parity