Faktor Risiko Underweight pada Anak dengan Penyakit Jantung Bawaan di RSUP Dr Sardjito Yogyakarta

ZAKY RAHMAT HAKIM, dr. Indah Kartika Murni, M.kes., Ph.D., Sp.A(K); dr. Sasmito Nugroho, Sp.A(K); dr. Noormanto, Sp.A(K)

2022 | Skripsi | S1 KEDOKTERAN

Latar belakang: Angka kejadian penyakit jantung bawaan (PJB) di dunia mencapai 8-10 per 1000 kelahiran, dan menyumbang 46% dari seluruh kematian akibat malformasi kongenital. Kondisi PJB dapat menyebabkan malnutrisi dan gangguan tumbuh kembang anak, serta menyumbang 45% dari total kematian balita di dunia. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran status gizi dan faktor risiko underweight pada anak dengan PJB. Metode: Penelitian dilakukan menggunakan desain kohort retrospektif terhadap 207 anak usia <18 tahun yang terdiagnosis PJB melalui ekokardiografi di Rumah Sakit dr. Sardjito, Yogyakarta, Indonesia. Data diambil dari rekam medis. Uji chi-square dan uji regresi logistik digunakan untuk mengidentifikasi faktor risiko yang berhubungan dengan underweight pada anak dengan PJB. Hasil: Prevalensi underweight pada subjek mencapai 69,6% (144/207), dengan 63% diantaranya (91/144) dikategorikan sebagai severe underweight. Sebesar 89% dari total subjek merupakan balita. Pada analisis chi-square, sindrom genetik penyerta PJB, gagal jantung kongestif (CHF), hipertensi pulmonal, berat badan lahir, prematuritas kelahiran, dan usia subjek memiliki hubungan terhadap underweight. Selanjutnya, melalui analisis regresi logistik, anak yang menderita sindrom genetik (adjusted odds ratio [aOR] = 5.80; 95% confidence interval [CI]: 1.9-17.8), berusia balita (aOR = 6.84; 95% CI: 2.2- 21.0), memiliki CHF (aOR = 3.37; 95% CI: 1.4-7.9), dan lahir dengan berat badan lahir rendah (BBLR) (aOR = 9.64; 95% CI: 3.0-30.1) lebih cenderung menderita underweight. Keempat faktor tersebut secara independen berpengaruh terhadapt kondisi underweight pada anak dengan PJB. Kesimpulan: Tujuh dari sepuluh anak penderita PJB mengalami underweight. Usia balita, sindrom kongenital, CHF, dan BBLR merupakan faktor risiko terjadinya underweight pada anak dengan PJB.

Background: The incidence of congenital heart disease (CHD) in the world reaches 8-10 per 1000 births, accounting for 46% of all deaths due to congenital malformations. This condition can lead to malnourishment and impaired child growth, and accounts for 45% of total under-five mortality in the world. Objective: This study aimed to determine the nutritional status and risk factors of underweight among children with CHD. Methods: A retrospective cohort study of 207 children aged <18 years with echocardiography diagnosed CHD was conducted at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Data were recorded from medical records. Chi-square test and logistic regression test were used to identify risk factors associated with underweight among children with CHD. Results: The prevalence of underweight was 69,6% (144/207), with 63% of them (91/144) being categorized as severe underweight. Amount 89% of the total subjects were under-five. In Chi-square analysis, CHD accompanying genetic syndrome, congestive heart failure (CHF), pulmonary hypertension, birth weight, birth prematurity, and age of subjects were having relationship with underweight. Further, after being analyzed to logistic regression, having genetical syndrome (adjusted odds ratio [aOR] = 5.80; 95% confidence interval [CI]: 1.9-17.8), aged under-five (aOR = 6.84; 95% CI: 2.2-21.0), having CHF (aOR = 3.37; 95% CI: 1.4-7.9), and born with low birthweight (aOR = 9.64; 95% CI: 3.0-30.1) were more likely to be underweight. These four factors were independently associated with underweight among children with CHD. Conclusions: Seven in ten children with CHD were underweight. The under-five age, congenital syndrome, CHF, and low birthweight were the risk factors of underweight among children with CHD.

Kata Kunci : PJB, anak, underweight, faktor risiko, Yogyakarta