Maternal Hypertension as a Risk Factor of Congenital Heart Disease

Nakami Dhabitah Mulyadi, dr. Nadya Arafuri, M.Sc., Sp. A(K), Prof. dr. Indah Kartika Murni, M.Kes., Sp. A(K)., Ph.D

2026 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Penyakit jantung bawaan (PJB) merupakan kelainan kongenital yang paling sering ditemukan dan masih menjadi penyebab utama morbiditas dan mortalitas bayi. Meskipun beberapa faktor maternal telah diidentifikasi, peran hipertensi maternal sebagai faktor risiko independen PJB masih jarang diteliti di Indonesia.

Tujuan: Menentukan apakah hipertensi maternal merupakan faktor risiko independen terjadinya penyakit jantung bawaan.

Metode: Penelitian ini menggunakan desain kasus–kontrol retrospektif tanpa pencocokan (unmatched) berdasarkan data sekunder dari registry departemen kardiologi anak RSUP Dr. Sardjito periode Januari 2021–Desember 2024. Kasus adalah anak usia 0–18 tahun dengan PJB yang dikonfirmasi melalui ekokardiografi, sedangkan kontrol adalah anak tanpa PJB yang juga dikonfirmasi melalui ekokardiografi. Hipertensi maternal didefinisikan sebagai tekanan darah ?140/90 mmHg atau penggunaan obat antihipertensi selama kehamilan. Faktor perancu yang dianalisis meliputi usia ibu, diabetes maternal, infeksi rubella maternal, dan adanya sindrom genetik. Analisis dilakukan dengan uji bivariat dan dilanjutkan regresi logistik multivariat.

Hasil: Hipertensi maternal berhubungan signifikan dengan kejadian PJB pada anak, dengan sindrom genetik sebagai faktor perancu yang kuat namun tidak menghilangkan efeknya. Setelah penyesuaian, anak dari ibu hipertensi memiliki peluang sekitar 3,4 kali lebih tinggi mengalami PJB dibandingkan anak dari ibu normotensif (Adjusted OR ? 3,41; CI 95%: 1,63–7,13). Keberadaan sindrom genetik juga berhubungan independen dengan PJB (Adjusted OR ? 3,26; CI 95%: 1,71–6,21). Usia ibu ?35 tahun, diabetes maternal, infeksi rubella maternal, dan usia anak tidak menunjukkan hubungan independen dengan PJB.

Kesimpulan: ipertensi maternal merupakan faktor risiko independen penyakit jantung bawaan. Deteksi dini dan penatalaksanaan optimal gangguan hipertensi selama kehamilan berpotensi menurunkan risiko PJB pada anak.

Background: Congenital heart disease (CHD) is the most common congenital anomaly and remains a major contributor to infant morbidity and mortality. While several maternal factors have been identified, the role of maternal hypertension as an independent risk factor for CHD is still limitedly explored in Indonesia.

Objective: To determine whether maternal hypertension is an independent risk factor for congenital heart disease.

Methods: This study used an unmatched retrospective case–control design based on secondary data from the Pediatric Cardiology Registry of RSUP Dr. Sardjito from January 2021 to December 2024. Cases were children aged 0–18 years with CHD confirmed by echocardiography, while controls were children without CHD confirmed by echocardiography. Maternal hypertension was defined as documented blood pressure ?140/90 mmHg or use of antihypertensive medication during pregnancy. Potential confounders included maternal age, maternal diabetes, maternal rubella infection, and the presence of genetic syndromes. Data were analyzed using bivariate analysis followed by multivariate logistic regression.

Results: Maternal hypertension was significantly associated with congenital heart disease (CHD) in children, with syndrome acting as a strong confounder but not eliminating the effect. After adjustment, children born to hypertensive mothers had approximately three and a shalf times higher odds of CHD compared with children born to normotensive mothers (adjusted OR ? 3.41; 95% CI: 1.63–7.13). The presence of syndrome was also independently associated with CHD (adjusted OR ? 3.26; 95% CI: 1.71–6.21). Maternal age ?35 years, maternal diabetes, maternal rubella infection, and child age did not remain independently associated with CHD.

Conclusion: Maternal hypertension is an independent risk factor for congenital heart disease. Early identification and optimal management of hypertensive disorders during pregnancy may reduce the risk of CHD in offspring.

Kata Kunci : congenital heart disease, congenital heart defect, maternal hypertension, preeclampsia, gestational hypertension, risk factor, pediatric, penyakit jantung bawaan, cacat jantung bawaan, hipertensi maternal, preeklamsia, hipertensi gestasional, faktor risik