Prognosis pemulangan dini bayi cukup bulan di ruang rawat gabung

ATIKAH, Tuti, Prof.dr. Purnomo S., DTM and H.,D.Sc.,Ph.D.,Sp.AK

2006 | Tesis | PPDS I Ilmu Kesehatan Anak

Latar Belakang. Untuk melindungi ibu yang baru melahirkan dan bayinya, diperlukan lama rawat inap yang optimal. Pulang dini dan pulang lama pada ibu yang baru melahirkan di rumah sakit merupakan dilema di bidang perinatologi. Lama rawat inap di rumah sakit bagi ibu dan bayi baru lahir mengalami penurunan. Banyak penelitian yang menyebutkan adanya peningkatan kejadian rawat inap ulang (readmission) dan angka kesakitan (morbiditas) pada bayi cukup bulan yang pulang dini. Tujuan Penelitian. Penelitian ini dilakukan untuk mengetahui faktor prognosis pulang dini pada kejadian rawat inap ulang (readmission) dan angka kesakitan (morbiditas) pada bayi baru lahir cukup bulan yang pulang dini di ruang rawat gabung RS Dr. Sardjito Yogyakarta. Desain penelitian. Kohort prospektif. Metode. Sampel penelitian diambil dari 818 bayi baru yang lahir di RS. Dr. Sardjito Yogyakarta pada bulan Februari 2004 sampai dengan bulan Agustus 2005. Dari 818 bayi lahir terdapat 574 sampel yang mendapatkan informed consent dari orang tua dan mengisi kuesioner. Subyek diikuti selama satu bulan setelah pemulangan. Hasil. Terdapat 108 subyek (18,8%) lost to follow up sehingga 466 subyek yang dianalisis dalam penelitian ini. Dari 466 subyek terdapat 246 (52,7%) pulang dini sedangkan 265 (46,2%) pulang lama. Luaran utama yang dinilai adalah kejadian rawat inap ulang (readmission) dan angka kesakitan (morbiditas) yang berhubungan dengan pulang dini. Kejadian rawat inap ulang dan angka kesakitan pada pulang dini dan pulang lama tidak ada perbedaan bermakna dengan RR berturut turut : 2,68 (IK 95% 0,74-9,78); RR 1,24 (IK 95% 0,75-2,05). Dengan analisis stratifikasi memakai uji Mantel Haenszel terhadap faktor ibu (umur, pendidikan, pekerjaan, pendapatan, paritas, ASI) tidak terdapat perbedaan bermakna pada kejadian rawat inap ulang dan kesakitan antara bayi baru lahir pulang dini dan pulang lama. Simpulan. Tidak ada perbedaaan bermakna pada kejadian rawat inap ulang (readmission) dan kesakitan (morbiditas) antara bayi baru lahir yang pulang dini dan pulang lama di ruang rawat gabung RS. Dr. Sardjito.

Background. In order to give good care for post partum mother and her baby it required an optimal length of stay. Early or late discharge for the term newborns is controversial on the field of perinatology. Length of stay in hospital for mothers and newborns tends to decrease. There are a lot of studies that reported increasing of readmission and morbidity in the term newborns who early discharge. Objective. This study is performed to determine prognostic factors that may increase morbidity and readmission rate on the early discharged term newborns. Design. Prospective cohort study. Methods. Eight hundred and eighteen newborns were delivered in rooming in ward Dr. Sardjito Hospital from February 2004-August 2005. Eligible subject for this study were 574 newborns who fulfilled inclusion and exclusion criteria and whose parents sign the informed consent were recruited to this study. Data had been collected by questionnaire. For this study 574 newborns were followed up after discharge until one month. Results. There were 108 subjects (18,8%) loss to follow up so only 466 were analyzed in this study, comprised of 246 (52,7%) early discharged and 265 (46,2%) late discharged. Main outcome were increasing of readmission and morbidity in term newborns who related with early discharged. Morbidity on early discharged in term newborns was no significant difference with RR 2,68(95% CI 0,74-9,78) and readmission was no significant difference with RR 1,24 ( 95% CI 0,75-2,05). By stratification analysis with Mantel Haenszel analysis from mother factors (age, education, occupation, income, parity and breast feeding) there were no significant difference between morbidity and readmission rate on early discharged in term newborns Conclusion. There were no significant difference between morbidity and readmission rate on early discharged in term newborns in rooming in Dr Sardjito Hospital Yogyakarta.

Kata Kunci : Rawat Inap Gabung,Pemulangan Dini, term newborns, early discharge, prognosis, rooming in