Asupan iodium ibu hamil dan TSH neonatus di daerah endemik GAKI Kabupaten Gunungkidul

ISMONO, Prof.dr. Hamam Hadi, MS.,ScD

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Gizi dan Kesehatan)

Latar Belakang : Defisiensi iodium menghasilkan spektrum yang luas , diantaranya endemik GAKI, hipotiroidisme, kretinisme dan kelainan kongenital yang termasuk dalam termin Iodine Deficiency disorders ( IDDs). Di daerah kekurangan iodium faktor zat gizi secara kompleks termasuk makanan sumber goitrogenik, kekurangan energi dan protein (PEM), dan defisiensi selenium, mungkin mempengaruhi prevalensi dan keparahan IDD dan modifikasi respon iodium secara luas.Gangguan Akibat Kekurangan Iodium ( GAKI ) merupakan salah satu masalah gizi utama di Indonesia. Tujuan : Penelitian ini ingin mengetahui prevalensi GAKI pada bayi neonatus di daerah endemik GAKI dan hubungan asupan iodium ibu hamil terhadap TSH pada bayi neonatus di daerah endemik Gangguan Akibat kekurangan Iodium ( GAKI ) Kabupaten Gunungkidul. Metode : Penelitian ini merupakan penelitian analitik dengan rancangan kohor prospektif. Subjek penelitian adalah ibu hamil dengan usia kehamilan 13 s/d 25 minggu sebanyak 137 reponden Data Asupan iodium akan dikumpulkan dengan metode Food Frequency Questionnaire ( FFQ ). Sampel darah bayi neonatus akan diambil dari tumit bayi ( hell piric ) pada hari ke 4 – 14 post-partum untuk dilakukan analisa kadar TSH-nya dengan menggunakan metode “ ELISA “. Analisis data untuk mengetahui hubungan antar variabel dilakukan analisa bivariat, univariat dan multivariate dengan menggunakan program SPSS for windows versi 11,5. Hasil Penelitian : Prevalensi TSH Neonatus > 5 mlU/L sebesar 32,8 %, sehingga termasuk daerah endemik GAKI tingkat sedang. Asupan iodium ibu hamil rata-rata 147,81 ug/hari ( 84,46 % AKG ). Tidak ada hubungan yang bermakna antara asupan iodium ibu hamil (p>0,05) dengan TSH neonatus di daerah endemik GAKI Kabupaten Gunungkidul. Kesimpulan : Tidak ada hubungan yang signifikan antara asupan iodium ibu hamil dengan TSH neonatus (p>0,05) di daerah endemik GAKI Kabupaten Gunungkidul.

Background: Iodine deficiency brings wide spectrum impacts, among others are iodine deficiency disorder, hypothyroidism, cretinism and congenital disorder which belong to iodine deficiency disorders (IDDs) category. In area which lacks iodine, factors of nutrients such as foods rich in goitrogenic substance, protein and energy malnutrition, and selenium deficiency may affect wide prevalence and intensity of IDD and modification of iodine responses. IDD is one of major nutrition problems in Indonesia. Objective: The objective of the study was to identify the prevalence of IDD among neonatus and relationship between iodine intake of pregnant mothers and neonatus thyroid stimulating hormone at the endemic area of IDD, District of Gunungkidul. Method: The study was analytical with prospective cohort design. The subject were pregnant mothers, as many as 137 respondents with gestation period between 13 to 25 weeks until they gave birth. Data of iodine and goitrogenic intake were obtained from food frequency questionnaire. The sample of blood the neonatus was taken through hell piric during 4th - 14th days of postpartum to be analyzed their TSH level using ELISA method. Data analysis used bivariable, univariable and multivariable techniques with SPSS program for windows version 11.5. Result: The prevalence of neonatus TSH > 5 mIU/L was as much as 32.8% so it belonged to IDD endemic area of medium level. Iodine intake of the mother was in average 147.81 ug/day (84.46% of malnutrition rate). There was no significant relationship between iodine intake of pregnant mothers (p<0.05) and neonatus TSH. Conclusion: There was no significant relationship between intake of iodine and level of TSH of neonatus (p>0.05) at the IDD endemic area of Gunungkidul District.

Kata Kunci : Epidemiologi GAKI,Asupan Iodium,TSH Neonatus, neonatus; iodine deficiency disorder, iodine