Pengaruh jarak kehamilan terhadap kematian perinatal di Kabupaten Agam

ANGGRAINI, Rozi, Prof.dr. Djauhar Ismail, MPH.,SpA(K).,PhD

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kes. Ibu dan Anak-Ke

Latar belakang: Kematian neonatal terjadi sekitar empat juta jiwa setiap tahunnya, dua pertiganya terjadi dalam minggu pertama bayi baru lahir dan dua pertiga kematian pada masa perinatal ini terjadi dalam 24 jam pertama. Kematian pada masa perinatal disebabkan oleh banyak faktor, salah satunya adalah jarak kehamilan yang terlalu pendek atau terlalu panjang. Pengaturan jarak kehamilan telah menjadi program Badan Koordinasi Keluarga Berencana Nasional (BKKBN) melalui program keluarga berencana (KB) namun hal tersebut belum sepenuhnya tercapai. Tujuan penelitan: 1) mengetahui pengaruh jarak kehamilan terhadap risiko terjadinya kematian perinatal di Kabupaten Agam Provinsi Sumatera Barat. 2) Mengetahui pada jarak kehamilan berapa yang berisiko terhadap kematian perinatal. 3) Mengetahui besarnya risiko kematian yang berhubungan dengan jarak kehamilan. 4). Mengidentifikasi faktor-faktor lain yang berpengaruh terhadap kematian perinatal Metode penelitian observasional menggunakan desain unmatched case control study. Subjek penelitian semua ibu melahirkan anak lebih dari 1 kali pada tahun 2006. Kelompok kasus 43 orang ibu melahirkan yang mengalami kematian perinatal sedangkan kelompok kontrol 86 orang ibu melahirkan perinatal hidup. Uji hipotesis menggunakan chi-sguare ( χ 2 ) dengan p<0,05 dan CI 95%. Analisis yang digunakan analisis bivariabel dan multivariabel. Hasil penelitian: jarak kehamilan <27 bulan secara statistik bermakna meningkatkan risiko kematian perinatal (OR=4,77 dan CI 95% 1,39- 16,30). Riwayat BBLR (OR=3,45 CI 95% 1,47-8,10), riwayat lahir mati (OR=3,15 CI 95% 1,28-7,69) dan riwayat ANC (OR=3,16 CI 95% 1,38- 7,26) secara statistik juga bermakna meningkatkan risiko kematian perinatal. Kesimpulan: Jarak kehamilan yang meningkatkan risiko kematian perinatal yaitu jarak kehamilan <27 bulan dengan OR sebesar 4,77, faktor lain yang berpengaruh terhadap risiko kematian perinatal yaitu riwayat BBLR, riwayat lahir mati dan Ante Natal Care.

Background: About four million cases of neonatal mortality occur each year. Two-third of the cases happen in the first week of newborn’ life and two-third of those deaths happen within twenty-four hours of newborn’s life. Perinatal mortality is caused by many factors, one of which is too short or too long inter pregnancy interval. It is one of National Coordination of Family Planning (BKKBN) programs done through Family Planning programs; however, it has not fully been achieved yet. Objective: This study was conducted to investigate the effect of inter pregnancy interval toward the risk of perinatal mortality in Agam District, West Sumatera Province, to investigate in which pregnancy interval that gives a risk on perinatal mortality, to investigate the magnitude of mortality risk regarding inter pregnancy interval, and to identify other factors affecting perinatal mortality. Method: This was an observational study with an unmatched case control study design. The subjects were divided into two groups, namely the case group consisting of mothers having delivered more than once with perinatal mortality (43 cases) and the control group consisting of mothers having delivered more than once with live perinatal (86 cases).. Chisquare was used for the hypothesis test with p<0.05 and CI 95%. The analyses employed bivariable and multivariable analyses. Result: Inter pregnancy interval of <27 had a statistically significant increase on the risk of perinatal mortality (OR = 4.77; CI 95% 1.39-16.30). Other factors such as LBW history (OR = 3.45; CI 95% 1.47-8.10), stillbirth history (OR 3.15; CI 95% 1.28-7.69), and ANC history (OR 3.16; CI 95% 1.38-7.26), also had a statistically significant increase on the risk of perinatal mortality. Conclusion: Inter pregnancy interval of <27 months will increase the risk of perinatal mortality with OR = 4.77. Other factors affecting perinatal mortality are LBW history, stillbirth history and antenatal care.

Kata Kunci : Kematian Perinatal,Jarak Kehamilan,inter pregnancy interval, perinatal mortality