Hubungan kekerasan selama kehamilan dengan kelahiran bayi berat lahir rendah di Kabupaten Ogan Komering Ulu

ROSA, Eni Folendra, Prof. dr. M. Hakimi, Sp.OG(K), Ph.D

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: BBLR salah satu faktor risiko yang mempunyai kontribusi terhadap kematian bayi pada masa perinatal dan penyumbang terbesar kematian neonatal di Indonesia. Beberapa peneliti melaporkan adanya hubungan yang signifikan kekerasan selama kehamilan dengan kelahiran BBLR. Di Kabupaten OKU kasus kekerasan dalam rumah tangga sebanyak 18 orang (2007) dan kejadian BBLR tahun 2006 sebesar 7,1%. Tujuan: Untuk mengetahui hubungan kekerasan selama kehamilan dengan kelahiran BBLR di Kabupaten OKU. Metode: Penelitian ini adalah penelitian observasional menggunakan rancangan unmatched case control study dengan pendekatan kuantitatif dan kualitatif. Subjek penelitian terdiri dari kelompok kasus dan kontrol dengan perbandingan 1:2. Analisis data terdiri dari analisis univariabel, analisis bivariabel menggunakan chi-square (χ2), analisis stratifikasi, analisis multivariabel menggunakan analisis regresi logistik serta analisis data kualitatif menggunakan content analysis. Hasil: Pada analisis bivariat kelompok BBLR mengalami lebih banyak tiga kali kekerasan fisik selama kehamilan dibandingkan BBLC dan kelompok BBLR mengalami lebih banyak 2,5 kali kekerasan psikologis dibandingkan kelompok BBLC, kekerasan seksual secara statistik tidak signifikan. Usia, pendidikan dan status ekonomi secara statistik tidak signifikan, sedangkan frekuensi ANC berhubungan dengan kelahiran BBLR. Pada analisis stratifikasi ditemukan bahwa frekuensi ANC merupakan efek modifikasi dan tidak dicurigai sebagai variabel pengganggu. Hasil analisis multivariabel; pada kelompok ibu BBLR mengalami lebih banyak 2,5 kali kekerasan selama kehamilan dibandingkan kelompok BBLC. Hasil analisis kualitatif ditemukan faktor yang meningkatkan terjadinya kekerasan selama kehamilan adalah suami tidak bekerja, khilaf, alkohol, judi, adanya wanita lain dalam pernikahan dan tidak menyukai anak perempuan, ketidakberdayaan secara ekonomi, pasrah pada nasib, istri cerewet, tidak bisa mengurus rumah tangga dan istri yang dianggap tidak patuh terhadap suami. Kesimpulan: Kelompok BBLR mengalami lebih banyak kekerasan selama kehamilan dibandingkan kelompok BBLC. Frekuensi ANC secara independen mempunyai hubungan yang signifikan dengan kelahiran BBLR disamping kekerasan selama kehamilan.

Background: Low birth weight (LBW) is a risk factor which contributes to infant mortality during perinatal period and the greatest contributor to neonatal mortality in Indonesia. Some studies show that there is significant relationship between violence during pregnancy and LBW delivery. At District of Ogan Komering Ulu (OKU) there were 18 cases of violence domestic (2007) whereas the prevalence of LBW in 2006 was 7.1%. Objective: To identify the relationship between violence during pregnancy and LBW delivery at District of OKU. Method: This was an observational study which used unmatched case control study design and both quantitative and qualitative approaches. Subject of the study consisted of intervention group and control group at a comparison 1:2. Data analysis used univariable, bivariable with chi square (x2), multivariable with logistic regression and stratification. Result: The result of bivariable analysis showed that the group of LBW had physical violence 3 times greater during pregnancy than the group with normal birth weight; and the group of mothers having LBW infants had psychological violence 2.5 times greater than the group with normal birth weight. Sexual violence, age, education and economic status statistically had no significant relationship with LBW; whereas frequency of antenatal care (ANC) had relationship with LBW delivery. The result of stratification analysis showed that the frequency of ANC was a modified effect and was not assumed as confounding variable. The result of multivariable analysis showed that the group of mothers with LBW infants had 2.5 times greater for violence during pregnancy than the group with normal birth weight infants. The result of qualitative analysis showed that factors contributing to violence during pregnancy were husbands who were unemployed, erroneous, alcoholic, gamblers, had another woman and did not like female children, had a wife who was fussy, could not maintain the household and was disobedient to her husband. Conclusion: The group of mothers with LBW infants had more violence during pregnancy than the group with normal birth weight infants. Frequency of ANC, apart from violence during pregnancy, independently had significant relationship with LBW delivery.

Kata Kunci : Kehamilan,Kekerasan,Bayi berat lahir rendah,BBLR,violence during pregnancy, low birth weight