Jarak antara kehamilan dan resiko abortus spontan di Kabupaten Purworejo

WANTANIA, Emanuel Elisabeth, dr. Siswanto Agus Wilopo, SU, MSc, Scd

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Sekitar 10-20% kehamilan klinis berakhir dengan abortus spontan. Jarak antar-kehamilan yang singkat mungkin menjadi salah satu faktor risiko terjadinya abortus spontan. Hasil penelitian sebelumnya mengenai hubungan jarak antar-kehamilan dengan abortus spontan masih bertolak belakang. Tujuan: Diketahuinya angka kejadian abortus spontan dan karakteristik ibu yang mengalami abortus spontan, diketahuinya hubungan antara jarak antar-kehamilan dan abortus spontan dengan mengontrol faktor risiko lainnya serta diketahuinya rentang jarak antar-kehamilan yang optimal. Metode: Penelitian kohort retrospektif menggunakan data survei longitudinal Laboratorium Penelitian Kesehatan dan Gizi Masyarakat Fakultas Kedokteran Universitas Gadjah Mada di Kabupaten Purworejo tahun 1994-1998. Sebanyak 1910 ibu hamil yang memenuhi kriteria untuk analisis kejadian abortus spontan. Subjek untuk analisis mengenai hubungan jarak antar-kehamilan dan risiko abortus spontan sebanyak 1291 ibu gravida ≥2 yang dikelompokkan menurut jarak antar-kehamilan dan ditelusuri apakah mengalami abortus spontan atau lahir hidup. Hasil: Selama tahun 1994-1998, 6 dari 100 ibu hamil mengalami abortus spontan. Insiden kumulatif abortus spontan pada ibu gravida ≥2 lebih besar daripada primigravida. Setelah umur, riwayat abortus dan penggunaan kontrasepsi dikontrol dalam multiple logistic regression analysis, risiko untuk mengalami abortus spontan pada jarak 1-12 bulan menjadi 2,6 kali (95%CI: 0,76-8,58) dibandingkan jarak 34-45 bulan. Risiko tersebut berkurang pada jarak 13-24 bulan dan 25-33 bulan yaitu berturut-turut 2,0 dan 2,3 kemudian meningkat mulai jarak 46-60 bulan serta paling tinggi pada jarak 85-229 bulan yaitu 3,3 (95%CI: 1,21-8.97). Kesimpulan: Jarak antar-kehamilan yang singkat dan jarak yang sangat panjang merupakan faktor risiko terjadinya abortus spontan. Rentang jarak yang optimal dimana risiko abortus spontan paling minimal adalah 34-45 bulan.

Background: Around 10-20% of pregnancy ends up with spontaneous abortion. Short interpregnancy interval are likely to be considered one of risk factors of spontaneous abortion. There are still arguments on the results about the relationship between interpregnancy interval and spontaneous abortion in previous studies. Objective: Finding of incidence and characteristic of women who experience spontaneous abortion, the relationship between interpregnancy interval and spontaneous abortion by controlling other risk factors and optimal range of interpregnancy interval. Method: This was a retrospective cohort study using data from longitudinal survey of Community Health and Nutrition Research Laboratory of Medical Faculty, Gadjah Mada University in Purworejo District from 1994-1998. Subjects for spontaneous abortion incidence were 1910 pregnant women that met the criteria. Subjects for relationship between interpregnancy interval and spontaneous abortion were 1291 gravida ≥2 women grouped based on interpregnancy interval and were seen whether ends up with spontaneous abortion or live birth. Results: During 1994-1998, 6 of 100 pregnant women experienced spontaneous abortion. Cumulative incidence of spontaneous abortion in gravida ≥2 was greater than that in primigravida. After age, abortion history and contraceptive use history were controlled in multiple logistic regression analysis, the risk of spontaneous abortion in the interval of 1-12 months became 2.6 times (95% CI: 0.76-8.58) as likely than the risk in the interval of 34-45 months. The risk was reduced in the interval of 13-24 months and 25-33 months, that was 2.0 and 2.3 respectively and then increased in the interval of 46-60 months with the highest value in the interval of 85-229 months, that was 3.3 (95% CI: 1.21-8.97). Conclusion: Short and long interpregnancy interval were likely to be considered risk factors of spontaneous abortion. Optimal range of interpregnancy interval in which the risk of spontaneous abortion is minimum was 34-45 months.

Kata Kunci : Jarak antarkehamilan,Abortus spontan,kohort retrospektif,Indonesia, Interpregnancy interval, spontaneous abortion, retrospective cohort, Indonesia