PEROKOK PASIF MENINGKATKAN KEJADIAN LAHIR MATI

NANI SUARNI, Prof. dr. Siswanto Agus Wilopo, SU, M.Sc., Sc.D

2012 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar belakang: Perilaku berisiko selama kehamilan dapat menyebabkan kejadian lahir mati. Terdapat 104 kasus lahir mati di Kabupaten Muna tahun 2009. Prevalensi perokok pasif di Indonesia 48,9%, setiap propinsi prevalensi perokok pasif 29,6%. Ibu hamil yang terpapar environmental tobacco smoke (ETS) selama kehamilannya dapat menyalurkan nikotin pada janinnya serta mempengaruhi outcome kehamilan. Tujuan: Untuk mengetahui apakah kejadian lahir mati sering terjadi pada ibu-ibu perokok pasif. Metodologi: Penelitian kuantitatif dengan rancangan case control study. Lokasi di kabupaten Muna. Populasinya seluruh kelahiran di Kabupaten Muna 2 tahun terakhir (Januari-Desember 2008, 2009). Kasus ibu melahirkan lahir mati, kontrol ibu melahirkan hidup. Instrumen penelitian: kuesioner, catatan rekam medik. Analisis uji statistik MC Nemar dan Conditional Logistic Regression tingkat kemaknaan p<0,05 dan confidence interval 95%. Hasil: Terdapat hubungan yang bermakna antara perokok pasif dengan kejadian lahir mati OR = 3,5 (95% CI; 1,67-7,92), pendidikan dasar, (OR = 5,22: 95% CI; 1,98-13,78), pendidikan menengah (OR = 1,37; 95% CI; 0,50-3,77), terdapat hubungan signifikan paritas dengan kejadian lahir mati. Primi (OR = 4,22: 95% CI: 1,31-13,60), grande (OR = 4,47; 95% CI; 1,92-10,40). Tidak signifikan antara umur kehamilan, trauma lahir dengan kejadian lahir mati. Analisis multivariabel (Perokok pasif, pendidikan dan paritas OR = 3,37 95% CI: 1,46-7,78) Kesimpulan: Kejadian lahir mati lebih besar pada kelompok ibu perokok pasif dibandingkan yang tidak perokok pasif dan mempunyai hubungan signifikan dengan kejadian lahir mati, pendidikan dan paritas ibu dengan kejadian lahir mati, Variabel paling besar berkontribusi kejadian lahir mati adalah variabel paritas.

Background: Risky behavior during pregnancy can cause stillbirth incidence. There were 104 cases of stillbirth in Muna District in 2009. The prevalence of passive smokers in Indonesia and in each province is 48.9% and 29.6%, respectively. Pregnant women exposed to environmental tobacco smoke (ETS) during pregnancy may supply nicotine to the fetus and this affects the pregnancy outcomes. Objective: To determine whether the incidence of stillbirth commonly occurs among nonsmoking women. Methodology: This was a quantitative study using a case-control study design. The study location was in Muna District. The study population was all births in Muna District during the past two years (the period from January 2008 to December 2009). The case group was all mothers who gave birth to stillbirth, while the control group was all mothers with live births. The study instruments were questionnaires and medical records. The data analysis was with MC Nemar test and conditional logistic regression at the significance level of p <0.05 and 95% confidence interval. Results: There was a significant association between passive smoking and the incidence of stillbirth (OR = 3.5; 95% CI: 1.67 to 7.92). Some variables which also had significant association were basic education, (OR = 5.22 95% CI: 1.98 - 13.78), secondary education (OR = 1.37, 95% CI: 0.50 to 3.77) and primiparity (OR = 4.22 95% CI: 1.31 to 13.60) and grand parity (OR = 4.47, 95% CI: 1.92 to 10.40). There was no significant association between gestational age and birth trauma and the incidence of stillbirth. Multivariable analysis showed that passive smoking, education and parity had OR = 3.37 95% CI: 1.46 to 7.78. Conclusion: The incidence of stillbirth was greater in the group of passive smoking mothers than that in the group of non passive smoking mothers. Passive smoking had a significant association with the incidence of stillbirth. There was a significant relationship between maternal education and parity and the incidence of stillbirth. The most contributing variable to the incidence of stillbirth was parity.

Kata Kunci : Lahir mati, Perokok pasif, Kabupaten Muna