Preeklampsia dengan gambaran berat sebagai faktor risiko kejadian asfiksia neonatorum

Abstract

Background: Asphyxia neonatorum is one of the most frequent perinatal issues caused by preeclampsia, which is one of the most common prenatal disorders. Neonatal asphyxia is one of the health problems that is very important to pay attention to because this condition is associated with perinatal morbidity and mortality. Several maternal conditions are thought to be associated with neonatal asphyxia, including maternal age, gestational age, obstetric history, degree of preeclampsia, and method of delivery. This study aims to confirm this hypothesis. Methods: This study used an observational analytic design with a cross sectional design conducted between June 2021 and June 2022 at the Department of Obstetrics and Gynecology at Wangaya Hospital Denpasar, 97 pregnant women with preeclampsia were included. The research data were obtained through direct recording from medical records. The data collected were maternal age, gestational age, gravida, parity, history of abortion, degree of preeclampsia and method of delivery. Results: Pregnant women with preeclampsia who had gestational age <37 weeks [p = 0.021; OR = 3.27 (1,2-8.8)], has a gravida of 1 and > 3 [p = 0.019; OR = 2.97 (1,2-7,1)], has a parity of 1 and > 3 [p = 0.033; OR = 2.62 (1.1-6.1)], had preeclampsia with severe features [p = 0.002; OR = 5.62 (1.7-17.8)], and delivered by SC [p = 0.005; OR = 6.9 (1.5-31.9)] had a higher probability of having a child with asphyxia neonatorum. Meanwhile, the mother's age at delivery [p = 0,516; OR = 0.72 (0.3-1.7)] and history of abortion [p = 0.074; OR = 2.53 (0.9-6.7)] is not a factor that causes asphyxia neonatorum. Conclusions: Factors related to the incidence of asphyxia neonatorum in pregnant women with preeclampsia are gestational age, gravida, parity, degree of preeclampsia, and method of delivery.   Latar Belakang: Preeklampsia merupakan salah satu penyulit kehamilan yang sangat umum ditemukan dan menyebabkan berbagai masalah perinatal, salah satunya asfiksia neonatorum. Asfiksia neonatorum merupakan salah satu masalah kesehatan yang sangat penting untuk diperhatikan karena kondisi ini terkait dengan morbiditas dan mortalitas perinatal. Beberapa kondisi maternal diduga terkait dengan asfiksia neonatorum, antara lain usia ibu, usia kehamilan, riwayat obstetri, derajat preeklampsia, dan metode persalinan. Penelitian ini bertujuan untuk mengkonfirmasi hipotesis tersebut.   Metode: Penelitian ini menggunakan rancangan analitik observasional dengan desain cross sectional yang melibatkan 97 orang ibu hamil dengan preeklampsia di Departemen Obstetri dan Ginekologi RSUD Wangaya Denpasar periode bulan Juni 2021 sampai Juni 2022. Data penelitian diperoleh melalui pencatatan langsung dari rekam medis. Data yang dikumpulkan adalah usia ibu, usia kehamilan, gravida, paritas, riwayat abortus, derajat preeclampsia dan metode persalinan Hasil: Ibu hamil dengan preeklampsia yang memiliki usia kehamilan < 37 minggu [p = 0,021; OR = 3,27 (1,2-8,8)], memiliki gravida 1 dan > 3 [p = 0,019; OR = 2,97 (1,2-7,1)], memiliki paritas 1 dan > 3 [p = 0,033; OR = 2,62 (1,1-6,1)], mengalami preeklampsia dengan gambaran berat [p = 0,002; OR = 5,62 (1,7-17,8)], dan bersalin secara SC [p = 0,005; OR = 6,9 (1,5-31,9)] memiliki kemungkinan lebih besar untuk memiliki anak yang mengalami asfiksia neonatorum. Sedangkan usia ibu saat bersalin [p = 0,516; OR = 0,72 (0,3-1,7)] dan riwayat abortus [p = 0,074; OR = 2,53 (0,9-6,7)] bukanlah faktor yang menyebabkan terjadinya asfiksia neonatorum. Kesimpulan: Faktor yang berhubungan dengan kejadian asfiksia neonatorum pada ibu hamil dengan preeklampsia adalah usia kehamilan, gravida, paritas, derajat preeklampsia, dan metode persalinan