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"Latar belakang: Hipotermia merupakan penyebab utama morbiditas dan mortalitas pada bayi, terutama pada bayi prematur dan atau dengan berat lahir kurang. Membungkus bayi menggunakan plastik terbukti mengurangi hipotermia. Saat ini terdapat Neohelp suatu plastik dengan desain baru yang diharapkan lebih efektif mencegah hipotermia. Tujuan: Mengetahui angka kejadian hipotermia bayi baru lahir dan waktu yang dibutuhkan untuk mencapai normotermia pada resusitasi bayi prematur menggunakan plastik polietilen lembaran dibandingkan dengan plastik Neohelp, serta mengetahui faktor risiko dan komplikasi hipotermia. Metode: Dilakukan randomized controlled trial pada 48 bayi baru lahir usia gestasi ≤ 32 minggu, pada 5 rumah sakit. Faktor lingkungan berupa suhu ruangan, kelembaban, waktu transport dari ruang bersalin ke ruang perawatan serta penggunaan 2 macam plastik untuk mencegah hipotermia, dianalisis secara bivariate menggunakan Uji Chi-square, Fisher exact, t-test dan Man-Whitney test. Hasil: Didapatkan nilai angka hampir sama antara kelompok plastik poietilen lembaran dibanding Neohelp untuk mencapai normotermi di ruang bersalin (4,5 menit vs 5 menit), serta rerata suhu tubuh ketika tiba di ruang perawatan (35,6⁰C vs 35,4⁰C). Suhu dan kelembaban ruangan, waktu tempuh dari ruang bersalin ke ruang perawatan, dan 2 jenis plastik tidak terbukti merupakan faktor risiko terjadinya hipotermia. Kesimpulan: Plastik Neohelp tidak terbukti lebih unggul dibanding polietilen lembaran dalam mencegah hipotermia. Peranan petugas kesehatan sangat besar dalam mencegah hipotermia, apapun jenis plastik yang digunakan.

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Background: Hypothermia is one of the primary causes of morbidity and mortality in newborn period, particularly preterm and low birth weight babies. Prevention of hypothermia by wrapping newborns with plastic sheets has been proven helpful. Neohelp is a specially designed plastic wrap for neonates to prevent hypothermia. Aim: We aimed to determine the prevalence of hypothermia of the newborn and time to reach normothermia on preterm newborn resuscitation using polyethylene plastic sheet compared to Neohelp. We also aimed to determine the risk factors and complications of hypothermia following the resuscitation. Method: This is a randomized control trial of 48 newborn ≤ 32 weeks age of gestation in 5 hospitals. The environmental factors assessed were room temperature, humidity, time of travel from delivery room to the care unit and the use of two types of plastic wrap to prevent hypothermia. All of the variables were analyzed using Chi-square, Fischer exact, t-test, and Mann-Whitney. Result: We found only slight difference between polyethylene plastic sheet and Neohelp to reach normothermia in delivery room (4.5 minutes vs 5 minutes). Average temperature on arrival in care unit was not also not significantly different (35.6 centigrade vs 35.4 centigrade). Room temperature, humidity, time of travel from delivery room to care unit, and the type of plastic wrap used were not proven as risk factors of hypothermia. Conclusion: Neohelp was not proven to be superior to polyethylene sheet in preventing hypothermia. Skill of the healthcare personnel has been the biggest role in preventing hypothermia, regardless of the type of plastic used."

"[Latar Belakang. Bayi kurang bulan (BKB) memiliki risiko tinggi mengalami gangguan neurobehavioral. Gangguan tersebut dapat dipengaruhi oleh faktor prenatal, natal, dan perinatal. Perlu dilakukan deteksi dini gangguan agar dapat dilakukan intervensi dini. Penilaian neurobehavioral metode Dubowitz dapat digunakan untuk deteksi dini gangguan neurobehavioral pada BKB.Tujuan. Mengetahui proporsi dan faktor risiko yang berhubungan dengan gangguan neurobehavioral BKB. Mengetahui hubungan antara kelompok bayi risiko tinggi dengan kejadian gangguan neurobehavioral.Disain Penelitian. Penelitian ini merupakan penelitian dengan studi potong lintang analitik untuk mengetahui karakteristik penilaian neurobehavioral BKB dengan metode Dubowitz dan faktor risiko yang berhubungan. Subjek penelitian adalah BKB yang pernah dirawat di Divisi Perinatologi Rumah Sakit Cipto Mangunkusumo (RSCM). Dilakukan analisis bivariat dengan uji kai kuadarat dan dilanjutkan dengan analisis multivariat dengan uji regresi logistik.Hasil Penelitian. Didapatkan 106 subjek yang sesuai dengan kriteria inklusi dan eksklusi. Proporsi BKB yang mendapat nilai suboptimal pada pemeriksaan neurobehavioral metode Dubowitz adalah 57,5%. Faktor risiko yang berhubungan dengan gangguan neurobehavioral adalah sepsis (OR 6,23 (IK 95% 2,18-17,73); p=0,001), perdarahan intraventrikular (OR 6,23 (IK 95% 2,18-17,73) p=0,007); dan berat lahir ≤1500 gram (OR 3,46 (IK 95% 1,15-10,37), p=0,027). Didapatkan 37 subjek (34,9%) masuk ke dalam kelompok risiko tinggi dan 69 subjek (65,1%) risiko rendah. Terdapat 86,5% bayi di kelompok risiko tinggi mendapatkan penilaian neurobehavioral suboptimal. Terdapat hubungan yang bermakna antara kelompok bayi risiko tinggi dengan penilaian suboptimal metode Dubowitz, dengan p<0,001.Simpulan. Faktor risiko yang berhubungan dengan penilaian suboptimal pada pemeriksaan neurobehavioral adalah sepsis, perdarahan intraventrikular, dan berat lahir ≤1500 gram. Bayi kelompok risiko tinggi berhubungan dengan besarnya penilaian suboptimal pada pemeriksaan neurobehavioral metode Dubowitz., Background. Preterm baby tend to be at risk for having neurobehavioral impairment. The risk factors included prenatal, natal, and perinatal factors. Early recognition of infants at risk for development disability is important. The Dubowitz Neurological Assessment can be used to evaluate infants at risk for developmental disabilitiesis.Objective. To determine proportion and factors that related to Dubowitz Neurobehavioral assesment in preterm baby.Methods. Cross-sectional study involving preterm baby in Cipto Mangunkusumo Hospital. The Dubowitz Neurobehavioral Assesment was performed to asses the neurobehavioral pattern at 37-40 weeks post menstrual age. The risk factors data was collected retrospectively from the medical record. Statistical analysis was done using bivariate (Chi-square test) and multivariate analysis (logistic regression) analysis.Results. One hundred and six infants fullfilled the eligibility criteria. Based on The Dubowitz Neurological Assesment, 57,5% subjects got suboptimal score. Logistic regression analysis showed significant association between sepsis (OR 6,23 (IK 95% 2,18-17,73); p=0,001), intraventricular haemorrhage (OR 6,23 (IK 95% 2,18-17,73) p=0,007); and birth weight ≤1500 gram (OR 3,46 (IK 95% 1,15-10,37), p=0,027) and neurobehavioral impairment. There was 86,5% from all high risk babies that got suboptimal score with signifficant association, p<0,001.Conclusion. In preterm infants, sepsis, intraventricular haemorrhage, and low birth weight can become factors that related to the neurobehavioral impairment. High risk babies potential to have neurobehavioral impairment.]"

"Latar belakang: Perdarahan intraventrikular (PIV) menjadi penyebab morbiditas dan mortalitas bayi prematur. Sekitar 27% bayi dengan BB <1.500 gram mengalami PIV pada berbagai derajat (1–4). Faktor risiko PIV dapat berasal dari maternal, seperti preeklamsia, tanpa steroid antenatal, dan persalinan per vaginam serta berasal dari neonatal, seperti usia gestasi lebih muda, berat badan lahir lebih rendah, jenis kelamin lelaki, nilai Apgar rendah, asfiksia, pemberian inotropik, trombositopenia, ventilasi mekanik invasif, sepsis, sindrom distres pernapasan, dan duktus arteriosus persisten. Identifikasi faktor risiko yang berhubungan dengan PIV penting agar penatalaksanaan yang tepat dapat dilakukan dan sebagai evaluasi pencegahan dan tata laksana PIV yang saat ini sudah diterapkan.Metode: Penelitian kasus kontrol ini melibatkan subjek bayi usia gestasi <35 minggu di RSCM yang diambil retrospektif secara consecutive sampling mulai perawatan Agustus 2022 hingga jumlah sampel terpenuhi. Subjek dibagi menjadi kelompok kasus (dengan PIV) dan kontrol (tanpa PIV) berdasarkan hasil USG kepala selama perawatan. Masing-masing kelompok diidentifikasi faktor risiko yang ada dari rekam medis, baik faktor maternal maupun neonatal. Data kemudian dianalisis menggunakan program SPSS.Hasil: Total 220 subjek diteliti terdiri atas kelompok kasus 110 subjek dan kontrol 110 subjek. Dari 110 kasus didapatkan PIV derajat 1 (69,1%), derajat 2 (12,7%), derajat 3 (10%), dan derajat 4 (8,2%). Analisis bivariat menunjukkan terdapat hubungan bermakna antara PIV dengan usia gestasi <28 minggu (OR 5,44; IK 95% 2,23-13,27; p<0,001), berat badan lahir <1.000 gram (OR 6,23; IK 95% 2,87-13,52; p<0,001), berat badan lahir 1.000-1.499 gram (OR 3,04; IK 95% 1,62-5,71; p=0,001), nilai Apgar menit ke-1 (p=0,004), nilai Apgar menit ke-5 (p=0,03), pemberian inotropik (OR 2,47; IK 95% 1,35-4,53; p=0,005), jumlah trombosit <50.000/μL (OR 2,52; IK 95% 1,17-5,42; p=0,018), jumlah trombosit 50.000-99.000/μL (OR 3,42; IK 95% 1,51-7,74; p=0,003), ventilasi mekanik invasif (OR 3,71; IK 95% 2,11-6,53; p<0,001), sepsis (OR 2,84; IK 95% 1,64-4,90; p<0,001), dan DAP (OR 2,01; IK 95% 1,07-3,79; p=0,042). Analisis multivariat menunjukkan hanya berat badan lahir <1.000 gram (OR 3,93; IK 95% 1,71-9,06; p=0,001), berat badan lahir 1.000-1.499 gram (OR 2,57; IK 95% 1,34-4,92; p=0,004), dan penggunaan ventilasi mekanik invasif (OR 2,49; IK 95% 1,34-4,63; p=0,004) yang mempunyai hubungan bermakna dengan PIV.Kesimpulan: Faktor risiko yang mempunyai hubungan bermakna dengan PIV pada bayi usia gestasi <35 minggu adalah berat badan lahir <1.500 gram dan penggunaan ventilasi mekanik invasif.

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Background: Intraventricular hemorrhage (IVH) is a cause of morbidity and mortality in preterm infants. Approximately 27% of infants weighing <1,500 gram have PIV in various degrees (1-4). Risk factors for IVH can be maternal origin, such as preeclamsia, absence of steroid antenatal, and vaginal delivery; and also from neonatal origin, such as younger gestational age, lower birth weight, male gender, lower Apgar score, asphyxia, inotropic administration, thrombocytopenia, invasive mechanical ventilation, sepsis, respiratory distress syndrome and patent ductus arteriosus (PDA). Identification of risk factors associated with IVH is important so that appropriate management can be carried out and as an evaluation of IVH’s prevention and treatment that are currently being implemented.

Method: This case-control study involved subjects with gestational age <35 weeks at Cipto Mangunkusumo Hospital who were taken retrospectively by consecutive sampling starting from admission in August 2022 until the number of samples were fulfilled. Subjects were divided into case (with IVH) and control (without IVH) groups based on the results of head ultrasound during hospitalization. Each group was identified existing risk factors from medical record, both maternal and neonatal factor. The data were then analyzed using the SPSS program.

Result: A total 220 subjects were studied, consisting 110 subjects in case group and 110 subjects in control group. Of the 110 cases, IVH grade 1 (69.1%), grade 2 (12.7%), grade 3 (10%), and grade 4 (8.2%). Bivariate analysis showed that PIV was significantly associated with gestational age <28 weeks (OR 5.44; 95% CI 2.23-13.27; p<0.001), birth weight <1,000 grams (OR 6.23; 95% CI 2.87-13.52; p<0.001), birth weight 1,000-1,499 grams (OR 3.04; 95% CI 1.62-5.71; p=0.001), 1st minute Apgar score (p=0.004), 5th minute Apgar score (p=0.03), inotropic administration (OR 2.47; 95% CI 1.35-4.53; p=0.005), platelet count <50,000/μL (OR 2.52; 95% CI 1.17-5.42; p=0.018), platelet count 50,000-99,000/μL (OR 3.42; 95% CI 1.51-7.74; p=0.003), invasive mechanical ventilation (OR 3.71; 95% CI 2.11-6.53; p<0.001), sepsis (OR 2.84; 95% CI 1.64-4.90; p<0.001), and PDA (OR 2.01; 95% CI 1.07-3.78; p=0.042). Multivariate analysis showed only birth weight <1,000 grams (OR 3.93; 95% CI 1.71-9.06; p=0.001), birth weight 1,000-1,499 grams (OR 2.57; 95% CI 1.34-4.92; p=0.004), and the use of invasive mechanical ventilation (OR 2.49; 95% CI 1.34-4.63; p=0.004) were significantly associated with IVH.

Conclusion: Risk factors that significantly associated with IVH in baby with gestational age <35 weeks are birth weight <1,500 grams and the use of invasive mechanical ventilation."

"Latar belakang: Duktus arteriosus persisten signifikan hemodinamik (DAPsh) ditandai dengan peningkatan aliran darah paru dan penurunan aliran darah sistemik. Hipoperfusi sitemik yang menyebabkan penurunan oksigenasi jaringan dapat dideteksi menggunakan near-infrared spectroscopy (NIRS) yang dipasang di area serebral, renal, dan abdomen.Tujuan: Mencari nilai diagnsotik dari NIRS serebral, renal, dan abdominal dalam mendeteksi dini DAPsh pada bayi <32 minggu.Metode: Sebanyak 43 subjek bayi prematur dilakukan pemantauan dengan memasang NIRS serebral, renal, dan abdomen pada 3 jam pertama selama 72 jam. Semua subjek dilakukan pemeriksaan dengan ekokardiografi dalam 24 jam pertama untuk menilai adanya DAPsh. Kriteria ekokardiografi yang digunakan termasuk parameter oversirkulasi paru dan pola aliran doppler di serebral, renal, dan abdominal. Nilai rerata dari NIRS selama 72 jam dibandingkan antara kelompok DAPhs dan non-DAPhs.Hasil: Terdapat 10 subjek dengan DAPsh dan 33 subjek tanpa DAPsh. Median dari nilai RrSO2 pada kelompok dengan DAPsh lebih rendah dibanding kelompok tanpa DAPsh, 72 (44-87) vs 78 (48-89) (p=0,044). Dengan menggunakan kurva ROC, nilai titik potong < 74% memiliki sensitivitas sebesar 80% dan spesifisitas sebesar 70%. Sedangkan nilai CrSO2 dan SrSO2 tidak bermakna secara statistik.Simpulan: Nilai RrSO2 < 74% dapat memprediksi adanya DAPsh pada bayi <32 minggu.

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Background: Hemodynamically significant patent ductus arteriosus (hsPDA) is characterised by systemic hypoperfusion and pulmonary overcirculation. Systemic hypoperfusion with subsequent decrease of tissue oxygenation can be detected using near-infrared spectroscopy (NIRS) applied at the cerebral, renal, and abdominal areas.

Objective: To seek the diagnostic value of cerebral, renal, and splanchnic NIRS to detect hsPDA in infants < 32 weeks of gestation.

Methods: Forty-three very preterm infants (birth weight <1500 gr and gestational age <32 weeks) were monitored continuously with cerebral, renal, and abdominal NIRS within three hours after birth for 72 hours. All infants were prospectively evaluated using echocardiography to detect hsPDA within 24 hours after birth daily during the NIRS application. Echocardiography criteria to diagnose hsPDA included indices of pulmonary overcirculation and organ Doppler pattern at cerebral, renal, and splanchnic. The mean value of regional NIRS during its application was compared between the hsPDA and no- hsPDA groups.

Results: Of 43 infants, there were 10 infants with hsPDA and 33 with no hsPDA. A lower median of mean RrSO2 was noted in hsPDA groups compared to no-hsPDA groups, 72 (44-87) vs 78 (48-89), respectively (p=0.044), while no significant difference was found in CrSO2 and SrSO2. Using ROC curves, Mean RrSO2 < 74% identified an hsPDA with a sensitivity of 80% and specificity of 70%, while CrSO2 and SrSO2 were not significant

Conclusion : Low RrSO2 <74% was associated with the presence of hsPDA in infants < 32 weeks of gestation."

"Untuk mencapai kehamilan sehat dibutuhkan interaksi dalam kandungan yang baik antara ibu hamil dengan janin. Apabila terjadi gangguan, maka masalah pada kehamilan yang bersifat fatal seperti preeklamsia dapat terjadi. Banyak studi telah menunjukkan adanya korelasi yang tinggi antara rusaknya proses aktivasi invasi trofoblas dan masalah pada maternal vascular endothelium. Peranan penting sebuah faktor transkripsi bernama Hif-1⍺ penting untuk regulasi oksigen khususnya dalam kondisi hipoksia, dan dipercaya juga berperan penting pada terjadinya preeklamsia di kehamilan. Pada studi ini, 20 sampel jaringan plasenta terdiri dari 10 sampel dari kehamilan preeklamsi dan 10 sampel dari kehamilan normal dianalisis menggunakan ELISA untuk melihat peranan protein HIF-1⍺ dan diinterpretasikan untuk menunjukkan hipoksia pada kehamilan preeklamsi. Hasil dalam studi ini menemukan bahwa tidak ada hasil yang signifikan ketika dianalisa secara statistic (p>0,05), namun ada kecenderungan bahwa kadar HIF-1⍺ lebih tinggi dibanding kadar HIF-1⍺ yang ditemukan dalam plasenta kehamilan normal.

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Healthy pregnancy requires successful appropriate interaction established between mother and the fetus. When this fails to occur, problems in pregnancy such as a life- threatening disorder called preeclampsia may occur. Many studies have shown high correlation between the development of preeclampsia with faulty trophoblast invasion and spiral artery remodelling at early weeks of gestation, that consequently led to placental ischemia. Hypoxia-inducible factor-1a (HIF-1⍺), an essential transcription factor for oxygen regulation induced in hypoxic environment, is believed to be important in the course of this disease. However, the exact mechanism of the pathogenesis of preeclampsia is still elusive. In this study, 20 tissue samples composed of 10 preeclamptic placenta and 10 normal pregnancy placenta were examined using ELISA Kit, with the aim to assess the HIF-1⍺ protein level and determine whether it could be used to demonstrate presence of persistent hypoxia in preeclampsia. The results demonstrated that there is no statistically significant difference between the HIF-1⍺ level in preeclamptic and normal placenta (p>0.05), but there is an evident tendency of the level in preeclampsia placenta to be elevated."

"Ruam popok dapat meningkatkan ketidaknyamanan pada bayi baru lahir, bahkan bisa menjadi masalah yang serius. Penelitian ini bertujuan mengetahui faktorfaktor risiko yang berhubungan dengan kejadian ruam popok pada bayi baru lahir dan prevalensinya, di ruang perinatologi salah satu rumah sakit rujukan di Jakarta, Indonesia. Penelitian menggunakan metode survey dengan desain cross sectional restrospective study. Sampel (n=95) dipilih berdasarkan teknik consecutive sampling. Ruam popok ditentukan menggunakan instrumen DDSIS (Diaper Dermatitis Severity Intensity Score). Hasil penelitian menunjukkan prevalensi ruam popok 26,3 %. Analisis multivariat regresi logistik menunjukkan dua faktor risiko yang berhubungan dengan kejadian ruam popok: infeksi mikroorganisme dan lama hari rawat.

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Besides increasing infant's discomfort, diaper rash could cause other serious problems. This study aimed to investigate the risk factors of infant's diaper rash and its prevalence in a perinatology ward at a recommended hospital in Jakarta, Indonesia. This study used a survey method with cross-sectional retrospective design. The respondents (n=95) were chosen based on consecutive sampling. Diaper rash was identified using DDSIS (Diaper Dermatitis Severity Intensity Score). The results showed that the prevalence of diaper rash was 26.3%. The multivariate logistic regression analysis showed that there were two risk factors related to diaper rash prevalence: microorganism infection and inpatient time."

"Latar Belakang:. Sepsis neonatorum awitan dini masih menjadi penyebab kesakitan dan kematian yang utama pada neonatus, dengan angka lebih tinggi terjadi pada bayi kurang bulan. Berbagai faktor diketahui berhubungan dengan kejadian sepsis neonatorum awitan dini, namun penelitian yang dilakukan pada bayi prematur masih terbatas. Tujuan:. Mengetahui faktor-faktor risiko yang berhubungan dengan kejadian sepsis neonatorum awitan ini pada bayi kurang bulan di RSCM.Metode:. Penelitian desain case-control dengan mengambil data dari rekam medis bayi lahir kurang bulan di RSCM pada rentang waktu Januari 2016-Desember 2017 sebanyak 186 sampel (93 untuk masing-masing kelompok). Data dianalisis secara bivariat dan multivariat.Hasil: Terdapat perbedaan bermakna dari karakteristik bayi kurang bulan antara kelompok kasus dan kontrol yaitu usia gestasi, jenis kelamin laki-laki, dan berat lahir. Gejala klinis tersering ditemukan adalah sesak napas. Dari 7 faktor yang dianalisis, infeksi intrauterin, nilai APGAR 1 menit pertama, dan nilai APGAR 5 menit pertama pada analisis bivariat dimasukkan ke analisis multivariat (p<0,25) sementara pada faktor lainnya tidak ditemukan hubungan yang bermakna. Pada analisis multivariat, ditemukan bahwa jenis kelamin laki-laki, usia gestasi, infeksi intrauterin, dan nilai APGAR 1 menit pertama memiliki hasil yang bermakna secara statistik.Kesimpulan: Jenis kelamin laki-laki, usia gestasi, infeksi intrauterin, dan nilai APGAR 1 menit pertama merupakan faktor risiko independen sepsis neonatorum awitan dini pada bayi kurang bulan. Penelitian lebih lanjut dibutuhkan untuk mengetahui pengaruh faktor-faktor tersebut terhadap kejadian sepsis neonatorum awitan dini pada bayi kurang bulan.

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Background: Early onset neonatal sepsis is still considered as a common cause of morbidity and mortality in neonates, with a higher prevalence found in preterm infants. Many factors are known to be correlating to the cases of early onset neonatal sepsis, but research done specifically in preterm infants is limited.

Objective: To determine the factors associated with early onset neonatal sepsis in preterm infants.

Method: This research was done using a case-control design, where the data is taken from the medical record of preterm patients born in RSCM within January 2016-December 2017. The total sample is 186 (93 for each group). Data was then analyzed using bivariate and multivariate analysis.

Result: A significant result was found in characteristic such as gestational age, gender, and birth weight. Out of 7 factors that were analysed, the factors that were analysed using multivariate analysis were intrauterine infection, low APGAR score in the first minute, and low APGAR score in the fifth minute. From multivariate analysis, gender, gestational age, intrauterine inflammation, and low APGAR score in the first minute were stastically significant.

Conclusion: gender, gestational age, intrauterine inflammation, and low APGAR score in the first minute are independent risk factors for early onset neonatal sepsis. Further study is needed to understand the correlation between those factors and early onset neonatal sepsis in preterm infants."

"[ABSTRAKLatar Belakang: Angka kejadian trombositopenia pada neonatus dilaporkan antara 22-35%, dan salah satu komplikasinya adalah perdarahan intraventrikular (PIV). Penelitian sebelumnya di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta melaporkan angka kejadian PIV masih tinggi pada bayi usia gestasi < 35 minggu sebesar 43,47%. Perdarahan intraventrikular menyebabkan dampak yang berat pada perkembangan neurologis dan mortalitas. Di Indonesia, belum ada penelitian mengenai hubungan trombositopenia dan PIV. Tujuan: Mengetahui hubungan trombositopenia dengan PIV pada bayi usia gestasi < 35 minggu dan korelasi antara derajat berat trombositopenia dan derajat berat PIV. Metode: Penelitian potong lintang dengan penelusuran rekam medis dilakukan di Divisi Neonatologi Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia RSCM pada subjek yang dirawat pada bulan Januari 2012 sampai Desember 2014 dengan diagnosis PIV. Subjek dibagi menjadi kelompok PIV ringan sedang (derajat ≤ 2) dan berat (derajat > 2). Nilai trombosit dicatat pada hari yang sama dengan diagnosis PIV. Digunakan uji Pearson?s chi-square, Fischer, analisis multivariat, dan korelasi untuk analisis data. Hasil: Angka kejadian PIV berat dengan trombosit < 100.000/uL sebesar 28,2% dibanding 10,4% pada nilai trombosit ≥ 100.000/uL (p=0,014). Berdasarkan analisis multivariat, faktor yang memiliki pengaruh terhadap terjadinya PIV berat adalah usia gestasi < 32 minggu dan penggunaan alat bantu napas berupa ventilator dan high frequency oscillatory ventilation (HFOV). Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV (koefisien korelasi 0,21). Simpulan: Trombositopenia tidak memiliki peranan pada terjadinya PIV berat. Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV.

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ABSTRACTBackground: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson?s chi-squared, Fischer's tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn?t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH., Background: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson’s chi-squared, Fischer’s tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn’t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH.]"

"Bayi baru lahir kurang bulan dengan kondisi imaturitas berisiko mengalami gangguan perlekatan dengan orang tua karena hospitalisasi. Tujuan karya ilmiah ini adalah menganalisis optimalisasi asuhan keperawatan pada bayi baru lahir kurang bulan dengan risiko gangguan perlekatan dengan pendekatan Teori Parent-Child Interacion. Metode karya ilmuiah ini adalah studi kasus. Terdapat lima kasus bayi baru lahir kurang bulan yang dirawat di ruang perinatologi yang diberikan asuhan keperawatan dengan pendekatan Teori Parent-Child Interaction. Aplikasi Teori Parent Child-Interaction diimplementasikan dengan memperhatikan aspek fisiologis, serta sosio-emosional. Aspek interaksi diobservasi dengan memperhatikan karakteristik ibu, karakteristik bayi dan faktor lingkungan mempengaruhi proses interaksi. Intervensi keperawatan menggunakan evidence-based nursing practice seperti promoting first relationship, sentuhan ibu, perawatan metode kanguru serta intervensi lainnya. Edukasi kepada orangt tua dengan menggunakan audiovisual terbukti efektif meningkatkan pengetahuan serta sikap dalam perawatan bayi baru lahir kurang bulan.

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Premature newborns with immaturity are at risk of experiencing attachment disorders with their parents due to hospitalization. The objective of the study is to analyze the optimization of nursing care for preterm newborns at risk of attachment disorders using the Parent-Child Interacion Theory approach. Five cases of preterm newborns who were hospitaization who were given nursing care with the Parent-Child Interaction Theory approach in this study. The application of Parent Child-Interaction Theory is implemented with cognize of physiological and socio-emotional aspects. The interaction aspect is observed to the mother's characteristics, the baby's characteristics and environmental factors that affect the interaction process. Nursing interventions use evidence-based nursing practice such as promoting first relationships, mother's touch, kangaroo method care and other interventions. Health promoting for parents using audiovisual has proven to be effective in increasing knowledge and attitudes in the care of preterm newborns."

"Latar belakang: Persalinan prematur semakin banyak dan memiliki tingkat morbiditas dan mortalitas yang tinggi. Prematur menyumbang angka kematian tertinggi selain asfiksia, infeksi dan kelainan kongenital. Korioamnionitis merupakan salah satu penyebab persalinan prematur dan berhubungan dengan kejadian sepsis neonatal awitan dini pada bayi prematur atau berat lahir rendah. Penelitian dilakukan untuk mengetahui korioamnionitis sebagai prediktor sepsis neonatal awitan dini.Metode : Penelitian kohort prospektif dilakukan bekerja sama dengan Departemen Obstetri dan Ginekologi RSCM dan RSUD Koja. Pengumpulan sampel dilakukan selama periode Maret-September 2022. Dilakukan evaluasi terhadap gejala klinis dan pemeriksaan penunjang ibu yang terkait korioamnionitis, dihubungkan dengan gejala klinis dan pemeriksaan penunjang bayi terkait sepsis neonatal awitan dini yang dirawat di NICU.Hasil : Insidens korioamnionitis sebesar 90% dan sepsis neonatus awitan dini 16%. Jenis persalinan spontan dan section caesarea dengan KPD tidak berhubungan dengan kejadian korioamnionitis (RR:1,049; IK 95% 0,982-1,120; p=1,000) and (RR:1,091; IK 95% 0,967-1,231; p=1,000).Korioamnionitis tidak berhubungan dengan sepsis neonatal awitan dini dengan p=0,358. Demam pada ibu berhubungan dengan kejadian SNAD EONS (RR:3,333: CI 95% 1,399-7,942; p=0,022)Simpulan : Korioamnionitis bukan prediktor sepsis neonatal awitan dini pada bayi usia gestasi ≤32 minggu atau bayi berat lahir ≤ 1500 gram.

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Background: Increasing number of preterm birth correlated with high morbidity and mortality rates. Prematurity contributed in high mortality rates alongside asphyxia, infections and congenital malformations. Chorioamnionitis were associated with preterm birth and early onset sepsis in preterm or low birth weight infants. Research was aimed to determine chorioamnionitis as a predictor of early onset neonatal sepsis (EONS) in preterm or low birth weight.

Methodes : Multicentre, Cohort prospective study conducted in collaboration with Obstetrics and Gynaecology Department of Cipto Mangunkusumo National Hospital (CMH) and Koja General Hospital. Samples were obtained in NICU Unit during March - September 2022. Maternal clinical symptoms and diagnostic tests for chorioamnionitis evaluated as a predictor to early onset neonatal sepsis.

Results : The incidence of chorioamnionitis and early onset neonatal sepsis were 90% and 16% respectively. Spontaneous and caesarean section delivery with PPROM is not associated with the incidence of chorioamnionitis (RR:1,049; CI 95% 0,982-1,120; p=1,000) and (RR:1,091; CI 95% 0,967-1,231; p=1,000). Chorioamnionitis is not a predictor of early onset neonatal sepsis with p=0,358. Maternal fever is associated with the incidence of EONS (RR:3,333: CI 95% 1,399-7,942; p=0,022).

Conclusion : Chorioamnionitis is not a predictor on early onset neonatal sepsis in gestational age ≤32 weeks or birth weight of ≤ 1500 grams."