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"Newborn Early Warning System (NEWS) dapat mengidentifikasi tanda perburukan melalui proses sistematisdengan memetakan tanda-tanda vital pasien. Tujuan karya ilmiah ini adalah untuk menganalisis optimalisasi   asuhan keperawatam pada sistem peringatan awal neonatus menggunakan NEWS melalui pendekatan Teori Konservasi Levine. Metode karya ilmiah ini adalah studi kasus. Terdapat lima kasus neonatus yang dirawat di ruang perinatologi yang diberikan asuhan keperawatan dengan pendekatan Teori Konservasi Levine. Aplikasi Teori Konservasi Levine memperhatikan empat konservasi yaitu energi, struktural personal dan sosial. Intevensi keperawatan yang dilakukan berdasarkan evidence based dan intervensi lainnya. Peringatan awal dengan menggunakan NEWS terbukti efektif dalam mengidentifikasi bayi yang berisiko, memudahkan untuk melakukan intervensi secara tepat, meningkatkan kualitas hidup neonatus serta dapat meminimalkan morbiditas dan mortalitas

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The Newborn Early Warning System (NEWS) can identify signs of worsening through a systematic process by mapping the patient's vital signs. The purpose of this scientific work is to analyze the optimization of nursing care in the neonatal early warning system using NEWS through Levine's Conservation Theory approach. The method of this scientific work is a case study. There were five cases of neonates who were treated in the perinatology room and were given nursing care using Levine's Conservation Theory approach. Levine's application of Conservation Theory pays attention to four conservations: energy, structural, personal, and social. Nursing interventions are based on evidence-based and other interventions. Early warning using NEWS has proven to be effective in identifying at-risk babies, making it easier to make appropriate interventions, improving the quality of life of neonates, and minimizing morbidity and mortality."

"ABSTRAK Bayi baru lahir rentan mengalami perubahan fungsi fisiologis karena bayi berada pada tahap transisi dan adaptasi. Teori Konservasi Levine mampu menjaga integritas struktur bayi selama proses adaptasi. Perubahan integritas struktur atau perubahan pada nilai fisiologis bayi namun tidak mendapatkan tindakan yang dibutuhkan menyebabkan terjadinya perburukan klinis yang signifikan dan berujung pada kematian. Newborn Early Warning System adalah suatu instrumen yang diperlukan untuk memungkinkan perawat mengetahui penurunan kondisi dan memanggil bantuan pada waktu dan bila diperlukan. Penerapan intervensi keperawatan berbasis bukti yaitu Newborn Early Warning System pada lima kasus terpilih terbukti dapat membantu dalam mengobservasi dan menjaga fungsi fisiologisselama proses adaptasi. Oleh karena itu penerapan Teori Konservasi Levine dengan menggunakan Newborn Early Warning System dirasa sangat tepat untuk mencapai keutuhan sistem tubuh bayi yang kompleks. Pendekatan ini mampu mempertahankan keutuhan bayi selama proses adaptasi. Kata kunci: Bayi baru lahir, Newborn Early Warning System, Teori Konservasi Levine. ABSTRACT Newborns are susceptible to changes in physiological function during the transition and adaptation stage. Levine Conservation Theory is able to maintain the integrity of infant structure during the adaptation process. Structural integrity changes or changes in the infant 39;s physiological value without an appropriate action may cause significant clinical deterioration and lead to death. The Newborn Early Warning System is an instrument to assist nurses to identification the deterioration of the condition and call for help on time and when it needed. The application of evidence-based nursing using Newborn Early Warning System in five selected cases has been shown it nessecary in observing and maintaining the physiological function of adaptation processes. Therefore, the application of Levine Conservation Theory by using Newborn Early Warning System is very appropriate to achieve the integrity of complex baby system, this approach is able to maintain the baby wholeness during the adaptation process. Keyword: Newborn, Newborn Early Warning System, Levine Conservation Theory."

"Pemulangan bayi dengan pemakaian selang orogastrik dapat berisiko terjadinya masalah risiko gangguan pertumbuhan karena ketidaksiapan orang tua/pengasuh dalam perawatan bayi di rumah. Studi kasus ini bertujuan untuk memberikan gambaran penerapan Model Adaptasi Roy terhadap asuhan keperawatan pada neonatus dengan risiko gangguan pertumbuhan di ruang perinatologi. Terdapat tiga kasus dengan masalah keperawatan risiko gangguan pertumbuhan yang didapat melalui pengkajian perilaku mode fisiologis dan interdependensi selama perawatan di ruang perinatologi. Tindakan keperawatan yang dilakukan dengan mengelola stimulus untuk meningkatkan dan mempertahankan perilaku adaptif pada bayi. Hasil menunjukkan bahwa Model Adaptasi Roy dapat digunakan dalam asuhan keperawatan pada bayi dengan masalah risiko gangguan pertumbuhan melalui penggunaan media video tentang pemberian minum bayi melalui selang orogastrik sebagai sarana edukasi kepada ibu sebagai pengasuh utama bayi di rumah. Terjadi respons efektif pada mode interdependensi melalui peningkatan pengetahuan dan ketrampilan ibu dalam pemberian minum bayi melalui selang orogastrik. Model Adaptasi Roy diharapkan dapat diterapkan dalam optimalisasi asuhan keperawatan bayi dengan masalah risiko gangguan pertumbuhan di ruang perinatologi.

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Infant’s discharge using orogastric tube could pose a risk growth failure due to the incapable of the parents/caregivers in caring for infant at home. This case study aims to provide an overview of the application of Roy's Adaptation Model in nursing care for infants at risk of growth failure in perinatology. There are three cases with nursing problems at risk of growth failure obtained through the assessment of physiological mode behavior and interdependence during hospitalization. Nursing intervention are carried out by managing stimuli to increase and maintain adaptive behavior in infants. The results show that Roy's Adaptation Model could be used in nursing care for infants with risk of growth failure through the use of video about infant feeding through an orogastric tube as media education for mothers as being main caregivers of infants at home. There was an effective response in the interdependence mode with the increasing mother's knowledge and skill in orogastric tube feeding. Roy Adaptation Model is expected to be applied in optimizing nursing care for infants with risk of growth failure in perinatology."

"[ABSTRAKLatar Belakang: Ketrampilan menghisap dan koordinasi antara menghisap, menelan dan bernafas belum adekuat belum adekuat pada neonatur prematur. Neonatal Oral-Motor Assessment Scale (NOMAS) adalah alat ukur yang telah sahih dan andal dalam menilai oromotor skill pada neonatus prematur. Penelitian ini ingin menguji validitas isi dan reliabilitas interrater dan test-retest yang diterjemahkan kedalam bahasa Indonesia yang belum pernah dilakukan sebelumnya.Metode : Desain penelitian ini adalah uji validasi, terdiri dari 16 subjek yang diambil berdasarkan kriteria penerimaan; neonatus prematur, kondisi umum stabil dan diizinkan oleh orang tua dengan mengisi informed consent. Data berupa video saat menyusu diawali dari saat pertama bertemu peneliti hingga usia koreksi 40 minggu. Oromotor skill dinilai dengan NOMAS yang telah diterjemahkan ke bahasa Indonesia. Validitas isi dilakukan dengan proses non-statistik; keandalan intrarater dinilai dengan uji Cohen?s Kappa dan Inter Class Correlation, keandalan interrater dengan uji Cronbach Alpha dan Inter Class Correlation.Hasil : Dari 16 neonatus didapatkan usia gestasi 32-35 minggu dan BBLR 93,75%. Secara isi NOMAS berbahasa Indonesia telah dinyatakan sesuai dengan NOMAS berbahasa Inggris. Keandalan intrarater bernilai baik hingga sempurna (K= 0,6-1,00 dan ICC= 0,4-1,00). Uji keandalan interrater bernilai rendah hingga hampir sempurna (Cronbach?s Alpha = 0,18-0,84 dan ICC= 0,05- 0,80).Kesimpulan : NOMAS berbahasa Indonesia mempunyai validitas isi dan reliabilitas yang baik untuk digunakan sebagai alat ukur oromotor skill pada neonatus prematur. Sebaiknya mengikuti pelatihan NOMAS agar lebih mengusai penggunaan alat ukur ini.

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ABSTRACTBackground : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach?s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure., Background : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach’s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure.]"

"Neonatus yang dirawat di rumah sakit sering mengalami nyeri yang disebabkan prosedur invasif. Karya ilmiah akhir ini bertujuan untuk menggambarkan penerapan teori model Konservasi Levine pada neonatus dengan gangguan rasa nyaman nyeri. Nyeri pada bayi perlu mendapatkan perhatian penting dari perawat dikarenakan dapat mempengaruhi pertumbuhan dan perkembangan bayi dimasa datang. Peningkatan kepedulian perawat melakukan menajemen non farmakologi salah satu caranya menggunakan poster. Hasil menunjukkan bahwa intervensi dengan pendekatan teori Konservasi Levine efektif meningkatkan kenyamanan pasien. Disarankan agar teori Konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan pada neonatus.

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Neonates who is hospitalized, experience pain frequenty that caused by invasif procedure. This scientific paper Aims to illustrate the application of levine conservation model theory to neonates with painful discomfort. Pain shoud become a nursing concern since it will have impact on baby rsquo;s growth and development in future. Increased care nurses do non-pharmacological management one way using posters. The result showed the intervention the evodance based on Levine Conservation theory effective to increase comfort. It suggested that levine Conservation Theory can apllied in the provision of nursing care to neonates. "

"Bayi Berat Lahir Rendah (BBLR) merupakan salah satu penyebab kematian bayi di Indonesia. BBLR dapat ditangani dengan Perawatan Metode Kanguru (PMK). Untuk itu, salah satu kemampuan yang perlu ditingkatkan bidan Musi Rawas adalah penerapan Perawatan Metode Kanguru (PMK). Penyebaran informasi PMK terhadap bidan dapat dilakukan dengan memanfaatkan potensi besar dari perkembangan media sosial (facebook, twitter, yahoo messenger/google+, whatsapp, line, dan blog). Tujuan dari penelitian ini adalah untuk mengetahui gambaran preferensi media sosial dan faktor-faktor yang berhubungan dengan preferensi media sosial tersebut sebagai sumber informasi PMK pada bidan di Musi rawas pada tahun 2016. Penelitian ini menggunakan disain cross-sectional dengan responden adalah anggota aktif IBI (Ikatan Bidan Indonesia) cabang Musi Rawas Sumatera sejumlah 197. Penelitian ini dilakukan pada bulan Mei 2016 di Musi Rawas, Sumatera Selatan. Hasil penelitian univariat menggambarkan anggota IBI Musi Rawas yang memiliki preferensi terhadap media sosial sebagai sumber informasi PMK sebesar 67,5%. Tiga bentuk media sosial yang paling banyak disukai adalah facebook (59,4%), yahoo messenger/google+ (20,3%), dan blog (11,28%). Hasil penelitian bivariat menunjukkan bahwa variabel yang berhubungan bermakna dengan preferensi media sosial sebagai sumber informasi PMK adalah faktor kebutuhan informasi PMK (p=0,006; OR=2,441; CI=1,326-4,495), keterpaparan pelatihan PMK (p=0,039; OR=2,444; CI=1,100-5,434), dan keterpaparan informasi PMK dari media sosial (p=0,000; OR=3,921; CI=2,040-7,535). Penelitian ini merekomendasikan kepada pihak IBI Musi Rawas untuk mendukung bidan dalam menggali pengetahuan lebih dalam mengenai PMK melalui media sosial yang digunakan terutama facebook. Bagi peneliti lain disarankan agar dapat meneliti ulang dengan variabel yang tidak diikutsertakan pada penelitian ini.

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Infant Low Birth Weight (LBW) is one cause of infant mortality in Indonesia. LBW can be handled with the KMC (Kangaroo Mother Care). So that, one needs to be improved capabilities Musi Rawas midwife is the application of the KMC. KMC information dissemination to the midwife can be done by utilizing the great potential of the development of social media (facebook, twitter, instagram, yahoo messenger/google+, whatsapp, line, and blogs).

The purpose of this study is to describe the social media preferences and factors associated with preference social media as a source of KMC information for midwives Musi Rawas. This study used a cross-sectional design. The respondents are consist of active members of IBI (Indonesian Midwives Association) branch Musi Rawas with 197 samples. This study was conducted on May, 2016 in Musi Rawas, South Sumatra.

The results of the univariate analysis describe the IBI Musi Rawas members who have a preference to social media as a source of KMC information is 67.5%. Three forms of social media among the most preferred is facebook (59.4%), yahoo messenger / google + (20.3%), and blogs (11.28%). The results of the bivariate analysis showed that variables related significantly with preferences of social media as a source of KMC information are information needs KMC (p = 0.006; OR = 2.441; CI = 1.326 to 4.495), exposure KMC training (p = 0.039; OR = 2.444; CI = 1.100 to 5.434), and exposure KMC information from social media (p = 0.000; OR = 3.921; CI = 2.040 to 7.535).

The study recommends to the IBI Musi Rawas to support midwives in digging deeper knowledge about KMC through social media are used primarily through facebook. For other researchers suggested in order to examine the variables that are not included in this study."

"ABSTRAKKondisi hiperbilirubinemia pada neonatus dapat dipengaruhi oleh berbagai faktor, salah satunya adalah polimorfisme genetik, seperti polimorfisme gen terkait, yaitu UGT1A1 dan OATP2/SLCO1B1. Polimorfisme nukleotida tunggal c.388A>G pada gen OATP2/SLCO1B1 mengakibatkan terjadi penurunan aktivitas kerja transporter Organic Anion Transporter Protein 2 OATP2 yang berfungsi memindahkan bilirubin dari darah ke hati dalam tahapan metabolisme bilirubin. Penelitian ini bertujuan untuk melihat profil polimorfisme c.388A>G pada neonatus penderita hiperbilirubinemia risiko rendah di Rumah Sakit Cipto Mangunkusumo RSCM. Analisis dilakukan terhadap 38 sampel neonatus yang lahir pada periode Januari-Agustus 2017, dengan kadar bilirubin ge-5 mg/dL tetapi G gen OATP2/SLCO1B1 di RSCM ini merupakan studi yang belum pernah dilaporkan sebelumnya, dan hasilnya adalah dominan tipe polimorfisme utama berupa homozigot G/G pada neonatus dengan hiperbilirubinemia risiko rendah.

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ABSTRACTThe condition of hyperbilirubinemia on neonates could be influenced by various factors, one of them is the genetic polymorphism, such as the related gene polymorphisms UGT1A1 and OATP2 SLCO1B1. This single nucleotide polymorphism SNP c.388A G at the OATP2 SLCO1B1 gene causes the decline in the activity of Organic Anion Transporter Protein 2 OATP2, which is responsible in removing bilirubin from the blood to the liver in the stages of bilirubin metabolism. This research aimed to find the polymorphism profile of c.388A G on low risk hyperbilirubinemia neonates at Rumah Sakit Cipto Mangunkusumo RSCM . Analysis was done on 38 neonates rsquo samples who were born during January ndash August 2017, with bilirubin concentration between 5 mg dL and 12 mg dL, using the Polymerase Chain Reaction ndash Restriction Fragment Length Polymorphism PCR RFLP method with the TaqI restriction enzyme. Analysis results from 38 samples showed that there are 73.69 samples with homozygote type G G , 21.05 samples with heterozygote type A G , and only 5.06 samples with wildtype A A. This is the first report on c.388A G polymorphism study on gene OATP2 SLCO1B1 at RSCM result determined that the major polymorphism with homozygote type G G is the dominant type on neonates with low risk hyperbilirubinemia."

"Salah satu faktor yang menyebabkan hiperbilirubinemia tak terkonjugasi adalah mutasi pada gen UGT1A1 yang menyandikan enzim UDP-glukuronosiltransferase, berupa single nucleotide polymorphism dari asam amino glisin menjadi asam amino arginin di posisi kodon 71 Gly71Arg , sehingga terjadi penurunan fungsi enzim tersebut sebagai pengatalisis bilirubin tak terkonjugasi menjadi bilirubin terkonjugasi. Penelitian ini bertujuan untuk mengetahui profil polimorfisme Gly71Arg gen UGT1A1 pasien neonatus RSUD M. Yunus-Bengkulu dengan hiperbilirubinemia tak terkonjugasi, khususnya yang berberat badan lahir normal. Sampel berupa darah dari 20 neonatus di RSUD M. Yunus Bengkulu yang telah diperiksa kadar bilirubinnya dengan Bilistick, diekstraksi untuk mendapatkan DNA genomiknya, kemudian dianalisis dengan metode PCR-RFLP menggunakan enzim AvaII. Terdapat 8 sampel DNA yang terdigesti 40 menunjukkan bahwa DNA tersebut normal dan membawa alel glisin, sedangkan tidak terdapat DNA yang tidak terdigesti, yaitu yang mengalami mutasi dengan membawa alel arginin. Namun terdapat 12 sampel DNA heterozigot 60 yang menunjukkan adanya alel glisin dan arginin bersamaan di dalam DNA tersebut. Dengan demikian, mutasi Gly71Arg pada ekson 1 gen UGT1A1 hanya memiliki sedikit pengaruh pada peningkatan kadar hiperbilirubinemia tak terkonjugasi pada neonatus di Bengkulu.

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One of many factors that causes unconjugated hyperbilirubinemia is the existence of mutations in the UGT1A1 gene that encode the UDP glukuronosiltransferase enzyme, where a single nucleotide polymorphism that causes the amino acid glycine to change into amino acid arginine at codon position 71 Gly71Arg , decreases the enzyme from functioning properly as a catalyzer of unconjugated bilirubin into a conjugated bilirubin. This study is aimed to determine the profile of polymorphism Gly71Arg in the UGT1A1 gene of neonatal patients RSUD M. Yunus Bengkulu with unconjugated hyperbilirubinemia, especially with normal birth weight. Samples of blood from 20 newborns in RSUD M. Yunus Bengkulu which had been checked its bilirubin concentration with Bilistick, were extracted to obtain the genomic DNA, then analyzed by PCR RFLP method using the AvaII enzyme. The digested DNA with total of 8 samples 40 indicated that the DNA are normal and carrying the allele glycine, while there is no the undigested DNA which showed the mutation with the allele arginine. But there are 12 heterozygous DNA samples 60 that showed allele glycine and arginine together in the DNA. Therefore, Gly71Arg mutation in exon 1 of UGT1A1 gene has a little effect of the unconjugated hyperbilirubinemia enhancement in neonatal in Bengkulu."

"Ketahanan hidup bayi didefinisikan sebagai kemampuan bayi untuk bertahan hidup menjalani kehidupan sampai dengan berusia 1 tahun. Ketahanan hidup bayi merupakan kebalikan dari kematian bayi yang merupakan kematian yang terjadi antara setelah lahir sampai bayi belum tepat berusia 1 tahun. Tahun 2012, AKB Indonesia sebesar 32 per-1000 kelahiran hidup. Angka ini tergolong tinggi jika dibandingkan Negara tetangga dengan kondisi sosial ekonomi yang sama. Di sisi lain, kesenjangan AKB juga terjadi pada tingkat sosial ekonomi di Indonesia. Sosial ekonomi merupakan faktor primer penentu ketahanan hidup bayi. Status sosial ekonomi ini akan mempengaruhi ketahanan hidup bayi melalui faktor maternal, gizi, kondisi bayi saat lahir, pengendalian penyakit dan lingkungan. Penelitian ini bertujuan untuk mengetahui gambaran ketahanan hidup bayi di Indonesia dan determinan yang mempengaruhinya berdasarkan data SDKI 2012. Penelitian inimenggunakan data SDKI 2012.Dari hasil analisis diperoleh bahwa ketahanan hidup bayi di Indonesia tahun 2012 adalah sebesar 97,8%. Ketahanan hidup bayi menurun tajam pada usia 1 bulan pertama, dimana proporsi kematian bayi pada masa neonatal adalah sebesar 53,8% dan kematian neonatal terbanyak terjadi pada usia 0-7 hari, sebesar 80%. Berdasarkan hasil regresi cox time dependent, variabel yang masuk ke dalam model adalah umur melahirkan (20-35 tahun, HR=1,9), pekerjaan (karyawan/pegawai, HR=2,2; informal/industri, HR=3,3; sektor pertanian, HR=2,1), berat bayi lahir (<2500 gram, HR=5,9; tidak timbang, HR=2,0), pemberian makanan prelakteal (HR=1,5), pemeriksaan paska persalinan (tidak periksa, HR=2,2). Terdapat interaksi waktu dengan efek berat lahir rendah dengan pemeriksaan paska salin pada model ketahanan bayi yang diperoleh.

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Infant survival is defined as the ability of infants to survive through life up to 1 year old. Infant survival is the opposite of infant mortality is the death that occurred between after birth until the baby has not exactly 1 year old. In 2012, Indonesia IMR reported as 32 per 1,000 live births. This figure is relatively high compared to the Asia countries with similar socio-economic conditions. Moreover, the gap of IMR also occurred in socio-economic level within Indonesia. Socio-economic status is the primary factor determining survival of infants. Socio-economic status will affect infant survival through maternal factors, nutrition, baby's condition at birth, disease control and environment. This study aims to reveal the infant survival in Indonesia and its determinants based on data IDHS 2012. This study uses Indonesia Demographic and Health Survey 2012.The result shows that probability of infant survival in Indonesia amounted to 97,8%. Infant survival decreased sharply in the first months of age 1, wherein the proportion of infant deaths in the neonatal period amounted to 53.8% and neonatal deaths occurred in the age of 0-7 days, by 80%. Based on the results of time-dependent Cox regression, the variables entered into the multivariate model were maternal age when gave birth (20-35 years, HR = 1.9), Maternal employment (officer/employee, HR = 2.2; informal sector/industrial, HR = 3.3 ; agriculture, HR = 2.1), birth weight (<2500 grams, HR = 5.9; not weigh, HR = 2.0), prelakteal feeding (HR = 1.5), post-delivery checked (not checked, HR = 2.2). There is interaction between time with the effects of low birth weight and postdelivery checked in the multivariate model obtained."