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"Latar belakang: Sekitar 10,6% persalinan di seluruh dunia adalah persalinan prematur. Pemantauan pertumbuhan yang adekuat dalam perawatan bayi prematur penting untuk mencegah kelebihan atau kekurangan asupan nutrisi, yang saat ini dapat dilakukan menggunakan kurva Fenton 2013 atau kurva INTERGROWTH-21st. Karena perbedaan metodologi dan populasi yang terlibat pada proses penyusunan kedua kurva, hasil yang didapatkan dapat berbeda. Oleh karena itu, dibutuhkan penelitian untuk membandingkan penggunaan kedua kurva tersebut pada populasi bayi prematur di Indonesia.Metode: Penelitian kohort prospektif ini melibatkan subjek bayi prematur dengan usia gestasi lahir 28–36 minggu di RSUPN Dr. Cipto Mangunkusumo selama Juni–September 2022. Seluruh subjek dipantau dengan kurva Fenton dan kurva INTERGROWTH-21st selama 2 minggu, dan dievaluasi perbedaan persentil berat badan, panjang badan, dan lingkar kepala, proporsi SGA, AGA, dan LGA, dan perbandingan proporsi subjek dengan EUGR pada usia 2 minggu.Hasil: Dari 131 subjek yang memenuhi kriteria inklusi, didapatkan persentil berat badan, panjang badan, dan lingkar kepala lebih tinggi secara bermakna pada kurva INTERGROWTH-21st dibandingkan kurva Fenton. Sebanyak 17 dari 36 (47,2%) subjek yang tergolong SGA berdasarkan kurva Fenton pada saat lahir didapatkan lebih sesuai dengan AGA berdasarkan kurva INTERGROWTH-21st, dan 30 dari 89 (33,7%) subjek yang tergolong AGA berdasarkan kurva Fenton saat lahir didapatkan lebih sesuai dengan LGA berdasarkan kurva INTERGROWTH-21st. Subjek yang lahir sesuai AGA tetapi mengalami EUGR pada usia 2 minggu didapatkan lebih tinggi secara bermakna pada kurva Fenton (14,7%) dibandingkan kurva INTERGROWTH-21st (8,9%, p <0,001).Kesimpulan: Insidens SGA didapatkan lebih tinggi pada kurva Fenton dibandingkan INTERGROWTH-21st, sedangkan LGA lebih tinggi pada kurva INTERGROWTH-21st dibandingkan kurva Fenton. Pada usia kronologis 2 minggu, insidens subjek dengan EUGR lebih tinggi secara bermakna dengan kurva Fenton dibandingkan kurva INTERGROWTH-21st.

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Background: Approximately 10.6% of all deliveries worldwide are premature. Adequate growth monitoring is essential in the care of preterm infants to prevent excessive or undernutrition, which can currently be performed using the Fenton 2013 curve or the INTERGROWTH-21st curve. Due to differences in the methods and study population involved in the development of these two curves, there is a high possibility of obtaining different results. Therefore, a study is warranted to compare the two curves in the Indonesian premature infant population.

Methods: This prospective cohort study involves premature neonates with gestational age of 28–36 weeks born in Cipto Mangunkusumo Hospital during June–September 2022. The growth of all subjects were plotted on the Fenton and INTERGROWTH-21st curves for 2 weeks, and differences in weight, height, and head circumference percentiles, proportion of SGA, AGA, and LGA, and proportion of infants with weight below the 10th percentile between the two curves at 2 weeks were also compared.

Results: Among 131 subjects meeting the inclusion criteria, the weight, height, and head circumference percentiles were significantly higher on the INTERGROWTH-21st curve compared to the Fenton curve. As many as 17 of 36 (47.2%) subjects classified as SGA on the Fenton curve were AGA on the INTERGROWTH-21st curve, and 30 of 89 (33.7%) subjects classified as AGA on the Fenton curve were LGA on the INTERGROWTH-21st curve. The prevalence of infants without SGA at birth but classified as EUGR at 2 weeks was significantly higher on the Fenton curve (14.7%) than the INTERGROWTH-21st curve (8.9%, p <0.001).

Conclusion: The incidence of SGA was significantly higher with the Fenton curve, whereas LGA was significantly higher with the INTERGROWTH-21st curve. At 2 weeks, the proportion of subjects with EUGR was significantly higher with the Fenton curve compared to the INTERGROWTH-21st curve."

"Breastmilk is the best nutrition for infant but giving only breastmilk for preamature infants older than 2 weeks could not comply the needs and has to be fortified Human milk fortifier HMF is very recommended to fortify breastmilk In west Sumatera including DR M Djamil Hospital HMF was unreachable and expensive At certain hospital in Africa and several Hospital in United States they exclusively use fortified breastmilk with Post Discharge Formula PDF Objective To compare the weight gain among premature infants receiving fortified breastmilk with PDF and premature formula milk and also to observe the adverse event Methods A 4 weeks experimental study on premature infants gestational age ge 28 until 37 weeks who receive fortified breastmilk with PDF and some of them received premature formula milk acted as a control from March until December 2015 in DR M Djamil Hospital West Sumatera Results Data was obtained from 30 sample for each group intervention and control Sample baseline characteristic such as sex gestational age GA birth weight and previous illness history was indifferent statistically The mean of birth weight in control group was 1643 grams the mean of weight at the initial study was 1631 grams and the mean of birth weight at the end of study 4 weeks was 2573 grams The mean of birth weight in intervention group was 1682 grams the mean of weight at the initial study was 1722 grams and the mean of birth weight at the end of study 4 weeks was 2775 grams The mean of time to reach full feed condition initial study in control group was 14 days and 18 days in intervention group The mean of weight gain during 4 weeks was 958 grams in control group and 1053 grams in intervention group p 0 22 There was no adverse event found in infants received both breastmilk fortified with PDF and premature formula milk Conclusion It appears that weight gain of premature infants who receive breastmilk fortified with PDF is indifferent statistically compared with premature infants who receive formula milk There is no adverse event found in this study"

"[ABSTRAKBayi prematur dapat mengalami hambatan kenaikan berat badan yang disebabkan oleh usia gestasi, penyakit penyerta, dan pengalaman nyeri atau stres. Hambatan kenaikan berat badan dapat diatasi dengan asuhan keperawatan yang tepat dalam pemenuhan kebutuhan nutrisi pada bayi prematur. Asuhan keperawatan dengan Model Konservasi Levine telah digunakan pada aplikasi praktik residensi di Ruang Neonatus Rumah Sakit Cipto Mangunkusumo dalam menganalisis kenaikan berat badan bayi prematur pada lima kasus terpilih mulai dari Bulan Maret-Mei tahun 2015. Analisis kasus didapatkan dari tahap pengkajian, tropikognosis, hipotesis, intervensi, dan evaluasi. Tropikognosis yang telah teridentifikasi yaitu risiko gangguan pemenuhan kebutuhan nutrisi. Intervensi telah dilakukan berdasarkan prinsip konservasi dan hasil evaluasinya yaitu bayi prematur mengalami kenaikan berat badan dengan konservasi energi. Kenaikan berat badan pada bayi prematur menunjukkan keberhasilan dari penerapan asuhan keperawatan berbasis Model Konservasi Levine.

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ABSTRACTThe preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. ;The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine?s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine?s Conservation Model. , The preterm infant can has an obstacle of increasing weight which is caused by gestational age, health problems which followed and pain/ stress experience. The obstacle of increasing weight can be handled with giving nursing care in proper nutrition needs. Nursing care with Levine’s Conservation Model has been applied in residence practice application in neonates wards Cipto Mangunkusumo hospital to analyze increasing weight of preterm infant in five selected cases start from March until May 2015. Case analyze is founded from assessment, trophicognosis, hypothesis, intervention, and evaluation. Trophicognosis which identified was disturbance risk in fullfil nutrition needs. Intervention were done based on conservation principle and the result of evaluation that preterm infant has increasing weight with energy conservation. Increasing weight in preterm infant showed a successful application of nursing care based on Levine’s Conservation Model. ]"

"Intoleransi minum merupakan masalah yang umum terjadi pada bayi prematur. Tujuan penulisan Karya Ilmiah Akhir ini adalah memberikan gambaran penerapan Model Konservasi Levine pada bayi prematur dengan intoleransi minum dan gambaran pelaksanaan Praktik Residensi Keperawatan Anak. Model Konservasi Levine berfokus pada peningkatan adaptasi melalui prinsip konservasi untuk mencapai integritas diri. Penerapan Model Konservasi Levine tertuang dalam lima kasus terpilih. Pada lima kasus terpilih tersebut ditemukan masalah gangguan pemenuhan kebutuhan nutrisi yang disebabkan oleh intoleransi minum. Adapun masalah keperawatan lainnya adalah bersihan jalan napas tidak efektif, gangguan pola napas, gangguan termoregulasi, risiko infeksi, risiko gangguan perkembangan dan gangguan proses keluarga. Masalah-masalah tersebut dapat memperberat intoleransi minum dan menghambat proses pemulihan pada bayi prematur. Asuhan keperawatan pada kasus terpilih diberikan oleh residen dengan melaksanakan perannya sebagai pemberi asuhan, pendidik, konsultan, koordinator, pengambil keputusan etik, legal, dan sebagai peneliti.

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Feeding intolerance is a common problem in premature infants. The purpose of this Final Scientific Work is to describe the application of Levine Conservation Model in preterm infants with feeding intolerance and the implementation of Pediatric Nursing Residency Practice. Levine Conservation Model focuses on the adaptation improvement through conservation principles to achieve wholeness. Levine Conservation Model was implemented in five selected cases. In the five selected cases, there was a nutritional intake problem caused by feeding intolerance. The other problems were ineffective airway clearance, ineffective breathing pattern, ineffective thermoregulation, risk for infection, risk for developmental disorder and altered family process. These problems can aggravate the feeding intolerance and inhibit the healing process of premature infants. The nursing care to selected cases was given by the resident by implementing the roles as a caregiver, an educator, a consultant, a coordinator, an ethical and legal decision maker, and a researcher."

"ABSTRAKDisertasi ini membahas pengaruh asfiksia pada bayi prematur terhadap kualitas hidup anak usia 2-4 tahun, dengan desain kohort retrospektif. Data asfiksia diperoleh dari catatan medik RSUP Dr. Sardjito, sedangkan kualitas hidup anak dinilai menggunakan PedsQL. Analisis data menggunakan regresi cox.Hasil penelitian menunjukkan ada pengaruh asfiksia terhadap kualitas hidup anak dengan RR: 2,2 (CI: 1.19-4.08). Asfiksia berpengaruh pada fungsi fisik dengan RR: 2,4 (CI: 1.33-4.36) dan fungsi sosial RR: 2,4 (CI: 1.36-4.15) tetapi tidak bermakna pada fungsi emosi RR: 1.4 (CI: 0.86-2.29) dan fungsi sekolah RR: 1.2 (CI: 0.63-2.31).

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ABSTRACT

This dissertation discusses the association of asphyxia in premature infants to the quality of life of children aged 2-4 years with retrospective cohort design. Asphyxia data were obtained from the medical records of Dr. Sardjito hospital, while the quality of life of children data were assessed using PedsQL. Data were analyzed using Cox regression.

The results of study showed strong association of asphyxia to the quality of life of children with RR: 2.2 (CI: 1:19 to 4:08). Risk of asphyxia effects on physical function was RR: 2.4 (CI: 1:33 to 4:36) and on social functioning was RR: 2.4 (CI: 1:36 to 4:15). However, the risk was not significant to the emotional function with RR: 1.4 (CI: 0.86-2.29 ) and school functions RR: 1.2 (CI: 0.63-2.31)."

"kelahiran prematur merupakan kelahiran dengan usia gestasi sebelum 37 minggu. Angka kelahiran prematur terus meningkat secara global selama dua dekade terakhir. Setiap tahun, sekitar 15 juta bayi lahir prematur, yang merupakan lebih dari 1 dari setiap 10 bayi, dan hampir 1 juta anak meninggal akibat komplikasi yang terkait dengan kelahiran prematur. Persalinan prematur menghambat pasokan nutrisi melewati plasenta yang penting untuk pertumbuhan dan perkembangan janin sehingga bayi prematur juga berjuang untuk memenuhi kebutuhan dasar hidup mereka akan makanan oral hal ini juga disebabkan koordinasi fungsi menghisap, dan fungsi menelan pada bayi prematur masih rentan. Sering kali kita jumpai bayi prematur terpasang selang orogastric dikarenakan fungsi menghisap dan menelan belum sempurna namun penggunaan selang orogastric untuk nutrisi optimal dalam jangka waktu yang lama tidak dianjurkan. Untuk meningkatkan efektifitas pemberian makan oral pada bayi prematur dapat diberikan rangsangan motorik seperti premature infant oral motor intervention (PIOMI) yang terdiri dari berbagai stimulasi oral dan dapat membantu bayi mengembangkan menghisap atau sucking. PIOMI dilakukan selama dua kali sehari berturut-berturut selama perawatan bayi dengan durasi Tindakan selama lima menit. Hasil evaluasi menunjukkan PIOMI efektif dalam meningkatkan refleks hhisap dan menelan bayi sehingga bayi menunjukkan kesiapan minum asi peroral. Pengukurannya dilakukan melaui penilaian skor Premature Oral Feeding readiness Asessment Scale (POFRAS) dan didapatkan peningkatan skor tiap harinya. PIOMI mampu meningkatkan kesiapan makan/ minum bayi dari enteral ke oral setelah PIOMI dilakukan secara rutin.

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Premature birth is any birth before 37 weeks. Preterm birth rates have continued to increase globally over the past two decades. Each year, approximately 15 million babies are born prematurely, which is more than 1 in every 10 babies, and nearly 1 million children die from complications related to premature birth. Premature birth hampers the supply of nutrients through the placenta which is important for the growth and development of the fetus so that premature babies also struggle to fulfill their basic life needs for oral food. This is also due to the coordination of sucking and swallowing functions in premature babies who are still vulnerable. We often find premature babies with orogastric tubes installed because their sucking and swallowing functions are not yet perfect, but the use of orogastric tubes for optimal nutrition for long periods of time is not recommended. To increase the effectiveness of oral feeding in premature babies, motor stimulation can be given, such as premature baby oral motor intervention (PIOMI), which consists of various oral stimulations and can help babies develop sucking or sucking. PIOMI is performed twice a day in a row during baby care with a duration of five minutes. The evaluation results show that PIOMI is effective in improving the baby's sucking and swallowing reflexes so that the baby shows readiness to drink breast milk orally. The measurement was carried out by assessing the Premature Oral Feeding Readiness Assessment Scale (POFRAS) score and an increase in the score was obtained every day. PIOMI is able to increase the baby's readiness to eat/drink from enteral to oral after PIOMI is carried out routinely. "

"Bayi prematur sangat rentan mengalami gangguan integritas kulit berupa lukatekan terutama pada telinga. Tujuan penelitian ini adalah untuk mengetahuiefektivitas penggunaan bantal kacang untuk pencegahan luka tekan grade I padatelinga bayi prematur. Desain penelitian ini menggunakan “quasi experimentposttest only with control group”, yang melibatkan 30 bayi prematur di ruangperinatologi. Hasilnya menunjukkan tidak ada perbedaan yang bermakna proporsikejadian luka tekan grade I pada telinga bayi prematur pada kelompok intervensidan kelompok kontrol (p value=0,65, α=0,05). Rekomendasi dari penelitian iniadalahperawatan dengan bantal tetap bermanfaat namun perlu dilakukanoptimalisasi alih baring.

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Preterm baby was very vulnerable to get skin integrity breakdown as pressure

ulcer particularly on the ear. The purposed of this study was to identify the

effectiveness using peanut pillow to prevent pressure ulcer on ears of preterm

baby. The design of this study was “experiment posttest only with control group”,

involving 30 preterm baby in the neonatology unit. The result showed there was

no significant differences proportion of pressure ulcer in the intervention group

and control group (p value=0,65, α=0,05). This study recommended that using

peanut pillow give the advantages but it is needed to optimize changing position."

"Kelahiran bayi prematur dan perawatan di ruang rawat intensif neonatusmerupakan peristiwa yang menyebabkan sumber stres pada orang tua khususnyaibu. Penelitian ini bertujuan untuk mendapatkan pemahaman yang mendalammengenai pengalaman ibu selama perawatan masa awal kehidupan bayi prematurdi ruang rawat intensif neonatus RSUP Dr. Soeradji Tirtonegoro Klaten. Desain penelitian kualitatif dengan pendekatan fenomenologi ini pada delapan partisipan. Analisis data menggunakan metode Colaizzi dan menghasilkan tujuh tema penelitian, yaitu: reaksi ibu, proses berduka, dampak perawatan bayi prematur, koping diri ibu, upaya ibu untuk meningkatkan hubungan kelekatan (bonding attachment), dukungan terhadap ibu, dan harapan selama perawatan bayi prematur.

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The birth and treatment of premature infants in the neonatal intensive care unit is the event that makes it the source of stress to parents especially the mother. This study aims to gain a deeper understanding of the experience of mother during the early life of premature infants in the neonatal intensive care unit of Dr. Soeradji

Tirtonegoro Central Hospital, Klaten. This qualitative research design with phenomenology approach took eight participants. The data analysis uses Colaizzi method and produced seven research themes, namely: the mothers? reaction, the grieving process, the impact of premature infant care, mother?s self ?coping efforts, the mothers? attempts to improve the close and attached relationship (bonding attachment), the support for the mother, and expectations for the care of premature infants.

"

"Bayi prematur dengan alat bantu nafas ventilasi mekanik memerlukan tindakan bersihan jalan napas. Penelitian menggunakan quasy experiment pada dua kelompok A dan B untuk mengetahui perubahan saturasi sebelum, selama dan setelah tindakan bersihan jalan napas. Kelompok A open suction dan B closed suction masing-masing 30 dan 10 bayi prematur. Analisis menggunakan uji statistik repeated Anova yang dilanjutkan dengan post hoc paired wise comparison. Tindakan bersihan jalan napas menggunakan open suction nilai p kurang 0,001 secara statistik terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi, sedangkan closed suction nilai p kurang 0,001 terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi. Penggunaan alat pengisap lendir closed suction menunjukan keadaan saturasi oksigen lebih stabil, sehingga lebih disarankan untuk tindakan bersihan jalan napas pada bayi prematur. Penggunaan closed suction akan efektif pada keadaan sekret yang encer.

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Premature infant with a mechanical ventilation need airway clearance. The study used quasy experiment in two groups A and B to provide information before and after airway clearance. Group A open suction and B closed suction each of 30 and 10 premature infants. The analysis used the statistical repeated Anova test followed by post hoc paired wise comparison. Airway clearance using an open suction with p.value 0.001, statistically, there is a mean actually oxygen saturation, while closed suction p value of less than 0.001 is the average actually oxygen saturation. The used closed suction shows a more stable oxygen saturation state, more for airway clearance in premature infants. The use of the closed suction will be effective in the state of dilute secretions."

"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."