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Abstrak :
Angka kematian ibu (AKI) di Indonesia yang masih tinggi menyebabkan sulit tercapainya salah satu poin Millenium Development Goals. Salah satu penyebab AKI yang tinggi adalah kurang baiknya kualitas pelayanan antenatal (ANC) dan ketidak tahuan ibu terhadap tanda bahaya kehamilan. Penelitian ini mencari hubungan kualitas ANC dengan pengetahuan dan sikap ibu hamil terhadap tanda bahaya kehamilan. Subjek penelitian ini sebanyak 109 ibu hamil yang berkunjung ke Puskesmas Kecamatan Koja pada Bulan Maret 2013. Kualitas ANC dinilai melalui observasi pada saat pelayanan, sementara pengetahuan dan sikap dinilai melalui kuesioner yang diajukan secara terpimpin. Penelitian ini mendapatkan bahwa terdapat hubungan bermakna antara kualitas ANC dengan pengetahuan ibu hamil terhadap tanda bahaya kehamilan (p=0,011). Ditemukan pula hubungan bermakna antara pendidikan (p=0,038) dan pengalaman mengikuti penyuluhan tanda bahaya kehamilan (p=0,043) dengan pengetahuan ibu hamil terhadap tanda bahaya kehamilan. Selain itu, terdapat hubungan bermakna antara jumlah kehamilan ≤ 2 (p=0,042) dan datang ke ANC ditemani (p=0,011) dengan sikap ibu hamil terhadap tanda bahaya kehamilan. Kualitas ANC perlu ditingkatkan agar pengetahuan ibu hamil terhadap tanda bahaya kehamilan semakin membaik. Terdapat hubungan antara beberapa faktor sosiodemografis terhadap pengetahuan dan sikap ibu hamil terhadap tanda bahaya kehamilan. Penelitian lanjutan diperlukan untuk menguji hubungan variabel lain yang dapat mempengaruhi kualitas pelayanan antenatal. ......The maternal mortality rate (MMR) in Indonesia that is still high causing one of the points the Millennium Development Goals becomes difficult to achieve. One of the causes is the lack of good quality of antenatal care (ANC), also the lack of knowledge of the danger signs of obstetric. This research finds relationship between quality of ANC and knowledge and attitude of pregnant woman towards danger signs of obstetric. Subjects were 109 pregnant women who visited Puskesmas Kecamatan Koja in March 2013. ANC Quality assessed through observation during the service, while knowledge and attitudes were assessed through a questionnaire guided by researcher. It was found that there is a significant relationship between the quality of ANC and maternal knowledge about the danger signs of obstetric (p = 0.011). Also found a significant relationship between education level (p = 0.038) and experience in danger sign of obstetric counseling (p = 0.043) with maternal knowledge of the danger signs of obstetric. In addition, there is a significant relationship between number of pregnancies ≤ 2 (p = 0.042) and being accompanied while having ANC (p = 0.011) with maternal attitude toward danger signs of obstetric. Quality of ANC needs to be improved in order to increase pregnant women’s knowledge about danger signs of obstetric. There are relationships between several sociodemographic factors of pregnant women and knowledge and attitude of pregnant women toward the danger signs of pregnancy. Further research is needed to examine the relationship of other variables that may affect the quality of antenatal care.

Abstrak :
Latar belakang: Enterokolitis nekrotikans merupakan salah satu komplikasi pada bayi prematur dengan angka mortalitas tinggi. Patogenesis terjadinya enterokolitis nekrotikans hingga kini belum dipahami namun bersifat multifaktorial. Berbagai penelitian mengaitkan enterokolitis nekrotikans dengan transfusi sel darah merah. Salah satu upaya untuk mencegahnya adalah dengan melakukan puasa saat transfusi, namun hingga kini masih bersifat kontroversial. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan puasa saat menjalani transfusi sel darah merah dengan kejadian enterokolitis nekrotikans pada bayi prematur. Metode: Penelitian menggunakan desain studi kohort retrospektif dilakukan di Rumah Sakit Cipto Mangunkusumo menggunakan data rekam medis. Bayi prematur yang dirawat di Unit Perinatologi RSCM dalam periode Januari 2019 hingga Desember 2023 dan menjalani transfusi sel darah merah, serta memenuhi kriteria inklusi dan eksklusi diikutsertakan dalam penelitian. Subyek kemudian dikelompokkan berdasarkan puasa atau tidak puasa saat menjalani transfusi sel darah merah. Diagnosis enterokolitis nekrotikan ditegakkan melalui hasil foto polos abdomen. Dilakukan pula pencatatan terhadap status maternal, usia gestasi, data antropometri saat lahir, skor APGAR usia 5 menit, jenis nutrisi enteral saat dilakukan transfusi sel darah merah. Hasil: Sebanyak 240 bayi prematur yang menjalani transfusi sel darah merah diikutsertakan dalam analisis. Seratus empat puluh empat bayi lelaki (60,0%), dengan rerata usia gestasi 31 (SD 2,69) minggu dan median berat lahir 1.256 (RIK 1.005-1.653) gram. Enterokolitis nekrotikans ditemukan pada 23,75% subyek dan EKN awitan dini lebih banyak ditemukan yaitu sebanyak 54,39% subyek. Proporsi bayi yang dipuasakan mengalami EKN lebih rendah dibandingkan yang tidak dipuasakan (22,09% dan 27,94%). Tidak ditemukan hubungan bermakna secara statistik antara kejadian EKN pada kelompok puasa dibandingkan kelompok tidak puasa saat menjalani transfusi sel darah merah (RR 1,081 (IK 95% 0,913-1,279). Kesimpulan: Puasa saat transfusi sel darah merah tidak memiliki hubungan bermakna secara statistik menurunkan kejadian enterokolitis nekrotikans. ......Background: Complications due to prematurity are major problems for premature infants. Necrotizing enterocolitis has been one of the most considered complication with high mortality rate. Pathogenesis of necrotizing enterocolitis yet to be fully understood, however multiple factors were proven to be associated. Transfusion associated necrotizing enterocolitis has been studied in many researches. Withholding feeds during red blood cell transfusion were postulated to decrease the rate of necrotizing enterocolitis in premature infants, however controversy still found among the research published. Objective: This study aimed to evaluate the association between withholding feeds during red blood cell transfusion and incidence of necrotizing enterocolitis in premature infants. Method: We conducted a retrospective cohort study in Cipto Mangunkusumo Hospital. Premature infants admitted from January 2019 to December 2023 who received red blood cell transfusion were selected according to inclusion and exclusion criteria. Subjects were divided into two group by looking at withholding feeds status during transfusion or fed during transfusion. Necrotizing enterocolitis was diagnosed by radiologist using abdominal radiograph. Maternal status, gestational age, birth anthropometric measurement, 5-minutes APGAR score, and type of enteral nutrition (breast milk or formula) while receiving red blood cell transfusion were recorded. Results: Two hundred and forty subjects included in this study. Among all subjects, male infants 144 (60%), mean gestational age was 31 (SD 2,26) weeks, and median birthweight was 1.256 (IQR 1,005-1.653) grams. Necrotizing enterocolitis were slightly lower in withholding feeds during transfusion group compared to fed group (22,09% and 27,94%, respectively). No association was found between withholding feeds during red blood cell transfusion compared to fed during transfusion with incidence of necrotizing enterocolitis (RR 1,081 (95% CI 0,913-1,279). Conclusion: Withholding feeds during red blood cell transfusion did not significantly decrease the incident of necrotizing enterocolitis in this study.