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Abstrak :
ABSTRAK Neonatus yang dirawat di rumah sakit sering mendapatkan tindakan yang menimbulkan nyeri. Sukrosa dan nonnutritive sucking (NNS) merupakan analgesik nonfarmakologi. Tujuan penelitian adalah mengetahui efektifitas sukrosa dan NNS terhadap respon nyeri dan lama tangisan neonatus yang dilakukan tindakan invasif. Desain penelitian adalah quasi experimental, rancangan postest only control group design. Teknik pengambilan sampel dengan nonprobability sampling jenis consecutive sampling. Sampel penelitian berjumlah 45 neonatus aterm yang terbagi menjadi tiga kelompok, tiap kelompok 15 neonatus. Hasil penelitian menunjukkan respon nyeri tidak berbeda bermakna antara kelompok sukrosa dan NNS (p=0,635). Lama tangisan tidak berbeda bermakna antara kelompok sukrosa dan NNS (p=0,848). Umur merupakan variabel perancu yang memberikan pengaruh pada respon nyeri. Pemberian sukrosa maupun NNS terbukti dapat menurunkan nyeri dalam manajemen nyeri nonfarmakologi pada neonatus yang dilakukan prosedur invasif.

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ABSTRACT Hospitalized neonates may experience pain caused by invasive procedures. Sucrose and non-nutritive sucking are non-pharmacological analgesics. This study aimed to examine the effectiveness of sucrose and non-nutritive sucking administration on pain and crying duration of neonates during invasive procedures. The study used quasi-experimental design with post-test only control group design approach. This study used nonprobability sampling technic with consecutive sampling. The sample consisted of 45 neonates, divided into three groups, each group of 15 neonates. The study used nonprobability sampling technic with consecutive sampling. The results showed that the pain response and the crying duration were insignificantly different between the sucrose group and the NNS, respectively p=0,635 and p=0,848. Age was identified as a confounding variable that effected pain responses. Provision of sucrose and NNS proven to reduce pain as non-pharmacological pain management for neonates during invasive procedures.

Abstrak :
Tesis ini bertujuan untuk mengetahui pengaruh pemberian stimulasi auditorivisual-taktil-kinestetik terhadap perkembangan perilaku neonatus prematur di ruang perinatologi RSCM Jakarta. Penelitian ini adalah penelitian quasi experiment dengan disain one group pre and post test. Sampel penelitian berjumlah 18 responden. Hasil penelitian terdapat perbedaan yang signifikan antara perilaku neonatus prematur sebelum dan setelah diberi stimulasi (p = 0,0005). Hasil seleksi bivariat menunjukkan bahwa usia gestasi, berat badan lahir dan jenis kelamin bukan merupakan faktor perancu pada perilaku neonatus prematur setelah diberi stimulasi. Hipotesis berupa adanya pengaruh pemberian stimulasi auditori-visual-taktil-kinestetik terhadap perkembangan perilaku neonatus prematur dapat dibuktikan dalam penelitian ini. ......This thesis aims to investigate the influence of stimulation of auditory-visualtactile-kinesthetic to the behaviour development of premature neonate. This study is a quasi-experimental research with one group pre and post test design. The samples were 18 respondents. The results there are significant differences between the behavior of preterm neonates before and after a given stimulation (p = 0.0005). Bivariate selection results showed that gestational age, birth weight and gender is not a confounding factor in the premature neonate behavior after a given stimulation. The hypothesis of the existence of the effect of stimulation of auditory-visual-kinesthetic-tactile to the development of a premature neonate behavior could be demonstrated in this study.

Abstrak :
[ABSTRAK
Latar Belakang: Kelahiran prematur masih menjadi salah satu penyebab utama kematian pada neonatus. Diseluruh dunia kematian akibat kelahiran prematur menempati posisi kedua pada anak usia dibawah lima tahun. Kelahiran prematur dapat disebabkan oleh komplikasi dari ibu, janin dan plasenta. Insufisiensi plasenta merupakan komplikasi kehamilan dimana plasenta tidak dapat membawa oksigen dan nutrisi yang diperlukan untuk pertumbuhan janin dalam uterus, sehingga menyebabkan berkurangnya suplai oksigen yang diperlukan janin dan terjadi keadaan hipoksia dalam uterus. Cygb yang terdapat dalam plasenta yang berfungsi dalam metabolisme oksigen akan berusaha menkompensasi keadaan ini agar suplai oksigen kembali normal. Hipoksia yang terus menerus ini dapat menyebabkan meningkatnya reactive oxygen species (ROS). Pada neonatus prematur terjadi peningkatan ROS dapat melalui dua jalur, yaitu : pertama, tidak tersedianya antioksidan. Kedua, berkurangnya kemampuan untuk meningkatkan pembentukan antioksidan sebagai respons dari hiperoksia atau oksidan lain. ROS yang terbentuk akan ditanggulangi oleh antioksidan yang ada sel baik yang enzimatik maupun nonenzimatik. Metode: Plasenta bayi prematur dibagi dalam dua kelompok berdasarkan status oksigennya menjadi hipoksia dan non hipoksia. Kemudian dilakukan pengukuran ekspresi mRNA dan protein Cygb, serta aktivitas antioksidan MnSOD, CAT, dan Gpx. Hasil: Terjadi peningkatan protein Cygb, akan tetapi terjadi penurunan ekspresi mRNA Cygb. Terjadi penurunan aktivitas spesifik MnSOD, sedangkan CAT dan GPx tidak berbeda bermakan. Analisis statistik menunjukan hubungan bermakna antara aktivitas spesifik MnSOD dengan aktivitas spesifik GPx dan terdapat hubungan yang bermakana antara mRNA Cygb dengan aktivitas spesifik MnSOD pada neonatus prematur hipoksia dan tidak hipoksia Kesimpulan: Terjadi peningkatan protein Cygb dan penurunan mRNA Cygb untuk mempertahankan homeostasis janin dalam keadaan hipoksia. Antioksidan pada bayi prematur lebih rendah, akan tetapi hal ini akan dibantu oleh Cygb dalam mengeliminasi ROS yang ada dalam tubuh, terlihat dari penurunan aktivitas spesifik MnSOD pada plasenta prematur hipoksia, sedangkan aktivitas spesifik katalase dan GPx relatif sama.

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ABSTRACT
Background: Preterm birth is still one of the main causes of mortality in neonates. Nowadays, preterm birth is the second most common cause of death in children younger than five years. Preterm birth can be caused by complications of the mother, fetus and placenta. Placenta insufficiency is complication of pregnancy, where the placenta can not carry oxygen and nutrients for fetus growth in uterus, that lead to decrease oxygen supplies for the fetus and hypoxia in uterus. Cygb in placenta, that have function in oxygen metabolism will try to compensate this situation, so the oxygen suplies will back to normal. The hypoxia will increase reactive oxygen species (ROS). In preterm neonates the increase of ROS is cause by: First, there is no antioxidant supplies. Second, the lack of antioxidant respon to hyperoxsia or other oxidan ROS will be eliminate by antioxidant system with in the cell. Methods: Placenta from preterm neonates divided in teo groups, hypoxia and non hypoxia. And the sample is measure for mRNA Cygb expression, Cygb proteins, and antioxidant activity for MnSOD, CAT and GPx. Results: The Cygb protein increase in placenta neonates hypoxia, but the expression of mRNA Cygb decrease in placenta neonates hypoxia. There is decrease of MnSOD specific activity in placental neonates hypoxia, but not in CAT and GPx. Statistical analysis show correlation between MnSOD specific activity with GPx specific activity, and correlation between mRNA Cygb with MnSOD specific activity. Conclusion: There is an increase of Cygb protein and decrease of Cygb mRNA in placental neonates hypoxia, to maintain the neonates homeostasis in hypoxia environment. Antioxidant is lower in preterm, Cygb with the capability to eliminate free radical will help antioxidant to reduce the ROS. It was seen at the decrease of MnSOD specific activity, and the katalase and GPx specific activity is relatively the same in plasenta hipoksia and non hipoksia, Background: Preterm birth is still one of the main causes of mortality in neonates. Nowadays, preterm birth is the second most common cause of death in children younger than five years. Preterm birth can be caused by complications of the mother, fetus and placenta. Placenta insufficiency is complication of pregnancy, where the placenta can not carry oxygen and nutrients for fetus growth in uterus, that lead to decrease oxygen supplies for the fetus and hypoxia in uterus. Cygb in placenta, that have function in oxygen metabolism will try to compensate this situation, so the oxygen suplies will back to normal. The hypoxia will increase reactive oxygen species (ROS). In preterm neonates the increase of ROS is cause by: First, there is no antioxidant supplies. Second, the lack of antioxidant respon to hyperoxsia or other oxidan ROS will be eliminate by antioxidant system with in the cell. Methods: Placenta from preterm neonates divided in teo groups, hypoxia and non hypoxia. And the sample is measure for mRNA Cygb expression, Cygb proteins, and antioxidant activity for MnSOD, CAT and GPx. Results: The Cygb protein increase in placenta neonates hypoxia, but the expression of mRNA Cygb decrease in placenta neonates hypoxia. There is decrease of MnSOD specific activity in placental neonates hypoxia, but not in CAT and GPx. Statistical analysis show correlation between MnSOD specific activity with GPx specific activity, and correlation between mRNA Cygb with MnSOD specific activity. Conclusion: There is an increase of Cygb protein and decrease of Cygb mRNA in placental neonates hypoxia, to maintain the neonates homeostasis in hypoxia environment. Antioxidant is lower in preterm, Cygb with the capability to eliminate free radical will help antioxidant to reduce the ROS. It was seen at the decrease of MnSOD specific activity, and the katalase and GPx specific activity is relatively the same in plasenta hipoksia and non hipoksia]

Abstrak :
[ABSTRAK
Latar Belakang. Tujuan penelitian untuk melihat faktor ibu dan neonatus yang dapat menyebabkan keberhasilan minum pada neonatus yang lahir dari ibu preeklamsi. Intoleransi minum yang tidak disebabkan sepsis seringkali menyulitkan pemberian makan pada neonatus agar tumbuh kembangnya sempurna. Akan diteliti faktor-faktor yang mempengaruhi kemampuan minum. Metode Penelitian. Dengan menggunakan desain potong lintang dan rumus analisis multivariat didapatkan 72 sampel rekam medik dari ibu dan neonatus yang diambil secara consecutive sampling di rekam medik RSCM kemudian dilakukan analisis univariat, bivariat, dan multivariat. Hasil. Karakteristik ibu dan bayi yaitu sebagian besar bayi lahir dari ibu berusia 31-35 tahun, tingkat pendidikan SMA, memiliki anak usia 1-3 tahun, ANC ≥ 4x, cara persalinan bedah kaisar, kriteria preeklamsia berat, nilai SDAU tidak membuat hipoksia. Sebagian besar bayi lahir usia gestasi ≤ 32 minggu, terbanyak berjenis kelamin perempuan. Proporsi bayi yang lahir dengan dengan berat lahir 1000-1500 gram tidak berbeda dengan 1501-2000 gram, terbanyak tidak PJT, terbanyak menggunakan CPAP, dan nilai APGAR menit ke-5 ≥ 7. Analisis multivariat menunjukkan ada 2 faktor yang dapat dijadikan prediktor keberhasilan minum yaitu usia gestasi dan kondisi klinis. Bayi dapat minum full feed dengan median 9,5 hari dengan rentang 3,5-15,5 hari. Simpulan. Faktor keberhasilan minum adalah usia gestasi ˃ 32 minggu dan tidak ditemukan intoleransi klinis.

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ABSTRACT
Introduction. The aim of this study is to observe predictive factors from mothers and neonates for successful feeding. Feeding intolerance can happen without sepsis and becomes worst in the future. Other factors that influence successful feeding will be assessed in this study. Methods. This study is a cross sectional study using secondary data obtained from medical records of 72 subject, recruited with consecutive sampling. Univariate, bivariate, and multivariate analyses were performed in this study. Results. A large proportion of the babies were born from mothers aged 31-35 years old, senior high school graduated, having an 1-3 year-parity interval, giving birth through sectio caesaria delivery, ANC ≥ 4x, and having severe preeclampsia, and non hypoxic SDAU. The most of the babies born at gestational age ≥ 32 weeks and females. The most of the babies born with a birth weight of 1000-1500 grams and 1501-2000 grams weeks were not different, the most babies not IUGR, being assisted with CPAP, having an APGAR score at the 5th minutes ≥ 7. Multivariate analyses revealed the gestational age and clinical symptoms were predictor factors for successful feeding in neonates. Neonates successful feeding in median 9,5 days and range from 3,5 to 15,5 days. Conclusion. Predictor factors for successful feeding in neonates were gestational age more than 32 weeks and the absence of clinical symptoms, Introduction. The aim of this study is to observe predictive factors from mothers and neonates for successful feeding. Feeding intolerance can happen without sepsis and becomes worst in the future. Other factors that influence successful feeding will be assessed in this study. Methods. This study is a cross sectional study using secondary data obtained from medical records of 72 subject, recruited with consecutive sampling. Univariate, bivariate, and multivariate analyses were performed in this study. Results. A large proportion of the babies were born from mothers aged 31-35 years old, senior high school graduated, having an 1-3 year-parity interval, giving birth through sectio caesaria delivery, ANC ≥ 4x, and having severe preeclampsia, and non hypoxic SDAU. The most of the babies born at gestational age ≥ 32 weeks and females. The most of the babies born with a birth weight of 1000-1500 grams and 1501-2000 grams weeks were not different, the most babies not IUGR, being assisted with CPAP, having an APGAR score at the 5th minutes ≥ 7. Multivariate analyses revealed the gestational age and clinical symptoms were predictor factors for successful feeding in neonates. Neonates successful feeding in median 9,5 days and range from 3,5 to 15,5 days. Conclusion. Predictor factors for successful feeding in neonates were gestational age more than 32 weeks and the absence of clinical symptoms]

Abstrak :
Gangguan pendengaran merupakan gangguan yang paling umum ditemukan pada neonatus. Gangguan dapat diatasi dengan mudah bila didiagnosis pada awal kelahiran. Prevalensi global gangguan pendengaran permanen pada neonatus kebanyakan berasal dari negara berkembang sekitar 0,5-5 per 1000 kelahiran. Tujuan penelitian ini untuk mengevaluasi efek terapi aminoglikosida dan faktor yang dapat menginduksi gangguan pendengaran pada neonatus yang dirawat di NICU Rumah Sakit Dr. Cipto Mangunkusumo. Penelitian bersifat case-control dengan sampel 112 neonatus di Rumah Sakit Dr. Cipto Mangunkusumo (RSCM). Data skrining pendengaran neonatus secara retrospektif dikumpulkan melalui data rekam medis elektronik dan data medis pasien. Hanya pasien yang dirawat dan diobati di Neonatal Intensive Care Unit (NICU) dari November 2018 hingga Oktober 2019 yang diambil sebagai sampel penelitian. Usia gestasional saat kelahiran (LGA) dan anomali kraniofasial dianggap sebagai faktor risiko yang berpengaruh terhadap gangguan pendengaran karena secara statistik signifikan (p < 0,05). Penelitian menunjukkan tidak ada hubungan yang signifikan dari jenis kelamin, berat badan saat kelahiran, ventilasi mekanik, lama rawat di NICU (>5 hari), hiperbilirubinemia (> 10 mg/dl), asfiksia, dan terapi aminoglikosida (p > 0,05). Prevalensi gangguan pendengaran pada neonatus dengan usia gestasional saat lahir dibawah dari 37 minggu dan adanya anomali kraniofasial memiliki signifikansi yang tinggi dibandingkan bayi yang lahir dengan normal. Kedua faktor tersebut memiliki risiko gangguan pendengaran pada neonatus 8 hingga 14 kali lebih tinggi. Sebaliknya, terapi aminoglikosida ditemukan tidak berbeda signifikan pada penelitian ini dikarenakan nilai p sebesar 0,124 yang lebih besar dari 0,05 untuk interval kepercayaan 95%. Temuan lainnya yang tidak berbeda secara signifikan adalah jenis kelamin, berat badan saat lahir, lama rawat di NICU selama > 5 hari, dukungan ventilator > 5 hari, bayi lahir dengan asfiksia dan hiperbilirubinemia > 10 mmol/l ......Hearing loss is the most common disorder in neonates; it can be best managed if diagnosed at an early stage of life. The global prevalence of permanent neonatal hearing loss mainly occurs in developing countries, accounting for 0.5 to 5.0 per 1000 live births. This study's objective was to evaluate effects of aminoglycoside therapy, and associated factors that can induce hearing loss in neonates admitted to NICU at Dr.Cipto-Mangunkusumo Hospital. This was a case-control study conducted among 112 neonates at Dr. Cipto-Mangunkusumo Hospital (CMH). Data of neonatal hearing screening were retrospectively collected from hospital electronic medical records and medical files. Only patients admitted and treated at the Neonatal Intensive Care Unit from November 2018 to October 2019 were recruited. Out of 112 neonates studied, the Low Gestational Age at birth (L.G.A.) and Craniofacial anomalies were considered as risk factors for hearing loss since they were statistically significant (p< 0.05). The study showed no statistically significant association in gender, birth weight, mechanical ventilation, NICU stay period (>5 days), hyperbilirubinemia (>10mg/dl), asphyxia, and aminoglycoside therapy (p>0.05). The prevalence of hearing loss in neonates with a lower gestational age of leser than 37 weeks and craniofacial anomalies are significantly higher compare to full-term neonates born. They are more associated with 8 to 14 times increased risk of hearing loss in neonates. In contrast, aminoglycoside therapy was found insignificant different in this study since its p-value were 0.124 which is greter than p-value <0.05 for 95% signicant interval. Other finds that were not significantly different are gender, birth weight, extended stay at ICU for >5 days, ventilatory support > 5days, baby borns with asphyxia and hyperbilirubinemia > 10mmol/l.

Abstrak :
Gangguan pendengaran merupakan gangguan yang paling umum ditemukan pada neonatus. Gangguan dapat diatasi dengan mudah bila didiagnosis pada awal kelahiran. Prevalensi global gangguan pendengaran permanen pada neonatus kebanyakan berasal dari negara berkembang sekitar 0,5-5 per 1000 kelahiran. Tujuan penelitian ini untuk mengevaluasi efek terapi aminoglikosida dan faktor yang dapat menginduksi gangguan pendengaran pada neonatus yang dirawat di NICU Rumah Sakit Dr. Cipto Mangunkusumo. Penelitian bersifat case-control dengan sampel 112 neonatus di Rumah Sakit Dr. Cipto Mangunkusumo (RSCM). Data skrining pendengaran neonatus secara retrospektif dikumpulkan melalui data rekam medis elektronik dan data medis pasien. Hanya pasien yang dirawat dan diobati di Neonatal Intensive Care Unit (NICU) dari November 2018 hingga Oktober 2019 yang diambil sebagai sampel penelitian. Usia gestasional saat kelahiran (LGA) dan anomali kraniofasial dianggap sebagai faktor risiko yang berpengaruh terhadap gangguan pendengaran karena secara statistik signifikan (p < 0,05). Penelitian menunjukkan tidak ada hubungan yang signifikan dari jenis kelamin, berat badan saat kelahiran, ventilasi mekanik, lama rawat di NICU (>5 hari), hiperbilirubinemia (> 10 mg/dl), asfiksia, dan terapi aminoglikosida (p > 0,05). Prevalensi gangguan pendengaran pada neonatus dengan usia gestasional saat lahir dibawah dari 37 minggu dan adanya anomali kraniofasial memiliki signifikansi yang tinggi dibandingkan bayi yang lahir dengan normal. Kedua faktor tersebut memiliki risiko gangguan pendengaran pada neonatus 8 hingga 14 kali lebih tinggi. Sebaliknya, terapi aminoglikosida ditemukan tidak berbeda signifikan pada penelitian ini dikarenakan nilai p sebesar 0,124 yang lebih besar dari 0,05 untuk interval kepercayaan 95%. Temuan lainnya yang tidak berbeda secara signifikan adalah jenis kelamin, berat badan saat lahir, lama rawat di NICU selama > 5 hari, dukungan ventilator > 5 hari, bayi lahir dengan asfiksia dan hiperbilirubinemia > 10 mmol/l ......Hearing loss is the most common disorder in neonates; it can be best managed if diagnosed at an early stage of life. The global prevalence of permanent neonatal hearing loss mainly occurs in developing countries, accounting for 0.5 to 5.0 per 1000 live births. This study's objective was to evaluate effects of aminoglycoside therapy, and associated factors that can induce hearing loss in neonates admitted to NICU at Dr.Cipto-Mangunkusumo Hospital. This was a case-control study conducted among 112 neonates at Dr. Cipto-Mangunkusumo Hospital (CMH). Data of neonatal hearing screening were retrospectively collected from hospital electronic medical records and medical files. Only patients admitted and treated at the Neonatal Intensive Care Unit from November 2018 to October 2019 were recruited. Out of 112 neonates studied, the Low Gestational Age at birth (L.G.A.) and Craniofacial anomalies were considered as risk factors for hearing loss since they were statistically significant (p< 0.05). The study showed no statistically significant association in gender, birth weight, mechanical ventilation, NICU stay period (>5 days), hyperbilirubinemia (>10mg/dl), asphyxia, and aminoglycoside therapy (p>0.05). The prevalence of hearing loss in neonates with a lower gestational age of leser than 37 weeks and craniofacial anomalies are significantly higher compare to full-term neonates born. They are more associated with 8 to 14 times increased risk of hearing loss in neonates. In contrast, aminoglycoside therapy was found insignificant different in this study since its p-value were 0.124 which is greter than p-value <0.05 for 95% signicant interval. Other finds that were not significantly different are gender, birth weight, extended stay at ICU for >5 days, ventilatory support > 5days, baby borns with asphyxia and hyperbilirubinemia > 10mmol/l.