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Abstrak :
ABSTRACTName : Yulia Novika JStudy Program: Magister Program in Public Heatlth ScienceTitle : Influence of Exclusive Breastfeeding on Linear Growth ofStunted Infants from Birth in Bandar Lampung CityGrowth assessment is an important part of health evaluation of children and as aglobal effort to improve early childhood growth. Exclusive breastfeeding is the onlyappropriate food for infant 0-6 months of age, an ideal nutrition for childdevelopment and growth. In the region of Bandar Lampung city, the prevalence ofstunting is stiil high compared to national data 22.4 ; 20.2 . This study aimedto know the effect of excelusive breasfeeding on linear growth infants with stuntingfrom birth in Bandar Lampung city. A quantitative study with prospective cohortdesign was carried out in Bandar Lampung city for 3 months since the babies were3 months of age. A number of 179 mother singleton baby coupled with stunted frombirth and exclusive breastfed from birth to six months of age were completed tofollow up. Exclusive breasfeeding in Bandar Lampung city is still low 45.8 .Proportion of stunted infants with exclusive breasfeeding achieving normal lineargrowth 97.6 up to six months of age. Linier growth of exclusively breast-fedinfants is higher than those who are not exclusively breastfed either on normalgrowth or in infants who remain stunting at 6 months of age and girls grew betterthan boys. Growth faltering occurred during 4 ndash; 5 months of age in those infantswho were not breastfed exclusively while those who breastfed exclusively at 5 ndash; 6months of age. Growth pattern throughout 3 ndash; 6 months of age were analyzed bylogistic regression and plotted in curves compared to WHO standard. Exclusivelybreastfed infants had 3,58 times better in linier growth compared to formula fedinfants. While partial breastfed infants had 1,6 times to achieve normal linier growthcompared to infants who were fed by formula after controlling infectious diseaseexposure, minimal weight gain standar, materbal occupation, maternal height, andearly complementary feeding. Thus, active role of health personnel to promoteexclusive breasfeeding and growth monitoring, especially linier growth during 0-72 months of age in every three month according to Minister of Health Permenkesnumber 66 year 2014 to monitor growth faltering, is required.Kata Kunci : exclusive breastfeeding, birth length, linier growth, stunting

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ABSTRACTName Yulia Novika JStudy Program Magister Program in Public Heatlth ScienceTitle Influence of Exclusive Breastfeeding on Linear Growth ofStunted Infants from Birth in Bandar Lampung CityGrowth assessment is an important part of health evaluation of children and as aglobal effort to improve early childhood growth. Exclusive breastfeeding is the onlyappropriate food for infant 0 6 months of age, an ideal nutrition for childdevelopment and growth. In the region of Bandar Lampung city, the prevalence ofstunting is stiil high compared to national data 22.4 20.2 . This study aimedto know the effect of excelusive breasfeeding on linear growth infants with stuntingfrom birth in Bandar Lampung city. A quantitative study with prospective cohortdesign was carried out in Bandar Lampung city for 3 months since the babies were3 months of age. A number of 179 mother singleton baby coupled with stunted frombirth and exclusive breastfed from birth to six months of age were completed tofollow up. Exclusive breasfeeding in Bandar Lampung city is still low 45.8 .Proportion of stunted infants with exclusive breasfeeding achieving normal lineargrowth 97.6 up to six months of age. Linier growth of exclusively breast fedinfants is higher than those who are not exclusively breastfed either on normalgrowth or in infants who remain stunting at 6 months of age and girls grew betterthan boys. Growth faltering occurred during 4 ndash 5 months of age in those infantswho were not breastfed exclusively while those who breastfed exclusively at 5 ndash 6months of age. Growth pattern throughout 3 ndash 6 months of age were analyzed bylogistic regression and plotted in curves compared to WHO standard. Exclusivelybreastfed infants had 3,58 times better in linier growth compared to formula fedinfants. While partial breastfed infants had 1,6 times to achieve normal linier growthcompared to infants who were fed by formula after controlling infectious diseaseexposure, minimal weight gain standar, materbal occupation, maternal height, andearly complementary feeding. Thus, active role of health personnel to promoteexclusive breasfeeding and growth monitoring, especially linier growth during 0 72 months of age in every three month according to Minister of Health Permenkesnumber 66 year 2014 to monitor growth faltering, is required.Kata Kunci exclusive breastfeeding, birth length, linier growth, stunting

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Berat dan panjang lahir bayi merupakan kondisi bayi yang dapat disebabkan oleh berbagai faktor risiko ibu dan bayi itu sendiri. Penelitian ini bertujuan untuk mengetahui hubungan status gizi ibu, karakteristik ibu dan karakteristik bayi dengan berat dan panjang lahir bayi dengan desain penelitian cross-sectional. Hasil penelitian menunjukkan 65% bayi lahir dengan berat baik dan 73,6% bayi lahir dengan panjang normal. IMT prahamil, paritas dan tingkat pendidikan ibu serta jenis kelamin bayi merupakan faktor risiko yang memiliki hubungan bermakna dengan berat lahir bayi. Model prediksi berat bayi lahir mengikutsertakan faktor IMT prahamil, tinggi badan, pertambahan berat badan dan umur ibu. IMT prahamil dan status pekerjaan ibu serta jenis kelamin bayi merupakan faktor risiko yang memiliki hubungan bermakna dengan panjang lahir bayi. Model prediksi panjang lahir bayi mengikutsertakan tinggi badan ibu dan jenis kelamin bayi. Staus gizi ibu sebelum memasuki kehamilan merupakan faktor penting dalam keberhasilan kehamilan dan kualitas bayi yang dilahirkan. ...... Birth weight and birth length are babies condition which influenced by many factors from mothers and babies itself. The purpose of this study is to determine the relation between maternal nutritional status, maternal characteristic and baby characteristic with birth baby birth weight and birth length by crosssectional design study. The result show that 65% of babies have favorable birth weight and 73,6% of babies have normal birth length. Pre-pregnancy BMI, parity,maternal education and newborn sex are significantly related to birth weight. Prediction model of birth weight includes pre-pregnancy BMI, maternal height, weight gain during pregnancy and maternal age. Pre-pregnancy BMI, maternal working status and newborn sex are significantly related to birth length. Prediction model of birth length includes only maternal height and newborn sex. Maternal nutritional status before pregnancy is important to pregnancy outcomes.

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Prevalensi berat bayi lahir rendah (BBLR) dan panjang lahir pendek di Indonesia masih cukup tinggi. BBLR dan panjang lahir pendek dapat memengaruhi pertumbuhan dan perkembangan bayi serta dapat meningkatkan risiko penyakit degeneratif saat dewasa, oleh sebab itu pemahaman hubungan antara antropometri ibu sebelum hamil, usia ibu, dan usia kehamilan dengan berat dan panjang lahir bayi menjadi sangat penting. Tujuan penelitian ini adalah mengetahui adanya hubungan antara antropometri ibu sebelum hamil, usia ibu, dan usia kehamilan dengan berat dan panjang lahir bayi di Jakarta, sehingga dapat diperkirakan tindakan preventif dalam rangka menurunkan angka morbiditas penyakit degeneratif dan angka mortalitas pada neonatus dan bayi di masa yang akan datang. Metode potong lintang digunakan untuk mengetahui hubungan antara pengukuran antropometri ibu sebelum hamil, usia ibu saat melahirkan, dan usia kehamilan dengan berat dan panjang lahir bayi di Jakarta berdasarkan data sekunder dari penelitian berjudul Longitudinal Study on the Effect of Multiple Micronutrients Supplementation on Haemoglobin Level of 8 to 22 Month-old Indonesian Children. Populasi terjangkau ibu dan bayi baru lahir dengan jumlah sampel sebesar 179. Pengolahan data meliputi analisis univariat Kolmogorov Smirnov dan bivariat dengan uji Chi Square dan uji korelasi Pearson dengan menggunakan perangkat lunak Stastistical Program for Social Science (SPSS) 20. Hasil utama penelitian ini memperlihatkan bahwa terdapat hubungan bermakna dengan kekuatan korelasi sangat rendah antara berat lahir bayi dengan usia kehamilan (r=0,199; p=0,008), berat badan ibu sebelum hamil (r=0,165; p=0,028), dan indeks massa tubuh (IMT) ibu sebelum hamil (r=0,172; p=0,022). Selain itu, terdapat hubungan bermakna dengan kekuatan korelasi rendah antara panjang lahir bayi dengan usia kehamilan (r=0,257; p=0,001). Berdasarkan hasil penelitian dapat disimpulkan bahwa terdapat hubungan bermakna antara usia kehamilan, berat badan dan IMT ibu sebelum hamil dengan berat dan panjang lahir bayi. Sedangkan, tinggi badan dan usia ibu tidak memiliki hubungan bermakna dengan berat dan panjang lahir bayi. ......The prevalences of low birth weight (LBW) and short birth length in Indonesia are still quite high. LBW and short birth length can affect the growth and development of infants and increase the risks of degenerative diseases as adult, therefore an understanding of the relationship between maternal anthropometry before pregnancy, maternal age, and gestational age with birth weight and length is very important. The purpose of this study was to determine the relationship between maternal anthropometry before pregnancy, maternal age at delivery, and gestational age with birth weight and length in Jakarta, so that preventive measures can be estimated in order to reduce the morbidity of degenerative diseases and mortality rates in neonates and infants in the future. The cross-sectional method was used to determine the relationship between maternal anthropometry before pregnancy, maternal age, and gestational age and length of birth in Jakarta based on secondary data from a study entitled Longitudinal Study on the Effect of Multiple Micronutrients Supplementation on Hemoglobin Level of 8 to 22-Month-old Indonesian Children. Covered population of mothers and newborns with samples of 179. Data processing included univariate analysis of Kolmogorov Smirnov and bivariate with Chi Square test and Pearson correlation test using the Statistical Program for Social Science (SPSS) 20 software. The main results of this study show that there are significant relationships with very low correlation between birth weight and gestational age (r=0,199; p=0,008), maternal body weight before pregnancy (r=0,165; p=0,028), and maternal body mass index (BMI) before pregnancy (r=0,172; p=0,022). In addition, there is also a significant relationship with a low correlation between birth length and gestational age (r=0,257; p=0,001). Based on the results of this study, it can be concluded that there are significant relationships between gestational age, maternal body weight and BMI before pregnancy with birth weight and length. Meanwhile, maternal height and age do not have a significant relationship with birth weight and length.

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ABSTRAK
Berat lahir dan panjang lahir bayi merupakan ukuran yang dapat digunakan sebagai indikator status kesehatan bayi. Ketidaksesuaian berat lahir dan panjang lahir dengan standar yang telah ditetapkan menunjukkan rendahnya status kesehatan bayi. Bayi kecil atau besar untuk usia kehamilan dapat diidentifikasi dengan menggunakan grafik persentil. Namun Indonesia belum memiliki grafik persentil berat lahir dan panjang lahir bayi. Tujuan dari penelitian ini adalah untuk mengetahui distribusi berat lahir dan panjang lahir bayi hidup tunggal intrauterine sesuai usia kehamilan di Puskesmas Kramatwatu Kabupaten Serang, tahun 2011-2015 dan membandingkan grafik persentil berat lahir bayi tunggal sesuai usia kehamilan dengan populasi dari negara lain. Penelitian ini menggunakan desain cross sectional. Pengambilan data sekunder sebanyak 1.021 data dilakukan pada bulan Mei hingga Juni tahun 2015 dengan kriteria inklusi ibu hamil yang melahirkan bayi hidup, bayi tunggal, dan bayi yang tidak mengalami kecacatan, serta melakukan pemeriksaan kandungan dan persalinan dengan dibantu oleh tenaga kesehatan profesional (bidan) di Puskesmas Kramatwatu. Penelitian mendapati hasil distribusi berat lahir dan panjang lahir bayi terhadap usia kehamilan ibu secara umum mengalami peningkatan di setiap persentilnya. Pada rentang persentil 5th hingga 95th, ibu dengan usia kehamilan 30 minggu memiliki berat lahir 900 hingga 2030 gram, dan panjang lahir 34 hingga 47 cm; ibu dengan usia kehamilan 37 minggu memiliki berat lahir 2085 hingga 3475 gram, dan panjang lahir 39 sampai 50 cm; ibu dengan usia kehamilan 42 minggu melahirkan bayi dengan berat 2535 hingga 4000 gram dan panjang lahir 44,6 hingga 53 cm. Persentil berat lahir sesuai usia kehamilan di negara Malaysia bila dibandingkan hampir sama dengan di Kramatwatu, Indonesia pada persentil 50th dan 90th. Namun pada persentil 10th Indonesia berada dibawah Malaysia dengan berat lahir sesuai usia kehamilan 30 hingga 43 minggu sebesar 1100 hingga 2700 gram.

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ABSTRACT
Birth weight and birth length is a measure that can be used as an indicator of the health status of the baby. Incompatibility birth weight and birth length with a predetermined standard show low health status of the baby. Baby is small or large for gestational age can be identified by using the percentile chart of birth and length for gestational age. However, Indonesia does not have a birth weight and birth length by gestational age percentile chart. The purpose of this study to determine the distribution of single birth weight and length infants by gestational age in Kramatwatu Public Health Center, Serang District in 2011-2015 and compared the birth weight and length percentile chart of single infants by gestational age with the population in another countries. This study used cross sectional design. As many as 1.021 secondary data collected in May until June 2015 with the inclusion criteria of pregnant women who delivered live infant, single baby, and babies who do not have disabilities, as well as prenatal and delivery assisted by health professionals (midwives) in PHC Kramatwatu. This study found that the distribution of birth weight and birth length for gestational age in general have increased in each percentile. On the 5th to 95th percentile range, mothers with gestational age 30 weeks had birth weights 900 to 2030 grams, and birth length 34 to 47 cm; mothers with gestational age 37 weeks had birth weight 2085 to 3475 grams, and birth length 39 to 50 cm; mothers with gestational age 42 weeks had birth weight 2535 to 4000 grams and birth length 44.6 to 53 cm. Birth weight percentile by gestational age in Malaysia when compared to almost the same as in Kramatwatu, Indonesia on the 50th and 90th percentiles. But at the 10th percentile Indonesia slightly below Malaysia with birth weight by gestational age of 30 to 43 weeks of 1100 to 2700 grams.

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Penelitian ini membahas pengaruh kadar vitamin D dan kalsium terhadap panjang dan berat lahir bayi. Jenis penelitian cross sectional melibatkan 144 ibu hamil trimester 3 dan bayi yang dilahirkan. Pemeriksaan vitamin D menggunakan biomarker 25(OH)D dan kalsium menggunakan kalsium total dari serum darah tali pusat. Pengukuran panjang dan berat lahir dilakukan terstandar segera setelah lahir dengan alat merk Seca tipe 231/231. Analisis menggunakan uji korelasi, t test, ANOVA dan analisis regresi linier ganda untuk melihat pengaruh status vitamin D dan kalsium terhadap panjang dan berat lahir dengan memperhatikan variabel pengganggu (umur, paritas, tinggi badan ibu dan ayah, kesesuaian penambahan berat badan ibu selama hamil sesuai IMT pra hamil, status anemia, aktifitas fisik, kecukupan gizi ibu dan merokok). Hasil yang diperoleh: rata-rata panjang dan berat lahir adalah normal 48.7 cm dan 3090.4 gram, panjang lahir pendek 31.2 % dan BBLR 8.3%. Rata-rata kadar serum 25(OH)D adalah 27.6 ng/dL, status vitamin D kurang mencapai 62,5%. Rata-rata kadar kalsium 10 ng/mL dan hipokalsemia 24.3%. Kadar vitamin D dan kalsium berpengaruh bermakna terhadap panjang lahir setelah dikontrol tinggi badan ibu, kadar haemoglobin dan kecukupan asupan energi ibu. Setiap peningkatan 10 ng/dL kadar vitamin D akan menambah panjang lahir sebesar 0,4 cm dan setiap kenaikan 10 ng/mL kadar kalsium akan menambah 2,22 cm. Kadar vitamin D dan kalsium berpengaruh bermakna terhadap berat lahir setelah dikontrol tinggi badan ibu, kadar haemoglobin, kecukupan asupan energi ibu dan kesesuaian penambahan berat badan ibu selama hamil. Setiap peningkatan 10 ng/dL kadar vitamin D akan menambah 100,9 gram berat lahir dan setiap peningkatan 10 ng/mL kadar kalsium akan menambah 448 gram berat lahir bayi. Hasil penelitian menyarankan ibu hamil perlu meningkatkan asupan vitamin D dan kalsium termasuk zat gizi lain sesuai standar kecukupan gizi ibu hamil dan mendorong agar kulit mendapatkan paparan sinar matahari. ......This study discusses the effect of vitamin D and calcium levels on the length and birth weight of babies. This type of cross sectional study involved 144 third trimester pregnant women and babies born. Vitamin D examination using biomarkers of 25(OH)D and calcium using total calcium from cord blood serum. Measurements of length and birth weight are standardized immediately after birth with the Seca brand type 231/231. Analysis using correlation test, t test, ANOVA and linear regression analysis to see the effect of vitamin D and calcium status on length and birth weight by considering confounding variables (age, parity, maternal and paternal height, suitability of maternal weight gain during pregnancy according to BMI pre pregnancy, anemia status, physical activity, nutritional adequacy of mother and family smoking). Results obtained: the average length and birth weight were normal 48.7 cm and 3090.4 grams, short birth length 31.2% and LBW 8.3%. The average serum level of 25(OH)D is 27.6 ng/dL, vitamin D status is less than 62.5%. The average calcium content is 10 ng /mL and 24.3% hypocalcemia. Vitamin D and calcium levels had a significant effect on birth length after control of maternal height, hemoglobin level and adequacy of maternal energy intake. Every 10 ng/dL increase in vitamin D levels will increase the birth length by 0.4 cm and every 10 ng/mL increase in calcium levels will add 2.22 cm. Vitamin D and calcium levels had a significant effect on birth weight after control of maternal height, hemoglobin level, adequacy of maternal energy intake and suitability of maternal weight gain during pregnancy. Every 10 ng/dL increase in vitamin D levels will add 100.9 grams of birth weight and each 10 ng/mL increase in calcium levels will add 448 grams of baby's birth weight. The results suggest that pregnant women need to increase their intake of vitamin D and calcium, including other nutrients according to the nutritional adequacy standards of pregnant women and encourage the skin to get sun exposure.

Abstrak :
Rokok merupakan masalah global dan menjadi ancaman serius bagi kesehatan ibu hamil dan janin. Studi kohor prospektif ini, dilakukan untuk menilai pengaruh pajanan pasif asap rokok ibu hamil terhadap gangguan pertumbuhan janin. Melibatkan 128 ibu hamil trimester 3, hamil janin tunggal, tidak memiliki riwayat penyakit kronis, bukan perokok aktif, bukan mantan perokok, dan bersedia terlibat dalam penelitian. Penilaian pajanan asap rokok ibu berdasarkan pemeriksaan nikotin darah tali pusat (cut off ≥1ng/ml). Pengukuran menggunakan nikotin plasma adalah metode yang paling akurat karena dapat mengukur kondisi sebenarnya dan membantu mengurangi misklasifikasi. Gangguan pertumbuhan janin dinilai dengan pengukuran berat lahir, panjang lahir, lingkar kepala, dan berat plasenta. Pengukuran dilakukan segera setelah lahir untuk menjamin ketepatan pengukuran. Analisis uji beda dua mean digunakan untuk mengetahui perbedaan rata rata ukuran gangguan pertumbuhan janin antara kelompok ibu terpajan asap rokok dan tidak terpajan asap rokok. Analisis regresi linier untuk melihat pengaruh pajanan asap rokok terhadap berat lahir, panjang lahir, lingkar kepala dan berat plasenta dengan memperhatikan variabel pengganggu seperti penambahan berat badan ibu selama hamil, BMI ibu, paritas ibu, usia dan kadar hemoglobin ibu. Hasil penelitian menunjukkan rata-rata kadar nikotin tali pusat sebesar 1,3±2,5 ng/ml. Berat lahir dan berat plasenta bayi dari ibu yang mendapat pajanan asap rokok lebih rendah dibandingkan ibu yang tidak mendapat pajanan asap rokok. Pajanan asap rokok secara signifikan mengurangi berat lahir bayi sebesar 205,6 gram (pvalue = 0,005) dan berat plasenta sebesar 51 gram (p value=0,010). ......This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).