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Angka kematian bayi (AKB) sebagai salah satu indikator mortalitas derajat kesehatan di Indonesia telah menurun cukup berarti, namun masih jauh lebih tinggi bila dibandingkan dengan beberapa negara ASEAN serta negara-negara maju. Angka kematian neonatal merupakan sekilar 40% dari AKB, dengan penyebab utama adalah bayi berat lahir rendah (BBLR) sebesar 29% (SKRT, 2001). Berbagai studi menyebutkan banyak faktor yang menyebabkan terjadinya BBLR, faktor kualitas pelayanan antenatal merupakan salah satu faktor risiko yang sangat penting, disamping faktor-faktor lain seperti paritas, jarak kelahiran, riwayat kehamilan terdahulu, pertambahan berat badan selama hamil, tingkat aktifitas fisik ibu, komplikasi selama hamil, perilaku merokok, umur ibu, tinggi badan ibu, tingkat pendidikan ibu, etnis atau ras, tingkat sosial ekonomi dan jenis kelamin bayi yang dilahirkan. Tujuan penelitian ini adalah untuk mengetahui pengaruh faktor kualitas pelayanan antenatal (berdasarkan frekuensi pelayanan, jadwal pelayanan, dan konseling) terhadap kejadian BBLR di Indonesia. Penelitian dirancang secara kasus kontrol dengan menggunakan data terdokumentasi basil SDKI 2002-2003. Kasus adalah subjek dengan atribut efek positif (BBLR) dicarikan kontrolnya yaitu subjek dengan atribut efek negatif (Tidak BBLR). Populasi studi adalah seluruh sampel SDKI 2002-2003 yaitu semua wanita berusia 15-49 tahun yang sudah pernah kawin dan melahirkan dengan lahir hidup dalam lima tahun terakhir sebelum survei, dengan kriteria inklusi kasus dan kontrol adalah kelahiran tunggal, ditimbang saat lahir, dan bapak juga diwawancarai, sedangkan kriteria eksklusinya adalah data terdokumentasi tidak tersedia lengkap. Dengan menggunakan rumus Batas minimal sampel untuk kasus kontrol tidak berpadanan didapatkan kasus sebanyak 82 dan kontrol 328. Dengan analisis regresi logistik ganda, model akhir pengaruh kualitas pelayanan antenatal terhadap kejadian BBLR didapatkan nilai OR = 2,71 (95% CI: 1,60-4,58), artinya bahwa responden yang mendapatkan kualitas pelayanan antenatal (berdasarkan frekuensi pelayanan, jadwal pelayanan, dan konseling) dengan kualitas buruk kemungkinan berisiko 2,71 kali lebih besar untuk melahirkan BBLR dibandingkan dengan ibu yang mcndapatkan kualitas pelayanan antenatal balk setelah dikontrol dengan komplikasi selama hamil, umur ibu, dan jenis kelamin bayi. Variabel yang terbukti signifikan secara statistik dengan kejadian BBLR adalah komplikasi selama hamil (OR = 3,98 atau 95% CI: 2,06-7,67), umur ibu (OR = 1,98 atau 95% CI: 1,02-3,85), dan jenis kelamin bayi (OR = 1,93 atau 95% CI: 1,14-3,28), sedangkan variabel yang tidak terbukti berpengaruh signifikan secara statistik adalah paritas, riwayat kehamilan, dan pendidikan ibu. Dapat disimpulkan bahwa kualitas pelayanan antenatal (berdasarkan frekuensi pelayanan, jadwal pelayanan, dan konseling) terbukti mempunyai pengaruh bermakna secara statistik terhadap kejadian BBLR setelah dikontrol dengan variabel komplikasi selama hamil, umur ibu, dan jenis kelamin bayi, sehingga perlu menjadi bahan pertimbangan oleh para pengambil kebijakan dalam upaya menurunkan kejadian BBLR di Indonesia.
Infant Mortality Rate (IMR) as one of mortality indicators of health level degraded in Indonesia significantly, but it is higher than many countries in ASEAN and also development countries. Neonatal mortality is almost 40% of infant mortality rate with main reason of low birth weight is 29% (SKRT, 2001). Various study mentioned many factors which caused a low birth weight occurrence, antenatal service quality factor is one of the important risk factors compared with other factors such as parity, birth interval, past pregnancy history, weight increased during pregnancy, activity level of mother's physic. Complication during pregnancy, smoking behavior, mother's age, mother's tall, education level of mother, ethnic or race, social and economic level, and baby gender which is born. This Research purpose is to know effect of antenatal service quality factor (according to service frequency, service schedule, and counseling) to low birth weight occurrence. Research designed with a control case by using result of documentation data SDKI 2002-2003. Case is subject with positive effect attribute (low birth weight) by looking for its control that is subject with negative effect attribute (no low birth weight). Study population are all samples of SDKI 2002-2003 that are all women 15-49 years old who have married and born with life birth in last five years before survey, with inclusion criterion of case and control are single birth, weighted when she born, and father is also held an interview, while its inclusion criterion of available documentation data is not complete. By using a minimum limit formula of samples for non match control case, it founded 82 cases and 328 controls. By analysis of multiple logistic regression, final model effect of antenatal service quality to low birth weight occurrence got a value of OR = 2,71 (95% CI: 1,60-4,58), this means responders who got antenatal service quality (according to service frequency, service schedule, and counseling) with a bad quality of risk possibility are 2,71 times bigger to bear with low birth weight compared with mother who got good quality of antenatal service after controlled with a complication during pregnancy, mother's age, and baby gender. Significant variable with a low birth weight occurrence statistically is complication during pregnancy (OR = 3,98 atau 95% CI: 2,06-7,67), mother's age (OR = 1,98 or 95% Cl: 1,02-3,85), and baby gender (OR = 1,93 or 95% CI: 1,14-3,28), while variables who does not significant effect statistically are parity, pregnancy history, and mother?s education. It is concluded that antenatal service quality (according to service frequency, service schedule, and counseling) have significant effects statistically to low birth weight occurrence after controlled with complication variable during pregnancy, mother?s age, and baby gender, so it is important to become consideration for all policies makers decreasing effort of low birth weight occurrence in Indonesia.
Pelayanan antenatal (ANC) adalah salah satu program kegiatan Puskesmas yaitu Kesehatan Ibu dan Anak (KIA) yang berupaya memberikan pelayanan yang berkualitas kepada ibu hamil, mendidik serta memotivasi ibu hamil agar dapat merawat dirinya selama hamil, serta berupaya merubah sikap dan perilaku kearah keamanan persalinan. Berdasarkan basil survei yang dilakukan, maka peneliti mencoba melakukan analisis data Survei Demografi dan Kesehatan Indonesia tahun 2002-2003 tentang Hubungan Kualitas Layanan Antenatal dengan Kejadian Komplikasi Persalinan, yang terdiri dari beberapa variabel yaitu variabel babas utama adalah kualitas layanan antenatal, dan variabel kontrol adalah status reproduksi (umur, paritas, jarak kehamilan), status kesehatan (riwayat obstetri), Perilaku sehat (penolong persalinan, penggunaan KB), tempat persalinan, kualitas pelayanan (penyuluhan) dan komplikasi persalinan yang terdiri dari dua kriteria (partus lama dan perdarahan). Penelitian dilakukan dengan desain cross sectional, dengan melakukan analisis data Survei Demografi dan Kesehatan Indonesia tahun 2002-2003. Setelah ditentukan kriteria inklusi dan eksklusi maka diperoleh sampel minimal meliputi 11674 sampel. Analisis data yang digunakan meliputi analisis univariat, bivariat dan multivariat. Hasil penelitian menunjukkan bahwa hubungan kualitas layanan antenatal berinteraksi dengan jarak kelahiran, dimana pada jarak kelahiran ? 2 tahun hubungan kualitas antenatal dengan komplikasi persalinan (OR F 0,94), sedangkan pada jarak kelahiran < 2 tahun hubungan kualitas layanan antenatal dengan komplikasi persalinan (OR = 1,98) atau dari hasil uji interaksi diperoleh (OR = 2,01, 95%CI 1,11-3,97). Hasil penelitian masih dipengaruhi cara pengukuran, sehingga untuk memperoleh hasil yang iebih valid disarankan dilakukan penelitian selanjutnya dengan perigukuran yang lebih baik dan desain yang lebih baik.
Antenatal Service (ANC) is one of the Puskesmas activities, which is Mother and Child Health (KIA) that make effort in giving quality service to pregnant mother, educating and also motivating pregnant mother to take care of herself during pregnancy, and also make effort to change attitude and behavior toward give birth safety. Based on survey conducted, researchers try to do data analysis of Demographic Survey and Health in Indonesia year 2002 - 2003 about Relation of Antenatal Service Quality with Give Birth Complication Cases, which consist of some variables such as main free variable is antenatal service quality, and control variable is reproduction status (age, parity, pregnancy gap), health status (obstetric history), health behavior (give birth assistance, KB use), give birth place, service quality (counseling) and give birth complication that consist of two criteria (delivery length and haemorrahage). Research design was cross sectional, with data analysis of Demographic Survey and Health in Indonesia year 2002 - 2003. After criteria of inclusion and exclusion determined then obtained minimal sample include 11674 samples. Data analysis that used is including univariate, bivariate, and multivariate analysis. Research result shows that relation of antenatal service quality interact with birth gap, where in birth gap? 2 years of antenatal quality relation with give birth complication (OR = 0,94). While in birth gap < 2 years of antenatal service quality with give birth complication (OR = 1.98) or from interaction test result got (OR = 2,01, 95% CI 1,11 - 3,97). Research result still affected by measuring method, so that to obtain valid result suggested that advanced research done with better measuring and better design.
Angka kematian bayi akibat makrosomia meningkat 0,1% menurut Data Survey Demografi Kesehatan Indonesia 2017. Sementara itu, komplikasi persalinan ibu meningkat dari 35% pada tahun 2012 menjadi 41% pada tahun 2017. Dengan menggunakan data dari Survei Demografi dan Kesehatan Indonesia, penelitian ini menyelidiki hubungan antara pemeriksaan kehamilan (antenatal care) dan variabel kejadian makrosomia dengan faktor pembaur (confounding) yakni Umur Ibu, Pekerjaan Ibu, Lokasi Tempat Tinggal Ibu, Tingkat Pendidikan Ibu, Status Sosial Ekonomi, Tempat Pemeriksaan saat kehamilan, dan Tenaga Pemeriksaan Kehamilan. Penelitian ini memakai metode penelitian kuantitatif observasional analitik melalui teknik cross-sectional. Hasil penelitian menunjukkan bahwa variabel independen memiliki korelasi yang signifikan dengan variabel dependen, yaitu kualitas pemeriksaan kehamilan dengan standar 10T yang dilakukan pada pasien ibu hamil dengan faktor konfounding-nya status pekerjaan ibu, daerah tempat tinggal ibu, dan tempat pemeriksaan kehamilan serta variabel interaksi antara daerah tempat tinggal dengan kuantitas ANC. Hasil analisis menunjukkan ibu yang tidak mendapatkan kualitas pemeriksaan kehamilan yang sesuai standar berisiko 1,304 (95% CI 1,096-1,551) kali memiliki bayi makrosomia dibandingkan dengan ibu yang mendapatkan kualitas pemeriksaan kehamilan yang sesuai standar. Pada faktor konfounding yang paling berisiko pada kejadian makrosomia adalah daerah tempat tinggal dengan POR=1,692 (95% CI 1,358- 2,109) artinya ibu yang tinggal di desa berisiko 1,692 kali memiliki bayi makrosomia dibandingkan ibu tinggal di kota. Kata kunci: Antenatal Care, Makrosomia, SDKI 2017
The infant mortality rate due to macrosomia increased by 0.1% according to the 2017 Indonesian Demographic Health Survey Data. Meanwhile, maternal birth complications increased from 35% in 2012 to 41% in 2017. Using data from the Indonesian Demographic and Health Survey, this research investigate the relationship between antenatal care and macrosomia incidence variables with confounding factors, namely maternal age, maternal occupation, maternal residence location, maternal education level, socio-economic status, examination location during pregnancy, and prenatal examination personnel. This research uses quantitative observational analytical research methods using cross-sectional techniques. The results of the study show that the independent variable has a significant correlation with the dependent variable, namely the quality of pregnancy examinations with the 10T standard carried out on pregnant women with the confounding factors being the mother's employment status, the area where the mother lives, and the place of pregnancy examination as well as the interaction variable between regions. residence with ANC quantity. The results of the analysis show that mothers who do not receive quality pregnancy checks that meet standards have a 1.304 (95% CI 1.096-1.551) risk of having macrosomia babies compared to mothers who get quality pregnancy checks that meet standards. The confounding factor that is most at risk for the incidence of macrosomia is the area of residence with POR=1.692 (95% CI 1.358-2.109) meaning that mothers who live in villages are 1.692 times more likely to have macrosomia babies than mothers who live in cities. Keywords: Antenatal Care, Macrosomia, IDHS
Kata kunci: BBLR; kehamilan remaja
Low Birth Weight (LBW) in Indonesia has the prevalence of 7,3 % according to IDHS 2012. Some research showed that more LBW occurences happened to mother aged 15-19 at the time of birth. This study aims to prove the association between adolescent pregnancy and low birth weight after controlling all the confounding variables. The method used for this study is case-control (1:1) by analyzing IDHS 2012. The selected cases are 871 with 871 controls. Covariate variables are education, parity, complication during pregnancy, complication at birth, months of pregnancy at first antenatal visit and number of antenatal visit. The result of the study is that there is a significant association between adolescent pregnancy after controlling all confounding variables which are education, complication during pregnancy and months of pregnancy at first antenatal visit and number of antenatal visit (OR: 2,65; p value= 0,013; 95% CI: 1,232-5,712).
Key words: LBW; adolescent pregnancy
The exclusive breastfeeding coverage trend in Indonesia remains suboptimal. The objective of this study was to examine the relationship between the frequency of standardized antenatal care (ANC) visits and the practices of exclusive breastfeeding among mothers with infants aged 0–23 months. This investigation utilized the 2023 Indonesia Health Survey (SKI) to conduct its analysis. This cross-sectional study employed modified Cox regression to estimate prevalence ratios (PR) and adjusted for covariates. The results indicated that 47.10% of infants aged 0–5 months were exclusively breastfed, and 64.90% of those aged 6–23 months had a history of exclusive breastfeeding, with 2.52% experiencing delayed complementary feeding. A significant association was identified between ANC visits with a p-value of at least 6 and exclusive breastfeeding in the 0–5 months group (PR adj: 3.01; 95% CI: 2.12–4.27). However, no such association was observed in the 6–23 months group. These findings underscore the necessity for the incorporation of sustained breastfeeding education initiatives beginning in pregnancy, along with the integration of MPASI timing into national monitoring indicators.