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Kata kunci: kehamilan tidak diinginkan, kematian neonatal, faktor risiko, perdesaan, perkotaan
This study discusses the effect of unwanted pregnancies towards neonatal mortality. The purpose of this study is to determine how unwanted pregnancy affecting the risk of neonatal mortality and the dominant risk factors for neonatal death among women at risk of childbirth considering their residence, rural and urban areas. The study design of this research is a cross sectional with multivariable logistic regression analysis using IDHS 2017. The number of research subject used in this study were 1618 live births in urban areas and 1645 live births in rural areas among women at risk of childbirth population. The results showed that unwanted pregnancy was not statistically associated to neonatal mortality both in urban and rural area. The results of the bivariate analysis showed that the variable which statistically associated to neonatal mortality both in urban and rural area is low birth weight (lbw) (purban=0,001; prural=0,002). Even After the unwanted pregnancy variables were being controlled by other variables using regression logistic analysis, it remains unrelated and does not increase the risk of neonatal mortality both in urban and rural areas. In urban area, multivariable analysis results show risk factors for neonatal mortality are lbw (OR = 10.14), low education (OR = 2.67), parity 2-3 (OR = 8.4), and parity> 3 (OR = 32). In rural area, the risk factors for neonatal death are lbw (OR = 11), antenatal care 3 births for urban area and lbw for rural area. It can be concluded that unwanted pregnancy is not directly associated to neonatal mortality. However, previous studies have explained there are changes in maternal behavior towards inappropriate pregnancy care. Risk factors for neonatal death vary according to types of residence, urban and rural area.
Keywords: unwanted pregnancy, neonatal mortality, risk factors, rural, urban
Defisit pertumbuhan anak usia kurang dari 5 tahun banyak didapatkan di negara Asia Tenggara, termasuk Indonesia (Schultink, Warner, 2000; WHO, 1997). WHO melaporkan di tahun 1992 terdapat ± 50% anak berumur kurang dari 5 tahun diklasifikasikan sebagai pendek (stunted) (WHO, 1992), keadaan ini masih tetap bertahan sampai dengan tahun 1997 (WHO, 1997). Jika keadaan ini di Indonesia tidak mengalami perubahan dari tahun ke tahun, maka dapat membawa dampak terutama pada perkembangan kognitif anak di usia 7-8 tahun. Dampak lain dari pendek ialah melemahnya kekebalan tubuh, mengurangi performa kerja. Pertumbuhan anak umur antara setahun sampai masa 7-8 tahun sering disebut sebagai masa laten atau tenang. Keadaan ini berbeda dengan masa bayi dan remaja dimana pertumbuhan fisiknya sangat pesat. Walaupun pada masa anak ini pertumbuhan fisiknya lambat, tetapi merupakan masa untuk perkembangan motorik, kognitif, dan emosional (McGregor, 1995). Pertumbuhan dan perkembangan anak merupakan proses panjang yang berkesinambungan. Dengan demikian, derajat kesehatan anak perlu diketahui perkembangannya dan tidak hanya dilihat sesaat, melainkan harus dilihat secara berkesinambungan selama kehidupan anak. Penelitian ini menggunakan data longitudinal Indonesian Family Life Survei tahun 1993-2000. Determinan defisit pertumbuhan tinggi badan anak usia 7-8 tahun dianalisis dengan menggunakan uji regresi generalized estimating equation (GEE). Hasil penelitian menunjukan variabel yang dapat mempengaruhi defisit tinggi badan anak pada usia 7-8 tahun adalah defisit pertumbuhan anak di usia 1-2 tahun, faktor genetik (tinggi badan bapak dan ibu), kebiasaan minum susu, area tempat tinggal anak, kesehatan lingkungan, dan jenis kelamin. Variabel yang paling dominan terhadap defisit pertumbuhan tinggi badan anak yaitu jenis kelamin anak. Anak laki-laki lebih berisiko untuk mengalami defisit tinggi badan sebesar 1,7 kali dibandingkan dengan anak perempuan. Berdasarkan penelitian tersebut disarankan perlunya peran orang tua dalam memantau perkembangan anak, perbaikan kondisi sosial ekonomi, edukasi bagi orang tua, revitalisasi fungsi posyandu, dan pemberian nutrisi bagi anak sekolah.
Growth retardation during early childhood found in many Southeast Asian countries, including Indonesia (Schultink, Warner, 2000). WHO reported in 1992 there were 50% of children age less than 5± years and classified as stunting (WHO, 1992). This situation still survive until the year 1997 (WHO, 1997). If this situation in Indonesia does not change from year to year, it can bring, especially the impact on cognitive development in children ages 7-8 years. Growth retardation during early childhood is rarely made up; so stunted children usually become stunted adults. The growth of children age between one year to the 7-8 year period is often referred to as a latent or quiet. The situation is different with the baby and young people where physical growth is very rapid. It is acknowledged that growth retardation in early chlidhood works through in adolescence and adulthood, but no information on the growth from infancy until adolencence was available in Indonesia. Causes and long term effects of growth retardation can only be studied through longitudinal studies, and only a limited number of these studies have been done in Indonesia. This study were used longitudinal data Indonesian Family Life Surveys in 1993 through 2000. Determinant growth retardation of children aged 7-8 years analyzed using a Generalized Estimating Equation (GEE). The research results showed that there was a positive realtionship between children retardation at the age of 7-8 years and their height at 1-2 years, genetic factors (height of the father and mother), drinking milk habits, the area where children live, environmental health, and sex. The most dominant of the children growth retardation is sex of the children. The boys are more at risk to have stunted 1.7 times compared with the girls. Based on the study, we recommended that need role of parents in monitoring child development, improvement of socio-economic conditions, education for parents, revitalization posyandu function, nutrition intervention for school children are necessary to support the attainment of their optimal growth potential.
Kata Kunci: Penyakit Jantung Koroner, Obesitas Sentral.
Coronary heart disease is a degenerative disease that remains a health problem in the world. One of the factors of coronary heart disease are central obesity. The percentage of central obesity status is increased from 2007 to 2013. This study was conducted to examine the relationship of central obesity to coronary heart disease. The study design used is cross sectional and use data Riskesdas 2013. Samples were all residents aged 45 years and over who meet the inclusion and exclusion criteria. The results of this study indicate that the prevalence of coronary heart disease was 1.2 and there is corelation between central obesity status of coronary heart disease at the age of 45 years and over in Indonesia in 2013 after being controlled by confounding variables. Confounding factors that are diabetes, hypertension, and smoking behavior. In addition, there is an interaction by confounding variables to central obesity, namely diabetes and smoking. Therefore, required health promotion ranging from coronary heart disease health promotion both primary prevention and secondary prevention.
Keywords: Coronary Heart Disease, Central Obesit
