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Kata kunci :Komplikasi kehamilan, ANC, neonatal, kematian neonatal
This thesis discusses the pregnant women who experience complications duringpregnancy with the incidence of neonatal mortality. Neonatal mortality rate in anarea can be used as an indicator of the success of health care and healthdevelopment programs. In addition to the direct causes, there are also manyfactors triggering the occurrence of neonatal mortality. These factors includesocioeconomic factors, maternal factors, health service factors, neonatal factors,factors childbirth and postnatal care. This study used cross sectional design byusing multiple logistic regression analysis. The results of this study indicate thatthe cause of neonatal mortality is completeness ANC, visit neonatal, maternalage, birth attendants, maternal education, maternal employment and the place ofdelivery. Respondents who experienced pregnancy complications heartburnbefore 9 months have a chance at 1,021 to experience neonatal death,respondents who experienced pregnancy complications excessive bleeding have achance at 1,170 times to experience neonatal death, respondents who experiencedkommplikasi pregnancy fever has the opportunity for 1,153 times to experienceneonatal deaths , respondents who experienced pregnancy complications seizureshave a chance at 1,036 times to experience neonatal death, respondents whoexperienced pregnancy complications with danger signs of more than onejenistanda hazards such as hypertension, headache, fetal position, breechpresentation, and edema have a chance at 1,276 times to experience neonataldeath. And associated with complications of pregnancy, it is expected thegovernment to make efforts terhadapa early detection of complications inpregnancy and should be followed by continuous monitoring on compliancemother against the advice of health officials.
Keywords :Complications of pregnancy, ANC, neonatal, neonatal death
Abstrak
Setiap tahunya diperkirakan 289.000 ibu dan 2,62 Juta neonatal meninggal di seluruh dunia. Indonesia sendiri menduduki peringkat ke lima sebagai negara di wilayah Asia Tenggara dengan tingkat kematian neonatal dengan 11.7 kematian per 1000 kelahiran. Penyebab utamanya adalah BBLR, Afiksia, dan infeksi. Upaya pemerintah Indonesia dalam mengurangi kematian neonatal adalah salah satunya dengan cakupan kunjungan neonatal ke pelayanan kesehatan. Namun cakupan kunjungan neonatal belum mampu mencapai target RENSTRA (88 %). Berdasarkan Riskesdas 2018 Provinsi Papua (19.2 %) dan Provinsi Papua Barat (14.7 %) merupakan dua provinsi dengan cakupan kunjungan neonatal terendah di Indonesia. Untuk itu, penelitian ini bertujuan untuk mengetahui factor yang berhubungan dengan ketidaklengkapan kunjungan neonatal di Provinsi Papua dan Provinsi Papua Barat. Penelitian ini menggunakan desain potong lintang untuk menganalisis data Riskesdas 2018 pada 1.956 ibu yang memiliki anak usia 0 – 59 bulan dan dianalisis menggunakan analisis regresi logistic ganda. Hasil dari penelitian ini didapatkan 3 faktor dominan yang berhubungan dengan ketidaklengkapan kunjungan neonatal yaitu penolong persalinan, pendidikan ibu, dan riwayat ANC setelah dikontrol oleh variabel pekerjaan, tempat persalinan, pemanfaatan buku KIA.
Every year an estimated 289,000 mothers and 2.62 million neonatal deaths occur worldwide. Indonesia alone ranks fifth as a country in the Southeast Asian region with a neonatal mortality rate of 11.7 deaths per 1000 births. The main causes are LBW, Afiksia, and infection. The Indonesian government's effort to reduce neonatal mortality is one of them with the coverage of neonatal visits to health services. However, the coverage of neonatal visits has not been able to reach the RENSTRA target (88%). Based on Riskesdas 2018, Papua Province (19.2%) and West Papua Province (14.7%) are the two provinces with the lowest coverage of neonatal visits in Indonesia. Therefore, this study aimed to determine the factors associated with incomplete neonatal visits in Papua and West Papua Provinces. This study used a cross-sectional design to analyze Riskesdas 2018 data on 1,956 mothers with children aged 0 - 59 months and analyzed using multiple logistic regression analysis. The results of this study obtained 3 dominant factors associated with incomplete neonatal visits, namely delivery assistants, maternal education, and ANC history after being controlled by variables of employment, place of delivery, utilization of the MCH book in pregnancy history and in newborn history (AOR = 16.41 95% CI 7.65-35.22).
This thesis aims to determine the relationship between unintended pregnancy and antenatal care behavior which is a composite of the first antenatal visit, the frequency of antenatal checks and iron consumption. The method used is a cross-sectional design using the 2017 IDHS data. Analysis was performed with chi square and logistic regression models of risk factors. There is a relationship between unintended pregnancy and antenatal care behavior (p value = 0.0001). Mothers with unintended pregnancies have an opportunity to perform poor antenatal care behavior 2,338 times compared to intended pregnancies. The effect of unintended pregnancy on antenatal care behavior depends or varies according to the group of risky maternal age, parity and type of residence.
ABSTRAK Nama : Isti Dariah Program Studi : Kesehatan Reproduksi Judul : Faktor yang Berhubungan dengan Kematian Neonatal di Wilayah Kerja Dinas Kesehatan Kota Cimahi Tahun 2016 Latar Belakang: Kondisi pembangunan kesehatan secara umum dapat dilihat dari status kesehatan dan gizi masyarakat, yaitu salah satunya Angka Kematian Bayi. Penyumbang Angka Kematian bayi di kota Cimahi adalah Angka Kematian neonatal dimana pada tahun 2013 sebesar 83% Kematian bayi terjadi pada periode neonatal dan pada tahun 2014 sebesar 76,9% .Pada Tahun 2016 terjadi kematian neonatal 50 orang dan kematian bayi 66 dan sebagaian besar terjadi pada periode neonatal. Dalam 7 tahun ke belakang ( Tahun 2009 – 2015) program penurunan kematian bayi khususnya kematian neonatal di Kota Cimahi kurang signifikan bahkan cendrung naik pada Tahun 2016 dan belum adanya analisis mendalam terhadap penyebab kematian bayi. Metode: Penelitian bersifat observasional dengan desain kasus kontrol. Kasus adalah bayi meninggal usia 0 sampai dengan 28 hari. Sedangkan kontrol adalah bayi lahir hidup. Sampel dalam penelitian sebanyak 86 yang terdiri dari 43 kasus dan 43 kontrol. Data penelitian data berupa data sekunder dari hasil laporan otopsi verbal kematian neonatal, buku KIA dan data primer yang diperoleh langsung dari responden melalui wawancara tertulis dan formulir. Analisa data secara univariate dan bivariate dengan uji chi square. Hasil Penelitian: Analisi faktor risiko menunjukkan variable pendidikan (Nilai P=0,828), sosial ekonomi (Nilai P=0,008; OR=4,440), Umur Ibu (Nilai P=0,471; OR= 1,5930), paritas (Nilai P = 0,375; OR= 1,640 ), Jarak persalinan (nilai P= 0,009; OR= 7,935), Pekerjaan (Nilai P= 0,000; OR= 15,333), Status Gizi (nilai P = 0,016; OR=7.047), pengetahuan ibu tentang tanda bahaya kehamilan (Nilai P=0,015; OR= 4,032), pengetahuan tentang tanda bahaya bayi baru lahir (Pvalue= 0,001; OR= 10,982), Jenis Kelamin (Nilai P= 0,512), Usia Getasi (Nilai P=0,000; OR= 25,895), Asfiksia (Nilai P=0,000; OR=2,870), BBLR (Nilai P=0,000; OR=12,316), Infeksi (Nilai P= 0,018; OR=2,344),faktor persalinan (Nilai P= 1,000), Komplikasi (P= 0,010; OR=3,496), post natal care (nilai P= 0,023; OR=5,161), Pemeriksaan ANC (nilai P= 0,001 ; OR=5,914), IMD (P= 0,001; OR=12,500). Kesimpulan : Faktor ekonomi keluarga, jarak kehamilan, pekerjaan, status gizi, pengetahuan tentang bahaya kehamilan, pengetahuan tentang bahaya BBL, usia getasi, asfiksia, BBLR, infeksi, komplikasi post natal care, pemeriksaan ANC dan intervensi (IMD) berhubungan dengan kematian neonatal. Kata kunci: Faktor Risiko; Kematian Neonatal; Kasus Control
ABSTRACT Name : Isti Dariah Study Program : Reproductive Health Title : Factors Associated with Neonatal Mortality in the Work Territory of Health Region in Cimah City 2016 Background:Health development conditions in general can be seen from the health status and nutrition of the community, one of which is the Infant Mortality Rate (IMR). The contributor of the Infant Mortality Rate in Cimahi city is neonatal mortality rate. In 2013 the incidenceof infant mortality in neonatal period is 83%and 76.9% in 2014. In 2016, there are 50 of infant mortality and 60 of neonatal mortality. In the past 7 years (from 2009 to 2015)program to decreaseinfant mortality, especially neonatal mortality in Cimahi City is not significant,yet tend to increasein 2016 and there has not any deep analysis to what causes the infant mortality. Methods: The study was observational with case control design. Cases are infants dying from 0 to 28 days. While the controls arethe infants-bornalive. Samples in this study were 86 consisting of 43 cases and 43 controls. The data collected were secondary data from verbal autopsy report of neonatal death, KIA book and primary data obtained directly from respondents through written interview and forms. Data analysis used univariate and bivariate data with chi square test. Results: Risk factor analysis showed educational variables (P value = 0.828), socioeconomic (P value = 0.008 OR = 4.440), maternal age (P value = 0.471, OR = 1.5930), parity (P value = 0.375 ; OR = 1,640), Gestational Distance (P value = 0.009; OR = 7,935), Occupation (P = 0,000; OR = 15,333), Nutritional Status (P = 0.016; OR = 7.047), maternal knowledge about pregnancy alert (P = 0.015; OR = 4,032), knowledge of the newborn hazard (Pvalue = 0.001; OR = 10,982), Gender (P value = 0.512), Age Gestation (P = 0,000; OR = 25,895) Asphyxia (P = 0,000; OR = 2,870), BBLR (P = 0,000; OR = 12,316), Infection (P = 0.018; OR = 2,344), labor factor (P = 1,000), Complications (P = 0.010 ; OR = 3,496), post-natal care (P value = 0.023; OR = 5,161), ANC examination (P value = 0.001; OR = 5,914), IMD (P = 0.001; OR = 12,500). Conclusions: Family economic factors, gestational distance, occupation, nutritional status, knowledge of pregnancy hazards, knowledge of BBL dangers, age of gestation, asphyxia, LBW, infections, postnatal care complications, ANC and intervention (IMD) are associated with neonatal mortality. Keywords: Case control; Risk Factors; Neonatal Mortality.
