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Kata kunci : Kematian Neonatal, Jarak Kelahiran, SDKI 2012
Infant Mortality Rate is one of development indicator from a nation. Neonatal mortality (0-28 days) accounts for more than half (59.4%) of infant mortality. Based on the 2012 IDHS data the neonatal mortality rate decreased by 41%, from 32/1000 live births in 1991 to 19/1000 live births in 2007. But in the last two periods, there are stagnant condition of neonatal mortality rate, which is 19/1000 live births in 2007 and 2012. One of the factors that can increase neonatal mortality is birth spacing. This study aims to know the relationship between birth spacing and the incidence of neonatal death. This research is an analysis of data of Indonesia Demographic and Health Survey (SDKI) 2012. The research design is using case control study with the number of sample are 102 cases and 306 controls. Cases are infants who have neonatal death and the last child in a single labor. And control is a baby that lives past the age of 28 days. Multivariate analysis is using logistic regression showed that there was a significant difference of risk for neonatal mortality between mothers with birth spacing 78 months compared with 28-77 month of birth spacing. Mothers with birth spacing 78 months, mothers with birth spacing > 78 months had a risk of neonatal deaths of 1.95 times (95% CI: 1,126-3,368) compared with 28-77 months of birth spacing.
Keywords: Birth spacing, antenatal death, case control study, IDHS 2012
Kematian neonatal dini merupakan penyumbang kematian bayi dan perinatal yang merupakan indikator derajat kesejahteraan dan kesehatan bangsa. Angka kematian bayi dan perinatal di Indonesia masih tergolong tinggi dibanding negara Asia lainnya. Komplikasi kehamilan diduga menjadi faktor kuat kematian neonatal dini. Penelitian bertujuan untuk mengetahui seberapa besar pengaruh adanya komplikasi kehamilan dan setiap jenis komplikasi kehamilan serta ingin mengetahui PAR (Population Attributle Risk) terhadap kematian neonatal dini di Indonesia pada anak yang lahir 2002-2007 terhadap kematian neonatal dini setelah dikendalikan seluruh confounding. Desain studi yang digunakan dalam penelitian ini adalah crossectional dengan analisis multivariat complex sample cox regression. Sampel penelitiansebanyak 13893 dari 33 provinsi Indonesia yang diambil dengan metode Stratified two-stage cluster design.
Hasil analisis menunjukkan komplikasi kehamilan terhadap kematian neonatal dini dimodifikasi oleh berat lahir. Peneliti membuat dua model untuk membuktikan pengaruh komplikasi kehamilan terhadap kematian neonatal dini. Pada model pertama, PR komplikasi kehamilan terhadap kematian neonatal dini pada strata berat lahir <2000 gram sebesar 28,74 (95%CI: 10,21-81,02) PAR 13,92%, pada stratum ≥2000 gram sebesar PR 1,03 (95%CI: 0,32-3,34) PAR 11,94%. Pada model kedua, PR prematuritas memiliki risiko tertinggi PR 3,98 (95%CI 1,36-11,63) dengan PAR 8,1%. Diharapkan pemerintah dan masyarakat dapat berperan aktif dalam penurunan dan penanggulangan komplikasi kehamilan sedini mungkin dengan Antenatal care.
Early neonatal death is a contributor to infant and perinatal mortality that is an indicator of well-being and health degree in the nation. Infant and perinatal mortality rate in Indonesia is still higher than other Asian countries. Complications during pregnancy may be a strong factor of early neonatal death. This study want to determine how much influence and PAR of complication during pregnancy to early neonatal death in Indonesia after adjusted all confounding. This study used the cross-sectional design study with complex samples cox regression to multivariat analysis. There were 13893 respondents from 33 provinces in Indonesia were taken by stratified two-stage cluster sample technique.
The Results indicated that there are effect modification of Complication during pregnancy and birth weight to early neonatal death. This study created 2fixed models in multivariat analysis. In the first model, PR complication during pregnancy with birth weight <2000 gr 28,74(95%CI 10,21-81,02) PAR 13,92, complication during pregnancy with birth weight ≥2000 gr PR 1,03 (95%CI 0,32-3,34) PAR 11,94. In third model, only proven premature has significant to be early neonatal death risk with PR 3,98 (95%CI 1,36-11,63) PAR 8,1%. Health ministry and public can improve efectiveness of ANC to reduce complication during pregnancy and premature.
