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ABSTRAK Nama : Debri Rizki Faisal Program Studi : Epidemiologi (Field Epidemiology Training Program) Judul : Pengaruh Status Gizi Stunting Saat Balita dan Obesitas Ketika Dewasa Terhadap Risiko Hipertensi (Studi Longitudinal IFLS 1993 – 2014) Pembimbing : dr.Syahrizal Syarif, MPH, PhD. Stunting merupakan salah satu bentuk kekurangan gizi kronis yang ditandai dengan tinggi badan menurut usia kurang dari -2 SD (standar deviasi). Kondisi stunting pada usia balita berdampak jangka panjang terhadap dewasa yang pendek dan rentan terhadap penyakit tidak menular ketika dewasa. Penelitian ini bertujuan untuk mengetahui pengaruh efek gabungan kondisi stunting saat balita dan obesitas ketika dewasa terhadap risiko hipertensi. Desain penelitian cohort retrospective menggunakan data sekunder Indonesia Family Life Survey (IFLS) periode 1-5. Populasi target adalah balita usia 2-5 tahun pada tahun 1993 sebanyak 2.642 orang, kemudian di follow up hingga dewasa pada tahun 2014. Jumlah sampel yang memenuhi kriteria inklusi dan eksklusi adalah 588 orang. Analisis data menggunakan uji cox regression dengan 95%CI. Standar pengukuran sebagai berikut stunting (TB/U < -2 SD), obesitas (IMT ≥ 27 kg/m 2 ) dan hipertensi (≥ 140/90 mmHg). Hasil penelitian didapatkan bahwa dari 588 orang dimana 13.27% mengalami hipertensi dengan proporsi orang yang stunting saat balita dan obesitas ketika dewasa 27.27%. Analisis multivariate ditemukan bahwa responden dengan status gizi stunting dan obesitas berisiko 2.46 (95% CI; 1.23 - 4.90) kali; obesitas dan tidak stunting 2.25 (95% CI; 1.12 – 4.50) kali; stunting dan tidak obesitas berisiko 0.95 (95% CI; 0.55 – 1.62) kali, mengalami hipertensi dibandingkan dengan responden yang tidak mengalami stunting saat balita dan tidak obesitas ketika dewasa. Risiko kejadian hipertensi meningkat 10.56% akibat interaksi antara kondisi stunting saat balita dan obesitas ketika dewasa. Pentingnya pencegahan stunting pada 1000 Hari Pertama Kehidupan dan mengoptimalkan Posbindu PTM dalam melakukan skrining obesitas dan hipertensi serta pengendalian faktor risiko PTM untuk menurunkan prevalensi penyakit tidak menular terutama obesitas dan hipertensi. Kata kunci: Stunting, Obesitas, Hipertensi, Kohort, Efek Gabungan.
ABSTRACT Name : Debri Rizki Faisal Study Program : Epidemiology (Field Epidemiology Training Program) Title : The Effect Of Early Stunting And Adult Obesity To Increase Risk Of Hypertension (Longitudinal Study IFLS 1993 – 2014) Counsellor : dr.Syahrizal Syarif, MPH, PhD. Stunting due to chronic malnutrition condition that is characterized by Height for Age Z score less than -2 SD (standard deviation). The early stunting in children under five years has a long-term impact on adults are short stature and vulnerable to risk non-communicable diseases in later life. This study aims to determine the joint effect of early stunting conditions and adult obesity to risk for hypertension. This study design was a cohort retrospective using secondary data from the Indonesia Family Life Survey (IFLS) period 1-5. The target population was children aged 2-5 years in 1993 with numbers of 2,642 people and then follow up until adulthood in 2014. The number of samples that met the inclusion and exclusion criteria were 588 people. Data analysis used Cox regression test with 95% CI. Standard of measurements was stunting (HAZ <-2 SD), obesity (IMT ≥ 27 kg / m 2 ) and hypertension (≥ 140/90 mmHg). The results showed that of 588 people where 13.27% had hypertension where the proportion of respondent with early stunting and adult obese was 27.27%. Multivariate analysis found that respondents with nutritional status both early stunting and adult obesity have a risk of 2.46 (95% CI; 1.23 - 4.90) times; obese and not stunting 2.25 (95% CI; 1.12 - 4.50) times; stunting and not obese 0.95 (95% CI; 0.55 - 1.62) times, for having risk of hypertension compared to respondents neither experience stunting and obese. The risk of hypertension increases 10.56% due to the interaction between early stunting and obesity adults. The importance prevention of stunting in The First 1000 Days of Life and optimize Posbindu PTM in screening obesity, hypertension and controlling risk factors NCD to reduce the prevalence of non-communicable diseases, especially obesity and hypertension. Key words: Stunting, Obesity, Hypertension, Cohort, Joint Effects.
Komplikasi kehamilan adalah masalah kesehatan yang sering terjadi selama hamil dan berdampak pada mortalitas dan morbiditas ibu dan bayi baru lahir. Peneliti tidak menemukan studi di Indonesia yang membahas komplikasi kehamilan secara umum pada kelompok usia <20 tahun dan ≥35 tahun. Penelitian ini bertujuan untuk menganalisis hubungan antara usia ibu saat hamil dengan kejadian komplikasi kehamilan di Indonesia menggunakan data IFLS V 2014/2015. Sampel yang di analisis pada penelitian ini berjumlah 1.325 setelah memenuhi kriteria inklusi dan eksklusi. Analisis multivariat menggunakan uji multiple cox regression digunakan untuk mengetahui pengaruh usia ibu yang berisiko dalam menyebabkan komplikasi kehamilan pada populasi ibu yang pernah melahirkan pada tahun 2013-2015. Pada penelitian ini dilakukan analisis pada sub populasi untuk jenis komplikasi tertentu. Hasil studi menunjukkan prevalensi komplikasi kehamilan sebesar 24%. Tidak terdapat hubungan yang signifikan secara statistik. Hasil akhir analisis multivariat, komplikasi kehamilan secara umum pada usia ibu saat hamil <20 tahun (aPR 0,98, 95% CI 0,60–1,57), sedangkan usia ibu saat hamil ≥35 tahun memiliki risiko 1,16 kali mengalami komplikasi kehamilan dibandingkan kelompok usia ibu saat hamil 20-34 tahun setelah dikontrol kovariat (aPR 1,16, 95% CI 0,85–1,57). Terdapat peningkatan risiko pada sub populasi komplikasi kehamilan dan sub populasi komplikasi perdarahan antepartum baik pada usia ibu saat hamil <20 tahun atau ≥35 tahun.
Pregnancy complications are common health issues during pregnancy and impact maternal and neonatal mortality and morbidity. Author did not find studies in Indonesia that analyze pregnancy complications in general, particularly for maternal age of <20 years and ≥35 years. This study aims to analyze the relationship between maternal age and the occurrence of pregnancy complications in Indonesia using IFLS V data. The samples analyzed in this study was 1,325 after fulfilling the inclusion and exclusion criteria. Multivariate analysis with multiple cox regression was used to determine the effect of maternal age at risk in causing pregnancy complications in a population of mothers who gave birth in 2013-2015. This study also analyzed subpopulations was performed for specific types of complications. The results showed that prevalence of pregnancy complications was 24%. There was no statistically significant relationship. The final results of the multivariate analysis showed that pregnancy complications in general occurred in maternal age <20 years (aPR 0.98, 95% CI 0.60–1.57), while maternal age ≥35 years had a 1.16 times higher risk of experiencing pregnancy complications compared to maternal age 20-34 years after controlling covariates (aPR 1.16, 95% CI 0.85–1.57). There is an increased risk in the subpopulation of pregnancy complications and antepartum hemorrhage among maternal age <20 years or ≥35 years during pregnancy.
Stunting is a malnutrition that is still a public health problem in Indonesia and causes various adverse effects on children's health. Besides caused by a chronic lack of nutrition, stunting can also be caused by recurrent of infectious diseases. Efforts to prevent infectious diseases, such as immunization, will play a role in increasing child growth, especially in developing countries. The purpose of this study was to examine the association between basic immunization status and the incidence of stunting in toddlers in Indonesia. This study used a cross-sectional study design using secondary data from SSGI 2021. The inclusion criteria for this study were that toddlers were aged 12–59 months at the time of data collection, their height was measured, were not experiencing severe or chronic illness, and had complete variable data. A total of 70,267 toddlers met the inclusion criteria, and all were taken as research samples. Data analysis was performed using the Cox regression to obtain a prevalence ratio (PR) with 95% of confidence interval. This study shows that the prevalence of stunting among children aged 12–59 months in Indonesia is 23.1%, and the proportion of children under five who have complete basic immunization status is 74.92%. The results of the multivariate analysis showed that basic immunization status had a statistically significant association with the incidence of stunting. Toddlers with incomplete basic immunization status are at risk 1.19 times higher for stunting compared to toddlers with complete basic immunization status [adjusted PR 1.19 (95% CI 1.15–1.23)]. Toddlers who are not immunized at all have an even higher risk of experiencing stunting, which is 1.27 times higher compared to toddlers with complete basic immunization status [adjusted PR 1.27 (95% CI 1.15–1.39)], after controlling for variables such as the mother's education, economic status, and the child's birth weight. Efforts are needed to complete the child's immunization status on time according to schedule and increase the mother's knowledge regarding the use of health services, the fulfillment of toddler nutrition, and the stimulation of child growth and development.
Preeclampsia/eclampsia is one of the major causes of maternal mortality inIndonesia. The maternal mortality rate in Indonesia is still relatively high in Asiancountries. One of the causes of preeclampsia/eclampsia is maternal obesity. Theaim of this studyis to know the distribution and prevalence of the factors thatcould affect the occurrence of preeclampsia/eclampsia and to know theassociation of the obesity and preeclampsia/eclampsia in the mother duringpregnancy or delivery in Indonesiain 2010,after controlled by maternal age,parity, mother's occupation, mother's education level, economic status, birthweight, history of smoking, history of abortion, antenatal visits and quality ofantenatal care variable. Study design is cross-sectional using multivariate analysiswith multiple logistic regression. The study sample by taking all sampled thateligible in 2010 Basic Health Survey are 5,112 respondents (680 respondentsobese and 4,432 respondents non-obese). Study result is shown the prevalence ofobesity was 13.30% and preeclampsia/eclampsia was 3.91%. There is arelationship of obesity and preeclampsia/eclampsia with Odds Ratios (OR) of1,88 (95% CI1,33 to 2,66) after controlled by maternal age, birth weight andsmoking history variable. So, obesity is a significant factor in the cause ofpreeclampsia/eclampsia. Therefore, the government and community should playan active role in the prevention of preeclampsia/eclampsia with maintaining ahealthy weight since their teens so not obese during pregnancy.Key word : Preeclampsia/eclampsia, obesity, 2010 Basic Health Survey
