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Claudia Holzman, Patricia K. Senagore, Jianling Wang
Abstrak:
Large numbers of polymorphonuclear leukocytes in the amnion and chorion define histological chorioamnionitis (HCA), a condition linked to spontaneous preterm delivery (PTD). Less is known about placental patterns of mononuclear leukocyte (MNL) density and PTD. In this prospective study (1998-2004), women were sampled from 52 clinics in 5 Michigan communities and enrolled at 16-27 weeks' gestation. HCA and MNL distributions in delivered placentas were evaluated microscopically in a subcohort (290 preterm, 823 term). Midpregnancy biomarkers from maternal blood (i.e., C-reactive protein (CRP), corticotropin-releasing hormone, and cytokines) were compared among term and PTD subjects grouped by presence/absence of HCA and high MNL density. A density of more than 10 MNLs per high-power field in the chorion of the membrane roll, referred to as MNL-CMR, was associated with medically indicated PTD (odds ratio = 2.2, 95% confidence interval: 1.3, 3.6) and spontaneous PTD (odds ratio = 2.5, 95% confidence interval: 1.7, 3.7). Associations persisted after removal of women with HCA-positive placentas, abruption, hypertensive disorders, or obesity. HCA-associated PTD showed higher CRP and cytokine levels. MNL-CMR-associated PTD showed higher CRP and corticotropin-releasing hormone levels. These data suggest that an MNL infiltrate in the chorion of the membrane roll marks PTD pathways that are distinct from HCA and not entirely explained by pregnancy complications.
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AJE Vol.177, No.10
Oxford : Oxford University Press, 2013
Indeks Artikel Jurnal-Majalah Pusat Informasi Kesehatan Masyarakat
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Agita Arintiany; Pembimbing: Yovsyah; Penguji: Trisari Anggondowati, Siti Maemun
Abstrak:
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Salah satu penyebab utama kematian neonatal di Indonesia adalah prematur. Selain kematian, komplikasi dari kelahiran prematur merupakan penyebab lamanya rawat inap di rumah sakit yang berdampak pada meningkatkan biaya kesehatan. Salah satu upaya untuk mencegah bayi lahir prematur dengan melakukan deteksi dini selama kehamilan melalui kunjungan antenatal care (ANC). Tujuan penelitian ini adalah untuk mengetahui hubungan keberlanjutan kunjungan ANC dengan kejadian kelahiran prematur di Indonesia. Data berasal dari hasil Survei Kesehatan Indonesia (SKI) tahun 2023 menggunakan desain studi cross sectional. Sampel terdiri dari 63.279 perempuan berusia 10-54 tahun yang pernah melahirkan bayi hidup dalam periode 2018-2023. Analisis statistik menggunakan uji chi square. Hasil penelitian ini menemukan prevalensi kelahiran prematur di Indonesia sebesar 12,4%. Terdapat hubungan signifikan antara keberlanjutan kunjungan ANC dengan kejadian kelahiran prematur (PR: 1,52; 95% CI: 1,46-1,59). Beberapa faktor lain yang berhubungan dengan kejadian kelahiran prematur di Indonesia diantaranya faktor risiko kehamilan (PR: 1,71; 95% CI: 1,64-1,78), kehamilan kembar (PR: 2,49; 95% CI: 2,19-2,84), kelengkapan pemeriksaan ANC (PR: 1,58; 95% CI:1,49-1,66), kepatuhan minum TTD (PR: 1,28; 95% CI:1,22-1,33), dan komplikasi kehamilan (PR: 1,27; 95% CI: 1,2-1,33). Kesimpulan: keberlanjutan kunjungan ANC memiliki hubungan signifikan dengan kelahiran prematur, dimana keberlanjutan ANC yang sesuai program menurunkan risiko lahir prematur. sehingga diharapkan ibu hamil dapat melakukan kunjungan ANC sesuai program yaitu minimal 6 kali selama kehamilan.
On of the main causes of neonatal death in Indonesia is prematurity. Apart from death, complications from premature birth are a cause of long hospital stays which have an impact on increasing health costs. One effort to prevent premature births is by carrying out early detection during pregnancy through antenatal care (ANC) visits. The aim of this research is to determine the relationship between the continuity of ANC visits and the incidence of premature birth in Indonesia. Data comes from the results of the 2023 Indonesian Health Survey (IHS) using a cross-sectional study design. The sample consisted of 63,279 women aged 10-54 years who had given birth to a live baby in the 2018-2023 period. Statistical analysis uses the chi square test. The results of this study found that the prevalence of premature birth in Indonesia was 12.4%. There is a significant relationship between continuity of ANC visits and the incidence of premature birth (PR: 1.52; 95% CI: 1.46-1.59). Several other factors associated with the incidence of premature birth in Indonesia include pregnancy risk factors (PR: 1.71; 95% CI: 1.64- 1.78), multiple pregnancies (PR: 2.49; 95% CI: 2, 19-2.84), completeness of ANC examination (PR: 1.58; 95% CI: 1.49-1.66), compliance with taking TTD (PR: 1.28; 95% CI: 1.22-1, 33), and pregnancy complications (PR: 1.27; 95% CI: 1.2-1.33). Conclusion: continuity of ANC visits has a significant relationship with premature birth, where continuity of ANC according to the program reduces the risk of premature birth. So it is hoped that pregnant women can make ANC visits according to the program, namely a minimum of 6 times during pregnancy.
S-11802
Depok : FKM UI, 2024
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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