Maternal education, prematurity and the risk of birth asphyxia in selected hospitals in Jakarta

Abstrak Latar belakang: Asfiksia dapat menyebabkan kerusakan organ berat dan berakibat fatal pada bayi barulahir. Berdasarkan hasil analisis lanjut Riskesdas 2007, asfiksia merupakan penyebab kematian keduapada bayi setelah infeksi. Tujuan penelitian ini adalah untuk mengidentifikasi faktor risiko yang berkaitandengan kejadian bayi asfiksia pada bayi baru lahir. Metode: Data diambil dari rekam medik wanita hamil yang melahirkan di dua rumah sakit (RS) diJakarta, yang dipilih secara purposif di antara yang melahirkan pada periode 1 Januari sampai 31Desember 2011. Kelahiran asfiksia ialah bayi baru lahir dengan skor Apgar kurang dari tujuh, satu menitsetelah lahir. Analisis data dilakukan dengan menggunakan regresi logistik. Hasil: Pada analisis ini diperoleh 2777 sampel dari 4191 yang memiliki data lengkap. Proporsi asfiksiapada bayi baru lahir adalah 6,5%. Jika dibandingkan wanita berpendidikan tinggi, wanita berpendidikanrendah memiliki risiko melahirkan bayi asfiksia 4,3 kali lebih tinggi [rasio odds suaian (ORa) = 4,31;P=0,000], sedangkan wanita berpendidikan menengah dibandingkan dengan yang tinggi berisiko 3,3kali lebih tinggi melahirkan bayi dengan asfiksia (ORa=3,31; P=0,000). Selanjutnya, jika dibandingkan bayi cukup bulan, bayi prematur memiliki risiko 3,1 kali lebih tinggimengalami asfiksia (ORa=3,07; P=0,000), sedangkan bayi postmatur 63% (namun tidak signifikan) lebihtinggi berisiko mengalami asfiksia (P=0.118). Kesimpulan: Wanita yang memiliki tingkat pendidikan rendah dan menengah serta bayi prematur memiliki risikolebih tinggi mempunyai bayi baru lahir yang asfiksia. (Health Science Journal of Indonesia 2015;6:111-5) Kata kunci: pendidikan, prematur, asfiksia bayi baru lahir Abstract Background: Birth asphyxia can causes hypoxic ischemic organ damage in neonates. According toadvanced Indonesian Basic Health Research 2007, asphyxia was the second highest cause of infant deathafter infection (13.8%). This study aimed to identify several risk factors associated with birth asphyxia. Methods: This study was carried out in one government and one private hospitals in Jakarta. All medicalrecords of pregnant women who gave birth between January 1 to December 31 of 2011 were included.Birth asphyxia was defined as an Apgar score less then seven at one minute after birth. Logistic regressionwas used to analyze the risk factors related to birth asphyxia. Results: As many as 2777 samples out of 4191 were included for this analysis. The proportion of asphyxiain newborn babies was 6.5%. Compared with those who had high educated mothers, those who had loweducation level had 4.3-fold higher risk to have an asphyxiated baby [adjusted odds ratio (ORa) = 4.31;P=0.000]. Meanwhile middle educated mothers had 3.3-fold higher risk to have birth asphyxia (ORa=3.31;P=0.000). In terms of gestasional age at birth, compared with those who had full term birth, those who hadpreterm birth had 3.1-fold higher risk to have birth asphyxia (ORa=3.07; P=0.000). Meanwhile, althoughnot significant, those who had postterm birth had 63% more risk (P=0.118) to have birth asphyxia. Conclusion: The mother who had lower and middle education levels as well as preterm babies had higherrisk for having birth asphyxia baby. (Health Science Journal of Indonesia 2015;6:111-5) Keyword: maternal education, prematurity, birth asphyxia