Tesis

Penelitian Pendahuluan Prevalens dan Faktor Risiko terkait Disfungsi Auditorik pada Penapisan Gangguan Pendengaran Bayi Prematur di Rumah Sakit Cipto Mangunkusumo = Preliminary Study of the Prevalence and Risk Factors of Auditoric Dysfunction Based on Hearing Loss Screening of Preterm in Cipto Mangunkusumo Hospital .

Latar belakang: Angka kelahiran dan kesintasan bayi prematur mengalami peningkatan. Prematur memiliki morbiditas 7 kali lipat dari bayi cukup bulan. Gangguan pendengaran merupakan salah satu morbiditas yang masih tinggi insidensnya dengan 6 kasus per 1000 kelahiran di negara berkembang. Deteksi dini dan identifikasi faktor risiko dilakukan agar tidak terjadi keterlambatan diagnosis dan intervensi. Tujuan: Mengetahui prevalens dan faktor risiko disfungsi auditorik pada bayi prematur. Metode: Penelitian deskriptif-analitik dengan metode potong lintang dilakukan selama bulan Oktober 2016 sampai Januari 2017 pada bayi prematur usia 48 jam3 bulan yang dirawat di Divisi Perinatologi Departemen IKA FKUI/RSCM. Sampel dipilih secara consecutive sampling. Pengambilan data dilakukan dengan wawancara orangtua pasien, pengumpulan data retrospektif dari rekam medis, uji tapis DPOAE dan AABR. Analisis bivariat disfungsi auditorik dengan faktor risiko dinilai dengan uji chi-square dan fischer sebagai uji alternatif. Analisis multivariat dilakukan untuk menilai interaksi faktor risiko dengan regresi logistik. Hasil: Sejumlah 100 subyek memenuhi kriteria inklusi dan sebesar 25% subyek pernah mendapat perawatan intensif. Prevalens disfungsi auditorik pada bayi prematur sebesar 14%. Analisis multivariat faktor risiko yang berhubungan dengan disfungsi auditorik adalah usia gestasi (OR 3,824; IK 95% 1,109-13,179; p=0,034). Faktor risiko lain seperti berat lahir, pertumbuhan janin terhambat, hiperbilirubinemia, proven sepsis, pemakaian aminoglikosida, ventilasi mekanik lebih dari 5 hari, nilai Apgar yang rendah, abnormalitas lingkar kepala, riwayat gangguan pendengaran di keluarga tidak memiliki hubungan bermakna dengan disfungsi auditorik. Simpulan: Prevalens disfungsi auditorik pada bayi prematur sebesar 14%. Usia gestasi merupakan faktor risiko disfungsi auditorik pada bayi prematur.
Kata kunci: Disfungsi auditorik, uji tapis, prematur, faktor risiko, prevalens


Background: Preterm birth rate and survival has increased lately. Preterm has morbidity 7 times than term baby. Hearing loss was one of the high morbidities with 6 cases per 1000 birth in developing countries, Early detection and risk factors identification need to be conducted to prevent delayed diagnosis and intervention. Aim: To know the prevalence and risk factors associated with auditoric dysfunction in preterms. Methods: An analytical-descriptive study with cross sectional methods was conducted during October 2016 to January 2017 to preterm inpatients aged 48 hours-3 months in Perinatology Division Pediatric Departement FKUI/RSCM through consecutive sampling. Data were obtained by interviewing the parents, retrospective collecting from medical record, screening using DPOAE and AABR. Bivariate analysis with chi-square test and fischer as alternative test. Multivariate analysis was used to evaluate interaction between risk factors with logistic regression. Results: One hundred subjects fulfilled the inclusion criterias and 25% of the subjects have had intensive care. The prevalence of auditoric dysfunction in preterms were 14%. Multivariate analysis between gestational age and birth weight showed that gestational age is a risk factor associated with auditoric dysfunction (OR 3.824; CI 95% 1.109-13.179; p=0.034). Other risk factors such as birth weight, intrauterine growth retardation, hyperbilirubinemia, proven sepsis, aminoglycoside therapy, mechanical ventilator more than 5 days, low Apgar score, head circumference abnormality, family hearing loss history had no significant association with auditoric dysfunction. Conclusion: Auditoric dysfunction prevalence in preterm is 14%. Gestational age was risk factor of auditoric dysfunction in preterm.
Keywords: Auditoric dysfunction, screening, preterm, risk factors, prevalence.