Tesis

Perbandingan Kadar Vitamin D pada Serum Darah, Darah Tali Pusat dan Jaringan Plasenta pada Kehamilan Normal dan Preeklamsia = Comparison of Vitamin D Rates in Normal and Preterm Pregnancy in Maternal Serum, Umbilical Cord Blood and Placental Tissue.

Latar Belakang: Preeklamsia merupakan masalah penting yang dapat menyebabkan morbiditas dan mortalitas maternal dan perinatal. Preeklamsia berhubungan dengan stres oksidatif pada sirkulasi maternal. Preeklampsia merupakan hasil dari ketidakseimbangan antara produksi radikal bebas dengan antioksidan sehingga terjadi reaksi inflamasi berlebihan pada kehamilan yang berakibat disfungsi endotel. Antioksidan dan inflamasi dalam tubuh ditentukan oleh status gizi ibu dan bayi yang dapat dinilai dari kadar serum ibu seperti vitamin D Tujuan: Penelitian ini membandingkan kadar vitamin D pada serum maternal, darah tali pusat dan jaringan plasenta pada ibu hamil normal dan preeklamsia. Metode: Penelitian ini merupakan studi potong lintang dengan jumlah sampel 86 pasien yang melakukan persalinan di RS Cipto Mangunkusumo dan RSUD Tangerang. Setelah itu data disajikan dalam tabel dan dianalisis dengan uji parametrik, yaitu uji-t berpasangan bila sebaran data normal atau uji non parametrik, yaitu uji Mann-Whitney bila sebaran data tidak normal. Penelitian ini sudah lolos kaji etik dan mendapat persetujuan pelaksanaan dari Komite Etik Penelitian Kesehatan FKUI-RSCM. Hasil: Didapatkan kadar vitamin D serum maternal kelompok preeklamsia sebesar 16.30 (6.20-49.00) ng/mL sedangkan pada sampel kelompok tidak preeklamsia, sebesar 13.50 (4.80 – 29.20) ng/mL di mana didapatkan nilai p = 0,459, dengan tidak ada perbedaan bermakna secara statistik. Didapatkan kadar vitamin D tali pusat kelompok preeklamsia sebesar 11.80 (3.50 – 38.60) ng/mL sedangkan kelompok tidak preeklamsia sebesar 11.70 (1.00 – 28.80) ng/m, di mana didapatkan nilai p = 0.964, dengan tidak ada perbedaan bermakna secara statistik. Didapatkan kadar vitamin D jaringan plasenta kelompok preeklamsia sebesar 49.00 (22.00 – 411.00) ng/mL. sedangkan kelompok tidak preeklamsia, sebesar 43.40 (11.80 – 153.00) ng/mL, di mana didapatkan nilai p 0.354 dengan tidak ada perbedaan bermakna secara statistik Didapatkan hasil kadar vitamin D serum kelompok preeklamsia awitan dini sebesar 10.80 (6.20 – 41.90) ng/mL sedangkan kelompok preeklamsia awitan lanjut sebesar 18.00 (7.00 – 49.00) ng/mL dengan nilai p = 0,133, di mana tidak didapatkan perbedaan bermakna secara statistik. Didapatkan hasil kadar vitamin D tali pusat kelompok preeklamsia awitan dini sebesar 10.65 (3.50 – 38.60) ng/mL. sedangkan pada kelompok preeklamsia awitan lanjut, sebesar 12.65 (6.40 – 33.20) ng/mL. di mana didapatkan nilai p = 0.377 dengan tidak didapatkan perbedaan bermakna secara statistik. Didapatkan kadar vitamin D pada jaringan plasenta kelompok preeklamsia sebesar 79.00 (36.00 – 411.00) ng/g. sedangkan pada kelompok tidak preeklamsia sebesar 40.00 (22.00 – 171.00) ng/g. di mana didapatkan nilai p 0.006, dengan didapatkan perbedaan bermakna secara statistik pada rerata kadar vitamin D jaringan plasenta Kesimpulan: Tidak terdapat perbedaan bermakna secara statistik pada rerata kadar vitamin D pada darah serum, tali pusat dan jaringan maternal pada wanita preeklamsia dan tidak preeklamsia. Tidak terdapat perbedaan bermakna secara statistik pada rerata kadar vitamin D pada darah serum dan tali pusat pada wanita preeklamsia dan tidak preeklamsia Terdapat perbedaan bermakna secara statistik pada rerata kadar vitamin D pada plasenta wanita preeklamsia dan tidak preeklamsia
Kata kunci: vitamin D, preeklamsia, serum, tali pusat, jaringan plasenta


Background: Preeclampsia is an important problem that can cause maternal and perinatal morbidity and mortality. Preeclampsia is associated with oxidative stress in the maternal circulation. Preeclampsia is the result of an imbalance between the production of free radicals and antioxidants resulting in excessive inflammatory reactions in pregnancy, which caused endothelial dysfunction. The antioxidants and inflammation in the body are determined by the maternal and fetal nutritional status, which can be assessed from several antioxidants, one of which is vitamin D Objective: This study is designed for comparing vitamin D levels in maternal serum, cord blood and placental tissue in non preeclampsia and preeclampsia pregnant women. Methods: This study is a cross sectional study with the number of samples of 86 patients who deliver in Cipto Mangunkusumo Hospital and Tangerang District Hospital. After that the data is presented in the table and analyzed by parametric test, ie paired t-test when the distribution of normal data or non parametric test, ie Mann-Whitney test when the data distribution is not normal. This research has passed the ethical review and got approval of the implementation of the Medical Research Ethics Committee FMUI-RSCM. Results: The serum maternal vitamin D levels of preeclampsia group were 16.30 (6.20-49.00) ng / mL while in the non-preeclamptic sample group, 13.50 (4.80 - 29.20) ng / mL were obtained p = 0.459, with no statistically significant difference . The umbilical cord vitamin D levels of preeclampsia group were 11.80 (3.50 - 38.60) ng / mL while the preeclampsia group was 11.70 (1.00 - 28.80) ng / m, where p = 0.964 was obtained, with no statistically significant difference. Obtained vitamin D levels of placental tissue in the preeclampsia group by 49.00 (22.00 - 411.00) ng / mL. while the group did not preeclampsia, amounting to 43.40 (11.80 - 153.00) ng / mL, where p value of 0.354 was obtained with no statistically significant difference Earning serum vitamin D serum pre-eclampsia group onset was 10.80 (6.20 - 41.90) ng / mL whereas the onset of pre-eclampsia group was 18.00 (7.00 - 49.00) ng / mL with p value = 0.133, where no statistically significant difference was obtained. The results of the umbilical cord vitamin D levels of early onset preeclampsia group were 10.65 (3.50 - 38.60) ng / mL. whereas in the onset of pre-eclampsia group, it was 12.65 (6.40 - 33.20) ng / mL. where obtained p value = 0.377 with no statistically significant difference. Obtained vitamin D levels in placental tissue preeclampsia group of 79.00 (36.00 - 411.00) ng / g. while in the pre-eclampsia group was 40.00 (22.00 - 171.00) ng / g. where obtained p value of 0.006, with statistically significant difference in mean vitamin D levels of placental tissue Conclusion: There was no statistically significant difference in mean serum vitamin D levels in serum, cord blood and maternal tissue in women with preeclampsia and not preeclampsia. There was no statistically significant difference in mean vitamin D levels in serum and umbilical blood in pre-eclampsia and nonpreeclampsia women. There were statistically significant differences in mean vitamin D levels in female placenta preeclampsia and not preeclampsia
Keywords: vitamin D, preeclampsia, serum, umbilical cord, placental tissue