Tesis

Profil Tumbuh Kembang Anak Usia 0-3 Tahun Hasil Fertilisasi In-Vitro (FIV) di Jakarta = Growth and Development Profile of Children Aged 0-3 Years as a Result of In-Vitro Fertilization in Jakarta.

Latar belakang: Di Indonesia praktik bayi FIV telah berkembang cukup pesat di berbagai klinik dan Rumah Sakit. Namun begitu, belum ada studi terkait luaran pertumbuhan dan perkembangan pada bayi FIV. Tujuan: Mengetahui dan menganalisis profil tumbuh kembang dan hubungan luaran anak usia 0-3 tahun hasil kehamilan FIV dibandingkan hasil kehamilan alami Metode: Studi potong lintang digunakan untuk menggambarkan data karakterstik, luaran pertumbuhan dan perkembangan, serta morbiditas. Kemudian dilakukan kohort retrospektif pertumbuhan anak sejak lahir sampai usia saat pemeriksaan pada kelompok anak usia 0-3 tahun. Hasil: Tren BB, PB/TB, dan LK di kelompok FIV cenderung sama sampai usia 30 bulan, 15 bulan, dan 24 bulan. Uji Capute Scales didapatkan hasil gangguan komunikasi pada 9 anak, yaitu 3 anak FIV dan 6 anak non-FIV dengan 66,7% dan 16,7% BBLR late-preterm. Subjek hasil kehamilan FIV memiliki risiko kehamilan 2,65x multipel dengan nilai interval kepercayaan/IK 1,877-3,762 (p < 0,001), risiko seksio sesarean 2,48x nilai IK 1,938-3,190 (p < 0,001), 1,8x kelainan kongenital nilai IK 1,296-2,514 (p 0,061), dan risiko ASI tidak eksklusif 2,68x nilai IK 1,573-4,593 (p < 0,001) dibandingkan hasil kehamilan alami. Regresi multivariat menunjukkan subjek kelompok FIV memiliki 39,8x risiko kehamilan multipel (p 0,001) dan 5x ASI tidak eksklusif (p 0,002) dibandingkan subjek kelompok hasil kehamilan alami. Simpulan: Tren BB, PB/TB, dan LK antara kedua kelompok relatif sama sampai usia tertentu. Gangguan komunikasi cenderung lebih banyak dijumpai pada anak hasil FIV. Anak hasil FIV memiliki risiko lebih tinggi kehamilan multipel, kelahiran SC, kelainan kongenital, dan ASI eksklusif inadekuat dibandingkan anak hasil kehamilan alami
Kata kunci: tumbuh kembang, anak, fertilisasi in-vitro, jakarta


Background: The IVF practice has been well developed in number of health facilities and hospitals in Indonesia. However, the growth and development in children as a result of IVF have not yet studied. Objective: To reveal and analyze the growth of development profile between children aged 0-3 years old resulted of IVF and spontaneous pregnancy Methods: Cross-sectional study was performed to describe the characteristic data, growth and development profile, and morbidities. Retrospective cohort study of growth data from birth to current age was then performed. Results: The trend of body weight, body length/height, and head circumference between the two groups were tend to similar up to 30 months, 15 months and 24 months of age. Capute Scales test resulted communication disorders in 9 children consisted of 3 IVF and 6 non-IVF children with 66.7% and 16.7% of them were LBW late-preterm. Subjects with IVF had 2.65x risks of multiple pregnancies with CI 1.877-3.762 (p < 0.001), 2.48x risks of SC labour 2.48x CI 1.938-3.190 (p < 0.001), risks of congenital anomalies 1.8x CI 1.296-2.514 (p 0.061) and risks of inadequate breast feeding 2.68x CI 1.573-4.593 (p < 0.001) than non-IVF subjects. Multivariate regression showed that IVF subjects had higher risks of multiple pregnancy 39.8x (p 0.001) and inadequate breastfeeding 5x (p 0.002) than non-IVF subjects. Conclusion: The trend of body weight, body length/height and head circumference between the two group are relatively similar up to certain age. Communication disorders were found higher in IVF subjects. Subjects with IVF pregnancy had higher risks of multiple pregnancies, SC labour, congenital anomalies and inadequate breast feeding than non-IVF subjects.
Keywords: Growth and development, children, in-vitro fertilization, Jakarta.