Tesis

Faktor Prediktor Luaran Buruk Maternal dan Perinatal pada Kehamilan dengan Hipertensi = Predictors of Maternal and Perinatal Outcome in Pregnancy with Hypertension.

Latar belakang: Hipertensi pada kehamilan merupakan salah satu penyebab utama morbiditas dan mortalitas maternal dan perinatal. Ketersedian sarana yang terbatas pada pelayanan kesehatan mengharuskan diketahuinya faktor prediktor luaran maternal dan perinatal kasus hipertensi pada kehamilan. Tujuan: Mengetahui faktor prediktor luaran buruk maternal dan perinatal pada kehamilan dengan hipertensi. Metode: Penelitian ini merupakan studi analitik observasional dengan desain potong lintang pada ibu hamil dengan hipertensi yang melahirkan di RSUP Persahabatan periode Januari 2014 hingga Desember 2018. Pengambilan sampel secara total sampling. Usia ibu, usia hamil, tekanan darah sistolik, tekanan darah diastolik, kadar asam urat, kadar platelet, kadar SGOT, kadar SGPT, kadar ureum, kadar kreatinin, kadar LDH, dan kadar albumin merupakan variabel bebas berskala kategorik yang diperoleh dari rekam medik. Variabel terikat adalah luaran buruk maternal yaitu eklamsia, sindrom HELLP dan edema pulmonal. Sedangkan luaran buruk perinatal yaitu kelahiran preterm, skor APGAR 11 mg/dL (p = 0,041 OR 1,45 IK95% 1,01 – 2,0), dan faktor prediktor luaran buruk maternal adalah kadar albumin < 3,2 g/dL (p = 0,046 OR 2,26 IK95% 1,02 – 5,06). Simpulan: Albumin merupakan faktor prediktor independen terjadinya luaran buruk maternal dan/atau perinatal pada kasus hipertensi pada kehamilan.
Kata kunci: Hipertensi dalam kehamilan, hipoalbuminemia


Background: Hypertension in pregnancy is one of the main causes of morbidity and mortality in pregnancy and childbirth. Limited resources in health centers make it necessary to know the most important predictors of maternal and/or perinatal outcomes in pregnancy with hypertension. Aim: This study aims to determine the predictors for adverse maternal and/or perinatal outcomes in pregnancy with hypertension. Method: This is a cross-sectional observational-analytic study whose subjects are pregnant women who gave birth at Persahabatan General Hospital in January 2014 until December 2018. Data of maternal age, pregnant age, systolic and diastolic blood pressure, uric acid, platelet, SGOT, SGPT, ureum, creatinine, LDH, and albumin levels are independent variables retrieved by medical records. Maternal adverse outcomes in this study were eclampsia, HELLP syndrome, and pulmonary edema, while perinatal adverse outcomes were preterm birth, APGAR score < 7, and small-for-gestasional-age infant. Patients with documented changes in the independent variables because of other problems were excluded from the study. Result: Data collected were categorized and analyzed using bivariate and multivariate analysis. There were 631 subjects met the subject criteria. Predictor(s) for general adverse outcomes is albumin levels < 3.2 g/dL (p=0.038 OR=1.43 IK95% 1.02 – 2.01), for perinatal outcomes are albumin levels < 3.2 g/dL (p=0.025 OR=1.48 IK95% 1.05 – 2.07) and ureum levels > 11 mg/dL (p = 0.041 OR=1.45 IK95% 1.01 – 2.0), and for maternal outcomes is albumin level < 3.2 g / dL (p = 0.046 OR=2.26 IK95% 1.02 – 5.06). Conclusion: Albumin is an independent predictive factor for adverse maternal and/or perinatal outcome in pregnancy complicated with hypertension.
Keywords: Hypertension in pregnancy, hypoalbuminemia.