Tesis

Hubungan Profil Lipid dengan Derajat Inflamasi pada Ibu Hamil = The Relationship between Lipid Profile and Degree of Inflammation in Pregnant Women.

Latar belakang: Inflamasi berperan penting sebagai pusat keberhasilan suatu proses reproduksi termasuk kehamilan. Namun, kondisi respon inflamasi yang berlebihan pada trimester pertama kehamilan dapat menimbulkan morbiditas kehamilan seperti preeklamsia, persalinan prematur dan pertumbuhan janin terhambat. Salah satu penyebab inflamasi berlebihan adalah hiperlipidemia. Kondisi hiperlipidemia merupakan faktor risiko yang dapat dimodifikasi sehingga morbiditas maternal dapat dicegah. Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan profil lipid dengan derajat inflamasi pada ibu hamil trimester pertama. Metode: Penelitian cross-sectional ini dilakukan pada bulan April hingga Oktober 2022, dengan jumlah sampel 98 ibu hamil berusia antara 20 sampai 40 tahun yang menjalani pemeriksaan kehamilan trimester pertama di Puskesmas Kramat Jati Jakarta. Peserta berusia 20-40 tahun dengan kehamilan intrauterin dimasukkan, sedangkan peserta dengan kondisi medis tertentu dikeluarkan. Pengumpulan data dilakukan melalui anamnesis, pemeriksaan fisik, pemeriksaan USG, dan sampel darah. Analisis data akan melibatkan analisis univariat dan bivariat, serta analisis multivariat dengan menggunakan model regresi logistik untuk menentukan variabel bebas yang paling signifikan. Hasil: Distribusi profil lipid pada sebagian besar responden didapatkan kadar kolesterol total, trigliserida, LDL, HDL, dan rasio LDL/HDL-nya normal. Sebagian besar responden mempunya kadar CRP yang normal (62,2%) dan hs-CRP yang tinggi (85,7%). Pada analisis bivariat menunjukkan terdapat hubungan trigliserda dengan CRP (p = 0,026) dengan risiko relatif (RR: 2,04, IK 95%). Pada analisis multivariat menunjukkan terdapat hubungan trigliserida dan CRP (p = 0,017) dengan risiko relatif (RR: 4,48, IK 95%). Kesimpulan: Peningkatan kadar TG pada wanita hamil dikaitkan dengan kemungkinan peningkatan peningkatan CRP selama trimester pertama. Profil lipid lain seperti kolesterol LDL, kolesterol HDL, dan rasio LDL/HDL tidak menimbulkan risiko peradangan selama periode ini.
Kata kunci: profil lipid, kehamilan, inflamasi


Background: Inflammation plays an important role as a center for the success of a reproductive process including pregnancy. However, conditions of excessive inflammatory response in the first trimester of pregnancy can cause pregnancy morbidities such as preeclampsia, preterm labor and stunted fetal growth. One of the causes of excessive inflammation is hyperlipidemia. Hyperlipidemia is a modifiable risk factor so that maternal morbidity can be prevented. Purpose: This study aims to evaluate the relationship between lipid profile and degree inflammation in pregnant women. Methods: This cross-sectional study was conducted from April to October 2022, with a sample size of 98 pregnant women aged between 20 and 40 who underwent first trimester antenatal care at Kramat Jati Community Health Center in Jakarta. Participants aged 20-40 years old with an intrauterine pregnancy was included, while participants with certain medical conditions were excluded. Data was collected through history-taking, physical examination, ultrasound examination, and blood samples. Data analysis will involve univariate and bivariate analysis, as well as multivariate analysis using logistic regression models to determine the most significant independent variables. Results: This study conducted on 98 first-trimester pregnant women with an average age of 28.39 years and a median of the 10th week of pregnancy found that 29.6% had high cholesterol levels, 15.3% had high triglyceride (TG) levels, 49% had high LDL levels, and 1% had a high LDL/HDL ratio. A majority (85.7%) of the respondents had high hs-CRP, while high CRP levels were found only in 37.8%. The bivariate analysis showed a significant relationship between CRP and triglycerides (p-value 0,026), while the other parameters were not significant. The multivariate analysis was showed the most significant relationship between CRP and triglycerides (p-value = 0.017). This study showed that the highest relative risk of CRP was against triglyceride (2,04), followed by total cholesterol (1,45) and LDL (1,31). Conclusion: Elevated TG levels in pregnant women are associated with an increased likelihood of CRP elevation during the first trimester. Other lipid profiles like LDL cholesterol, HDL cholesterol, and LDL/HDL ratio do not pose a risk of inflammation during this period.
Keywords: lipid profile, pregnancy, inflammation