Tesis

Perkembangan Neonatus Kurang Bulan Pascarawat di RSCM pada Usia Koreksi 9-10 Bulan Berdasarkan Bayley Scales of Infant and Toddler Development dan Faktor Risiko yang Memengaruhinya = Development of preterm neonates after hospitalization at RSCM at corrected age 9-10 months based on Bayley Scales of Infant and Toddler Development and risk factors influencing developmental disorder.

Latar belakang: Neonatus kurang bulan merupakan kelompok risiko tinggi yang rentan terhadap masalah perkembangan. Selama beberapa dekade terakhir, kemajuan teknologi di Neonatal Intensive Care Unit (NICU) telah meningkatkan kelangsungan hidup neonatus kurang bulan. Secara keseluruhan, perawatan neonatus kurang bulan adalah tidak hanya untuk menurunkan angka kematian tetapi juga untuk meningkatkan kualitas hidup bagi neonatus yang hidup. Rumah Sakit Cipto Mangunkusumo (RSCM) merupakan rumah sakit rujukan tersier neonatal dengan pelayanan neonatal terbaik di Indonesia. Oleh karena itu, penelitian ini bertujuan untuk melihat luaran perkembangan dan faktor risiko gangguan dari neonatus kurang bulan pascarawat di RSCM. Metode: Studi analitik dengan metode potong lintang terhadap neonatus kurang bulan pascarawat di RSCM selama periode April-Agustus 2023. Penilaian perkembangan menggunakan instrumen Bayley Scales of Infant and Toddler Development edisi III. Hubungan antara usia kehamilan, kecil masa kehamilan, status gizi, brain injury, sepsis neonatal dengan luaran perkembangan dianalisis dengan uji Fisher exact. Hasil: Dari 75 subjek yang memenuhi kriteria inklusi, didapatkan sebaran jenis kelamin yang hampir sama besar antara laki-laki dan perempuan dengan usia kronologis 11,9±0,9 bulan dan usia koreksi 10,1±0,7 bulan. Sebesar 29,3% neonatus kurang bulan mengalami gangguan perkembangan. Gangguan motor merupakan gangguan perkembangan yang paling banyak ditemukan, yaitu sebesar 21,3%, diikuti gangguan bahasa, kognitif, dan sosial-emosional, yaitu 18,7%, 10,7% dan 1,3%, secara berurutan. Status gizi berhubungan signifikan dengan luaran perkembangan bahasa ekspresif (p=0,004; OR 8,04, CI=1,64-42,63). Kesimpulan: Sebesar 29,3% neonatus kurang bulan pascarawat di RSCM mengalami gangguan perkembangan. Gangguan motor adalah gangguan perkembangan yang paling banyak ditemukan. Status gizi merupakan faktor risiko gangguan perkembangan bahasa ekspresif pada neonatus kurang bulan.
Kata kunci: neonatus kurang bulan, luaran perkembangan, faktor risiko, Bayley III


Background: Premature neonates are a high-risk group ofdevelopmental problems. Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of premature neonates. Premature neonates care is not only to reduce mortality but also to improve the quality of life for surviving neonates. Cipto Mangunkusumo Hospital (RSCM) is a tertiary neonatal referral hospital with the best neonatal services in Indonesia. This study was aimed to analyze the risk factors of developmental delay and developmental outcomes of preterm neonates after hospitalization at RSCM. Methods: An analytic study with cross-sectional design involves premature neonate posthospitalization at RSCM during April-August 2023. Developmental assessment using of Bayley Scales of Infant and Toddler Development-Third edition. Association between gestational age, small gestational age, nutritional status, brain injury, neonatal sepsis and developmental outcomes were analyzed using Fisher exact test. Results: Out of the 75 subjects who met the inclusion criteria, there was nearly an equal distribution of gender, with both males and females, having a chronological age of 11.9 ± 0.9 months and a corrected age of 10.1 ± 0.7 months. A total of 29.3% of preterm neonates experienced developmental disorders. Motor disorders were the most commonly identified developmental issue, accounting for 21.3%, followed by language, cognitive, and social-emotional disorders at 18.7%, 10.7%, and 1.3%, respectively. Nutritional status was significantly associated with the outcomes of expressive language development (p=0.004; OR 8.04, CI=1.64-42.63). Conclusion: 29.3% of preterm neonates after care at RSCM experienced developmental disorders. Motor disorders were the most frequently observed developmental disorders. Nutritional status is a significant risk factor for expressive language developmental disorders in preterm neonates.
Key words: premature neonates, developmental outcomes, risk factor, Bayley III