Tesis

Faktor Risiko Hipertensi Sistemik pada Bayi Prematur Usia Gestasi Kurang Dari 32 Minggu = Risk Factors for Systemic Hypertension in Preterm Babies with Gestational Age Less Than 32 Weeks..

Latar Belakang Teknologi dan pengetahuan yang makin maju dalam perawatan bayi prematur meningkatkan angka harapan hidup, namun itu juga meningkatkan komplikasi prematuritas, salah satunya hipertensi. Hipertensi berat dan tidak diterapi mengakibatkan kegagalan multi organ dan kerusakan vaskular yang berat. Penelitian ini bertujuan untuk mengetahui faktor risiko hipertensi pada bayi usia gestasi (UG) < 32 minggu. Metode Penelitian observasional analitik dengan desain kasus kontrol dilakukan di Unit Neonatologi - Rumah Sakit Cipto Mangunkusumo, Jakarta periode 2020-2023. Kriteria inklusi, bayi UG < 32 minggu, berat lahir < 1500 gr yang mengalami hipertensi tiga hari berturut – turut, data rekam medis yang lengkap. Bayi dengan kelainan kongenital multipel, penggunaan inotropik, skala nyeri (NIPS) ≥ 3 dieksklusi. Total sampling sampai didapatkan 90 subjek untuk tiap kelompok. Analisis bivariat menggunakan uji chi-square dan uji t-test tidak berpasangan. Analisis multivariat menggunakan regresi logistik Hasil Sejumlah 536 data periode 2020 - 2023, 356 dieksklusi, 180 subjek penelitian. Hipertensi maternal, pemakaian kateter umbilikal dan perdarahan intraventrikular (PIV) dapat meningkatkan risiko kejadian hipertensi neonatal (OR = 2,29 (95% IK 1,20 – 4,36); p = 0,017; OR=2,48 (95% IK=1,36 – 4,54); p = 0,004 dan OR=5,37 (95% IK = 1,74 – 16,60); p = 0,003. Hasil analisis multivariat faktor risiko PIV memiliki pengaruh terbesar terhadap hipertensi neonatal, diikuti hipertensi maternal dan kateter umbilikal (OR = 5,31 (95% IK = 1,66 – 16,91); p = 0,005; OR = 2,34 (95% IK = 1,19 – 4,60); p = 0,013 dan OR = 2,14 (95% IK = 1,14 – 4,03); p = 0,017. Kesimpulan Hipertensi maternal, pemasangan kateter umbilikal dan perdarahan intraventrikular meningkatkan risiko kejadian hipertensi pada bayi UG < 32 minggu.
Kata Kunci Neonatus, Prematur, Hipertensi, Faktor Risiko


Background Knowledge and technology advancements in preterm care, has increased the life expectancy as the complications of prematurity. Severe neonatal hypertension that is not treated will lead to multi-organ failure and severe vascular damage. The study aimed is to determine the risk factors for hypertension in babies with gestastion age (GA) < 32 weeks. Method This analytical observational study with case control design was conducted at the Neonatology Unit, Cipto Mangunkusumo Hospital, Jakarta from 2020-2023. Inclusion criteria were GA < 32 weeks, birth weight < 1500 g with prove of high blood pressure at three consecutive days, and complete medical records. Preterm with multiple congenital anomalies, inotrope administration, and pain scale above 3 were excluded. Total sampling of 90 subjects were obtained for each group. Bivariate analysis used chi-square test and unpaired t-test method. Multivariate analysis using logistic regression. Results A total of 536 medical record data obtained periode 2020 - 2023, 356 excluded, 180 recruited. Maternal hypertension, umbilical catheters placement and intraventricular hemorrhage (IVH) were increased a risk of neonatal hypertension (OR = 2.29 (95% CI 1.20 – 4.36); p = 0.017; OR = 2.48 (95% CI = 1,36 – 4,54); p = 0.004 dan OR = 5.37 (95% CI = 1,74 – 16,60); p = 0.003. Multivariate analysis obtained that IVH was the strongest risk factor followed by maternal hypertension and umbilical catheter (OR = 5.31 (95% CI = 1.66 – 16.91); p = 0.005; OR = 2.34 (95% CI = 1.19 – 4.60); p = 0.013 dan OR = 2.14 (95% CI = 1.14 – 4.03); p = 0.017. Conclusion Maternal hypertension, umbilical catheter placement and intraventricular hemorrhage increased the risk of hypertension in babies with GA < 32 weeks
Keywords Neonates, Premature, Hypertension, Risk Factors