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"Latar belakang: Penyakit jantung bawaan (PJB) didapatkan pada 40-50% pasien sindrom Down, merupakan penyebab utama morbiditas dan mortalitas. Salah satu manifestasi tambahan lain selain PJB adalah hipertensi pulmoner. Faktor-faktor risiko yang berperan untuk terjadinya PJB, terjadi pada periode perikonsepsi yaitu 3 bulan sebelum kehamilan hingga trimester pertama kehamilan. Beberapa penelitian mengenai faktor risiko PJB yang telah dilakukan memiliki hasil yang tidak konsisten baik dalam populasi sindrom Down sendiri, maupun apabila dibandingkan dengan populasi umum. Tujuan: Mengetahui prevalens PJB dan hipertensi pulmoner, jenis PJB yang banyak didapatkan, dan faktor risiko PJB pada sindrom Down. Metode: Studi potong lintang observational analytic pada pasien sindrom Down berusia ≤5 tahun di RSCM. Data diambil dari wawancara dengan orangtua subyek yang datang langsung ke poliklinik rawat jalan RSCM Kiara, Departemen Rehabilitasi Medis, dirawat di Gedung A RSCM, IGD, perinatologi maupun orangtua dari subyek yang tercatat di rekam medis dengan diagnosis sindrom Down atau memiliki International Classification of Disease (ICD) 10 Q90.9 sejak Januari 2012 hingga Desember 2015. Hasil penelitian: Sebanyak 70 subyek sindrom Down memenuhi kriteria inklusi. Median usia subyek adalah 16,5 bulan. Penyakit jantung bawaan didapatkan pada 47,1% subyek. Defek septum atrium dan duktus arteriosus paten merupakan PJB terbanyak yang didapatkan yaitu masing-masing 30,3%. Penyakit jantung bawaan lain yang didapatkan adalah defek septum atrioventrikel dan defek septum ventrikel yaitu sebesar 18,2 dan 21,2%. Hipertensi pulmoner didapatkan pada 17,1% subyek dengan 10/12 subyek terjadi bersamaan dengan PJB. Usia ibu ≥35 tahun [p= 0,77; OR 0,87 (0,34-2,32)], usia ayah ≥35 tahun [p= 0,48; OR 1,44 (0,52-4,01)], febrile illness [p= 0,72; OR 0,81 (0,25-2,62)], penggunaan obat-obat yaitu antipiretik [p= 0,71; OR 0,60 (0,14-2,82)], antibiotik (p=0,91; OR 1,13 (0,15-8,5)], jamu/obat herbal [p=0,89; OR 0,89 (0,22-3,60)], keteraturan penggunaan asam folat [p= 0,27; OR 0,58 (0,22-1,50)], ibu merokok (p= 0,34), dan pajanan rokok [p= 0,89; OR 0,94 (0,36-2,46)] saat periode perikonsepsi tidak terbukti berhubungan dengan terjadinya PJB pada sindrom Down. Kesimpulan: Faktor risiko lingkungan periode perikonsepsi tidak terbukti berhubungan dengan kejadian PJB pada sindrom Down."

"ABSTRAKPenyakit jantung bawaan (PJB) mengakibatkan morbiditas yang signifikan pada anak dan merupakan penyebab kematian utama dari antara kelainan kongenital lainnya. Usaha preventif PJB dengan cara identifikasi faktor risiko maternal diharapkan dapat menurunkan morbiditas dan mortalitas PJB.Tujuan. Penelitian ini bertujuan untuk mengetahui: (1) karakteristik (usia saat pertama kali terdiagnosis, jenis kelamin, status gizi, dan status ekonomi keluarga) penderita PJB anak di Poliklinik Kardiologi Ilmu Kesehatan Anak (IKA) Rumah Sakit Cipto Mangunkusumo (RSCM), (2) faktor risiko maternal yang diperkirakan mempengaruhi terjadinya PJB pada anak, yaitu: merokok aktif dan pasif selama kehamilan, diabetes melitus, obesitas, infeksi rubela saat kehamilan, usia saat kehamilan, dan pendidikan.Metode. Penelitian kasus kontrol dengan consecutive sampling dilakukan di Poliklinik Kardiologi IKA RSCM pada bulan Januari-Maret 2014. Pemeriksaan klinis, ekokardiografi, dan wawancara dilakukan terhadap 68 subjek PJB (kelompok kasus) dan 68 subjek anak sehat (kelompok kontrol).Hasil. Jumlah subjek penelitian sebanyak 136 subjek, dengan perbandingan kasus:kontrol adalah 1:1. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebesar 80,9% terdiagnosis saat berusia kurang dari 1 tahun. Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dengan 7,4% di antaranya merupakan gizi buruk, dan memiliki status ekonomi keluarga menengah ke bawah (76,5%). Defek PJB non sianotik terbanyak adalah defek septum ventrikel (44,1%) dan PJB sianotik terbanyak adalah Tetralogi Fallot (14,7%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah. Faktor risiko merokok aktif dan pasif saat kehamilan, obesitas, dan usia ibu saat kehamilan tidak terbukti berhubungan dengan PJB anak, sedangkan faktor diabetes melitus dan infeksi rubela saat kehamilan tidak dapat dianalisis pada penelitian ini.Simpulan. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebagian besar subjek terdiagnosis saat berusia kurang dari 1 tahun (80,9%). Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dan 7,4% di antaranya merupakan gizi buruk, dengan status ekonomi keluarga menengah ke bawah (76,5%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah.

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ABSTRACTCongenital heart defects (CHD) cause significant morbidities and are the leading cause of death among other congenital anomalies. Preventive measures with identification of maternal risk factors are expected to decrease morbidity and mortality rate in children due to CHD.Objectives. This study aimed to define: (1) characteristics (age at diagnosis, gender, nutritional status, and family’s economy status) of CHD patients in Pediatric Cardiology Clinic Cipto Mangunkusumo Hospital (CMH), (2) maternal risk factors that may influence CHD in children, namely: active and passive smoking in pregnancy, diabetes mellitus, obesity, rubella infection in pregnancy, age at pregnancy, and education.Method. Case-control study with consecutive sampling was performed in Pediatric Cardiology Clinic CMH in January-March 2014. Clinical examination, echocardiography, and interview were performed in 68 CHD subjects (case group) and 68 healthy subjects (control group).Results. Total subject in this study was 136, with ratio of case:control is 1:1. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and 80.9% were diagnosed in the first year of age. Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). The most prevalent non cyanotic CHD was ventricle septal defect (44.1%), and the most prevalent cyanotic CHD was Tetralogy of Fallot (14.7%). Maternal risk factor that was significantly associated with CHD was low maternal education. Active and passive smoking in pregnancy, obesity, and maternal age at pregnancy were not associated with CHD, whereas diabetes mellitus and rubella infection in pregnancy could not be analyzed in this study.Conclusion. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and mostly were diagnosed in the first year of age (80.9%). Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). Maternal risk factor that was significantly associated with CHD was low maternal education."

"Penyakit Jantung Bawaan (PJB) sering dikaitkan dengan malnutrisi yang dipengaruhi oleh berbagai faktor yang mengakibatkan peningkatan morbiditas dan mortalitas, penatalaksana yang tepat dapat menurunkan infeksi, lama rawat, bahkan kematian. Penelitian ini dilakukan untuk mengidentifikasi faktor-faktor yang berhubungan dengan status gizi kurang pada anak dengan PJB. Penelitian ini menggunakan observasional analitik dengan rancangan case control.  Sampel penelitian berjumlah 114 anak PJB di Rumah Sakit Jantung Jakarta periode Juli 2020 hingga Juni 2023. Uji statistik menunjukkan tidak ada hubungan antara usia, jenis kelamin, riwayat BBLR, pemberian ASI eksklusif, jenis PJB dan penyakit penyerta terhadap status gizi kurang pada anak PJB, terdapat hubungan antara kelengkapan imunisasi dengan status gizi kurang pada anak PJB (p value <0,05). Simpulan: dari penelitian ini yaitu faktor nutrisi dan organik tidak berhubungan dengan status gizi kurang anak PJB. Oleh karena itu pelayanan perlu memberikan perhatian terkait status nutrisi dan imunisasi disamping masalah jantung.

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Congenital Heart Disease (CHD) is often associated with malnutrition which is influenced by various factors resulting in increased morbidity and mortality, appropriate management can reduce infection, length of stay, and even death. This research was conducted to identify factors associated with malnutrition status in children with CHD. This study used an analytical observational with a case control design. The research sample consisted of 114 CHD children at the Jakarta Heart Hospital for the period July 2020 to June 2023. The result of this study showed that there was no relationship between age, gender, history of LBW, exclusive breastfeeding, type of CHD and comorbidities on malnutrition status in CHD children, there is a relationship between complete immunization and malnutrition status in CHD children (p value <0.05). Conclusion from this research, nutritional and organic factors are not related to the malnutrition status of CHD children. Therefore, services need to pay attention to nutritional status and immunization in addition to heart problems."

"Latar Belakang: Infeksi menjadi masalah pada anak dengan penyakit jantung bawaan (PJB),terutama pneumonia. Faktor risiko yang mendasari perjalanan pneumonia pada anak adalah:usia, jenis kelamin, status gizi, pemberian ASI, berat lahir rendah, status imunisasi,pendidikan orangtua, status sosioekonomi, penggunaan fasilitas kesehatan. Insidenspneumonia pada anak dengan PJB pirau kiri ke kanan meningkatkan morbiditas danmortalitas.Tujuan: Mengetahui insidens pneumonia anak dengan PJB pirau kiri ke kanan dan faktorrisiko yang terkait.Metode: Penelitian ini adalah studi analitik dengan rancangan cohort retrospectiveberdasarkan penelusuran rekam medis di RSUPN dr. Cipto Mangunkusumo dari tahun 2015 -2019, Jakarta. Diagnosis PJB pirau kiri ke kanan berdasarkan echocardiography. Dari hasilyang ada, dilakukan analisis multivariat dan dilaporkan sebagai odds ratio (OR).Hasil: Dari 333 subyek dengan PJB pirau kiri ke kanan, 167 subyek mengalami pneumonia(50,2%). Proporsi jenis PJB pirau kiri ke kanan terbanyak yang menyebabkan pneumoniaadalah defek septum ventrikel (VSD), yaitu 41,9%. Defek ukuran besar berhubungan denganangka kejadian pneumonia (p=0,001). Faktor risiko yang mempengaruhi kejadian pneumoniapada anak dengan PJB pirau kiri ke kanan antara lain: status gizi buruk [OR 5,152 (95% CI2,363-11,234)], status imunisasi tidak lengkap [OR 9,689 (95% CI 4,322-21,721)], statussosioekonomi rendah [OR 4,724 (95% CI 2,003-11,138)], dan ukuran defek yang besar [OR5,463 (95% CI 1,949-15,307)].Simpulan: Insidens pneumonia pada anak dengan PJB pirau kiri ke kanan sebesar 50,2 %.Tipe PJB dengan insidens pneumonia terbanyak adalah VSD. Status gizi, imunisasi, statussosioekonomi dan ukuran besar defek mempengaruhi angka kejadian pneumonia."

"Mortalitas pneumonia anak masih menjadi masalah kesehatan di seluruh dunia hingga saat ini. Bayi dengan penyakit jantung bawaan pirau kiri kanan (PJB L-R) berisiko menderita pneumonia. Data mortalitas pneumonia pada PJB L-R dan faktor-faktor yang memengaruhi belum banyak diketahui. Penelitian kohort retrospektif ini membandingkan mortalitas pneumonia dengan PJB L-R dengan tanpa PJB. Sebanyak 129 subyek dengan rentang usia 1 bulan - 7 tahun dengan diagnosis primer pneumonia, 54 subyek dengan PJB L-R dan 75 subyek tanpa PJB. Proporsi mortalitas pneumonia dengan PJB L-R lebih banyak (57,1%) dan risiko mortalitas lebih besar (OR 2,35; IK 95% 1,06 sampai 5,18) dibandingkan pneumonia tanpa PJB. Status gizi kurang/buruk, pneumonia rekuren, dan pneumonia terkait rumah sakit (HAP) lebih banyak secara signifikan pada pneumonia dengan PJB L-R. Sedangkan, tingkat keparahan dan anemia tidak berbeda bermakna di kedua kelompok. Pneumonia dengan tingkat keparahan berat memengaruhi mortalitas secara bermakna (OR 3,24; IK95% 1,16 sampai 9,08). Pneumonia rekuren, status gizi kurang/buruk, status imunisasi tidak lengkap, anemia, dan HAP tidak terbukti berhubungan dengan mortalitas pneumonia dengan PJB L-R.

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Childhood pneumonia is still a worldwide problem with high mortality. Infants with left to right shunt congenital heart disease (L-R CHD) are at risk of developing pneumonia. Pneumonias mortality in L-R CHD and its influencing factors are not well known. This retrospective cohort study analyzed mortality of pneumonia with L-R CHD with and without CHD. There were 129 subjects (age range of 1 month up to 7 years 11 months) with pneumonia as the primary diagnosis, consisting of 54 subjects with L-R CHD and 75 subjects without CHD. Mortality rate in children with L-R CHD was higher than those without CHD group (57.1%). The risk of mortality was greater (OR 2.35; 95% CI 1.06 to 5.18) compared to pneumonia without CHD. Moderate to severe malnutrition, recurrent pneumonia, and hospital acquired pneumonia (HAP) are significantly higher in L-R CHD group. Meanwhile, pneumonia severity and anemia were not significantly different in both groups. Severe pneumonia significantly affected mortality (OR 3.24; 95% CI 1.16 to 9.08). Recurrent pneumonia, moderate-to-severe malnutrition, incomplete immunization status, anemia, and HAP have not been proven to be associated with pneumonia mortality with L-R CHD."

"Latar Belakang: Pasien sindrom Down (Down?s syndrome/DS) berbeda dari anak normal karena memiliki banyak kelainan selain defek jantung yang dapat memengaruhi luaran pasca-operasi jantung. Sampai saat ini belum ada penelitian mengenai luaran pasca-operasi penyakit jantung bawaan (PJB) pada DS di pusat-pusat pelayanan jantung di Indonesia.Tujuan: Untuk mengetahui luaran jangka pendek dan mortalitas pada pasien DS yang dilakukan operasi jantung di RSUPN Cipto Mangunkusumo, Jakarta.Metode: Studi kohort retrospektif dan prospektif pada subjek anak dengan DS yang menjalani operasi koreksi PJB. Kontrol adalah anak tanpa DS yang masuk kriteria inklusi dan eksklusi, dengan matching rentang usia dan jenis penyakit jantung yang sama dengan pasien DS.Hasil: Sebanyak 57 pasien DS dan 43 non-DS yang telah menjalani operasi koreksi PJB diikutkan dalam penelitian. Karakteristik dasar antar kelompok tidak berbeda bermakna. Jenis PJB terbanyak pada DS adalah defek septum atrioventrikular (AVSD) dan defek septum ventrikel (VSD) masing-masing sebesar 31,6%, tetralogi Fallot (TF) 21%, defek septum atrium (ASD) 7%, duktus arteriosus persisten (PDA) 7% dan transposisi arteri besar (TGA)-VSD 1,8%. Lama rawat ruang rawat intensif (ICU) pada DS 1,9 (0,6-34) hari dibanding non-DS 1 (0,3-43), p=0,373. Lama penggunaan ventilator pada DS 19,9 (3-540) jam, non-DS 18 (3-600), p=0,308. Krisis hipertensi pulmoner (PH) tidak terjadi pada kedua kelompok, proporsi komplikasi paru pada DS 24,6% dibanding non-DS 14%, dan sepsis pada DS 28,1% dibanding non-DS 14% tidak berbeda bermakna. Proporsi blok atrioventrikular (AV) komplit pada DS 10,5% dan non-DS tidak ada, dengan p=0,036. Kematian di rumah sakit (RS) pada DS 8,8%, non-DS tidak ada, dengan p=0,068.Simpulan: Morbiditas dan mortalitas pasca-operasi jantung pada DS tidak terbukti lebih sering terjadi dibandingkan dengan non-DS.

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Background: Down syndrome patients different from normal child because many other genetic related aspects that can affect outcome after congenital heart surgery. Until now there has been no research on the outcome after congenital heart surgery on paediatric Down syndrome patients in Indonesia.

Objective: To determine the short term outcomes and mortality in DS patients who underwent heart surgery at Cipto Mangunkusumo hospital, Jakarta.

Methods: A prospective and retrospective cohort study was conducted to subject with DS who underwent heart surgery from July 2007- April 2015. Control group was patients without DS who underwent heart surgery with matching on age and type of heart defects.

Results: A total of 57 DS patients and 43 non-DS patients were recruited during study period. Basic characteristics between groups were not significantly different. Most type of CHD in patients with DS were AVSD and VSD respectively in 18 (31,6%), tetralogi of Fallot 12 (21%), ASD 4 (7%), PDA 4 (7%) and TGA-VSD 1 (1,8%) patients. Duration of ICU stay in patients with DS was 1,9 (0,6-34) days compared to non-DS patients 1 (0,3-43) days, p=0,373. Duration of mechanical ventilation in patients with DS was 19,9 (3-540) hours, compared to non-DS patients 18 (3-600) hours, p=0,308. Pulmonary hypertension crisis was not occurred in both groups. Pulmonary complication in patients with DS was 14 (24,6%) compared to non-DS 6 (14%) patients, and sepsis in patients with DS was 16 (28,1%) compared to non-DS 6 (14%) patients, there was no difference. Complete AV block in patients with DS was 6 (10,5%) compared none in patients with non-DS, p=0,036. In-hospital mortality in patients with DS was 5 (8,8%), compared none in patients with non-DS, significantly different with p=0,068.

Conclusion: Morbidity and mortality after cardiac surgery in DS is not proven to be more frequent compared to non-DS."

"Pemberian air susu ibu ASI merupakan bentuk pemberian makanan yang paling disarankan untuk semua bayi, termasuk bayi dengan kebutuhan medis khusus seperti penyakit jantung bawaan. Penelitian ini bertujuan untuk memaparkan perilaku pemberian ASI pada 165 ibu yang memiliki bayi penderita penyakit jantung bawaan. Metode penelitian menggunakan survey deskriptif kuantitatif. Pengumpulan data menggunakan kuesioner pemberian ASI dan kuesioner perilaku pemberian ASI yang dimodifikasi dari penelitian Rickman 2017. Pemberian ASI eksklusif pada bayi penderita penyakit jantung bawaan hanya sebesar 36,4. Responden berusia 21-39 tahun tidak memberikan ASI eksklusif, begitupun dengan responden berpendidikan tinggi, tidak bekerja, berpendapatan cukup, multipara, dan berpengetahuan baik. Berdasarkan riwayat persalinan, responden yang melahirkan di fasilitas kesehatan, melahirkan secara sesar, melakukan inisiasi menyusu dini IMD. dan yang dirawat gabung tidak memberikan ASI eksklusif. Pada variabel dukungan sosial, responden yang mendapat dukungan suami dan ibu/mertua tidak memberikan ASI ekslusif. Sebanyak 62,2 bayi penderita kelainan asianotik dan 65,3 bayi penderita kelainan sianotik tidak mendapatkan ASI eksklusif. Kondisi medis bayi yang menyebabkan kendala menyusu pada bayi merupakan faktor utama tidak berhasilnya pemberian ASI eksklusif pada bayi penderita penyakit jantung bawaan. Hasil penelitian juga menunjukkan bahwa tenaga kesehatan kurang memberikan motivasi dan dukungan pada responden untuk memberikan ASI secara eksklusif. Hasil studi ini dapat menjadi informasi untuk menerapkan konseling ASI yang efektif dan tenaga kesehatan diharapkan mampu memberikan dukungan dan motivasi pada ibu untuk memberikan ASI secara eksklusif pada bayinya.

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Breastfeeding is the most recommended feeding for all infants, including infants with special medical needs such as congenital heart disease. This study aims to describe the breastfeeding behavior in 165 mothers who have infants with congenital heart disease. This research method used. quantitative descriptive survey. Data were collected using. modified breastfeeding and breastfeeding behavior questionnaire from Rickman 2017 study. Exclusive breastfeeding in infants with congenital heart disease is only 36.4. Respondents aged 21 39 years old did not provide exclusive breastfeeding, as did high educated, unemployed, fair income, multiparent, and knowledgeable respondents. Based on the history of labor, respondents who gave birth at. health facility, delivered by cesarean section, initiated breastfeeding, and who were treated together with their infants did not provide exclusive breastfeeding. In social support variables, respondents who have the support of husband and mother mother in law did not provide exclusive breastfeeding. As many as 62.2 of infants with asianotic abnormalities and 65.3 of infants with cyanotic abnormalities were not exclusively breastfed. The infant 39. medical condition that causes breastfeeding difficulties in infants is. major factor in the failure of exclusive breastfeeding in infants with congenital heart disease. The results also show that health workers less motivation and support to respondents to exclusively breastfeed. The results of this study can become an information to implement effective breastfeeding counseling and health workers are expected to provide support and motivation in mothers to exclusively breastfeed their babies. "

"Sekitar 1% anak terlahir dengan penyakit jantung bawaan (PJB). Sebagian akan memerlukan kateterisasi jantung baik diagnosis maupun terapeutik. Prosedur ini memerlukan kooperasi pasien dan imobilisasi sehingga dibutuhkan anestesia yang mungkin berulang. Penelitian ini bertujuan melihat efek anestesia umum terhadap fungsi kontraktilitas jantung anak dengan PJB. Kontraktilitas jantung dilihat dari fraksi ejeksi dan TAPSE yang diukur dengan ekokardiografi. Pengukuran dilakukan sebelum anestesia umum, 5 menit pascaintubasi dan akhir tindakan kateterisasi. Metode penelitian kohort observasional dengan consecutive sampling telah dilakukan. Analisis dilakukan terhadap 42 anak berusia 6 bulan hingga 18 tahun dengan PJB yang menjalani kateterisasi jantung dalam anestesia umum pada periode Juni – Agustus 2018. Uji T-test berpasangan dilakukan untuk analisis perubahan fraksi ejeksi dan TAPSE dan analisis multivariat untuk melihat pengaruh usia, jenis PJB, lama dan jenis tindakan kardiologi terhadap perubahan kontraksi. Perubahan fraksi ejeksi turun bermakna pada 5 menit pascaintubasi dan akhir tindakan kardiologi dan TAPSE turun bermakna hanya pada 5 menit pascaintubasi. Pengaruh usia, jenis PJB, lama dan jenis tindakan kardiologi tidak bermakna terhadap perubahan fraksi ejeksi dan TAPSE. Dengan demikian diharapkan kewaspadaan dalam penanganan pasien PJB, termasuk ketika memberikan informasi sebelum persetujuan tindakan medis (informed consent), dan jika memungkinkan menghindari tindakan anestesia umum yang berulang.

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Approximately 1% of children borned with congenital heart disease (CHD). Some will require cardiac catheterization which repeated anesthesia may be needed. This study aims to see the effect of general anesthesia on the cardiac contractility in children with CHD. Cardiac contractility seen from ejection fraction and TAPSE as measured by echocardiography. Measurements were taken before general anesthesia, 5 minutes post-intubation and at the end of the catheterization. An observational cohort with consecutive sampling was conducted. Analysis was carried out on 42 children aged 6 months to 18 years with CHD who underwent cardiac catheterization under general anesthesia in the period June - August 2018. Paired T-test was performed to analyze changes in ejection fraction and TAPSE and multivariate analysis to analyze the effect of age, type of CHD, duration and type of cardiology intervention. Ejection fraction decreased significantly at 5 minutes post-intubation and at the end of cardiology intervention and TAPSE decreased significantly only at 5 minutes post-intubation. Changes of contratility was not significant affected by age, type of CHD, duration and type of cardiology intervention. Therefore, alertness in handling patients with CHD is expected, including when providing information prior to informed consent, and if possible avoid repeated general anesthesia."

"ABSTRAK Latar belakang : Sindrom Down merupakan penyakit genetik yang dapatmenyebabkan keterlambatan perkembangan motorik, bahasa, kognitif, danpsikososial. Periode perkembangan anak dalam tiga tahun pertama kehidupansangat penting, karena merupakan dasar untuk hasil perkembangan selanjutnya.Sampai saat ini belum dilakukan penelitian yang menghubungkan kemampuanmotorik pasien sindrom Down dengan faktor-faktor yang memengaruhinya.Mengingat prevalensi anak sindrom Down yang cukup banyak di Indonesia, danbelum didapatkan data tersebut maka penelitian dilakukan pada anaksindrom Downsehingga anaksindrom Down mendapatkan hasil optimal dari program intervensiyang dijalankan Tujuan : Mengetahui karakteristik pertumbuhan dan perkembangan motorik anaksindrom Down serta faktor yang memengaruhi tingkat perkembangan motorik kasaruntuk menentukan kemampuan anak, kebutuhan terapi dan meningkatkan kualitaspelayanan. Metode: Studi potong lintang deskriptif dan analitik selama Agustus sampai September 2015 pada 103 anak sindrom Down usia 6 bulan - 3 tahun di Poli Anakdan Poli Rehabilitasi medic Rumah Sakit Cipto Mangunkusumo (RSCM). Dataorang tua didapat dari autoanamnesis dan pencarian rekam medis, dataantropometrik berupa beratbadan, tinggi badan dan lingkar kepala diplot pada kurvapertumbuhan khusus anak sindromDown, perkembangan motorik kasar dinilaiberdasarkan milestone khusus anak sindrom Down. Hasil penelitian : Sejumlah 103 subjek (56 laki-laki, 47 perempuan) memenuhikriteria inklusi. Median subjek adalah 12 bulan. Jumlah subjek yang mengalamigizi baik dan gizi kurang hampir sama. Mikrosefali dialami oleh sebagian kecilsubjek 10 (9,6%). Anak sindrom Down dengan tipe klasik ditemukan pada sebagianbesar pasien sebanyak 99 (96%) dan tipe translokasi sebanyak 4 (3,9%). Keterlambatan motorik ringan dialami oleh 69,2% subjek, keterlambatan motoriksedang 16,3%, dan keterlambatan motorik ringan 13,5%. Hasil analisis multivariatememperlihatkan faktor risiko yang berhubungan dengan keterlambatan motorikadalah lingkar kepala (p=0,011; OR 6,852; IK95% 1,565-30,038), riwayat asfiksia(p=0,009; OR 4,033; IK95% 1,427-11,4), dan frekuensi program stimulasi(p=0,006; OR 3,845; IK95% 1,460-10,125). Kesimpulan : Lingkar kepala, riwayat asfiksia, dan frekuensi program stimulasimerupakan faktor risiko keterlambatan perkembangan motorik anak sindromDown.ABSTRACT Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of thefirst three years of life is crucial, because it is a basic for further development. Untilrecently, there are not study which conducted to correlates motoric capabilitiesDown Syndromes patients to factors that interfere its. In Indonesia, prevalence ofchild with Down Syndromes is quite high, there are no data depicted thatcorrelation;hence, this study was conducted in child with Down Syndromes so thatthey obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children withDown Syndromes and factors interfere degree of gross motoric development whichto determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children withDown Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics andMedical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo(RSCM) during August to September 2015. Data were obtained by their parents(auto-anamnesis) and medical records, anthropometric data comprised bodyweight, body height, and head circumference which were plotted to special growthcurve of children with Down Syndromes, gross motoric developments wereassessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions.Median subject was twelve months. Amount of subjects with good nutrition andmalnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children withclassical type of Down Syndromes were 99(96%) and translocation type were4(3.9%). Children with mild motoric development were 69.2%, intermediatemotoric development were 16.3%, and severe motoric development were 13.5%.Multivariate analysis showed risk factors correlates to motoric development werehead circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history ofasphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulationprograms (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency ofstimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of thefirst three years of life is crucial, because it is a basic for further development. Untilrecently, there are not study which conducted to correlates motoric capabilitiesDown Syndromes patients to factors that interfere its. In Indonesia, prevalence ofchild with Down Syndromes is quite high, there are no data depicted thatcorrelation;hence, this study was conducted in child with Down Syndromes so thatthey obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children withDown Syndromes and factors interfere degree of gross motoric development whichto determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children withDown Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics andMedical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo(RSCM) during August to September 2015. Data were obtained by their parents(auto-anamnesis) and medical records, anthropometric data comprised bodyweight, body height, and head circumference which were plotted to special growthcurve of children with Down Syndromes, gross motoric developments wereassessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions.Median subject was twelve months. Amount of subjects with good nutrition andmalnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children withclassical type of Down Syndromes were 99(96%) and translocation type were4(3.9%). Children with mild motoric development were 69.2%, intermediatemotoric development were 16.3%, and severe motoric development were 13.5%.Multivariate analysis showed risk factors correlates to motoric development werehead circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history ofasphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulationprograms (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency ofstimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of thefirst three years of life is crucial, because it is a basic for further development. Untilrecently, there are not study which conducted to correlates motoric capabilitiesDown Syndromes patients to factors that interfere its. In Indonesia, prevalence ofchild with Down Syndromes is quite high, there are no data depicted thatcorrelation;hence, this study was conducted in child with Down Syndromes so thatthey obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children withDown Syndromes and factors interfere degree of gross motoric development whichto determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children withDown Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics andMedical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo(RSCM) during August to September 2015. Data were obtained by their parents(auto-anamnesis) and medical records, anthropometric data comprised bodyweight, body height, and head circumference which were plotted to special growthcurve of children with Down Syndromes, gross motoric developments wereassessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions.Median subject was twelve months. Amount of subjects with good nutrition andmalnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children withclassical type of Down Syndromes were 99(96%) and translocation type were4(3.9%). Children with mild motoric development were 69.2%, intermediatemotoric development were 16.3%, and severe motoric development were 13.5%.Multivariate analysis showed risk factors correlates to motoric development werehead circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history ofasphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulationprograms (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency ofstimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of thefirst three years of life is crucial, because it is a basic for further development. Untilrecently, there are not study which conducted to correlates motoric capabilitiesDown Syndromes patients to factors that interfere its. In Indonesia, prevalence ofchild with Down Syndromes is quite high, there are no data depicted thatcorrelation;hence, this study was conducted in child with Down Syndromes so thatthey obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children withDown Syndromes and factors interfere degree of gross motoric development whichto determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children withDown Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics andMedical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo(RSCM) during August to September 2015. Data were obtained by their parents(auto-anamnesis) and medical records, anthropometric data comprised bodyweight, body height, and head circumference which were plotted to special growthcurve of children with Down Syndromes, gross motoric developments wereassessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions.Median subject was twelve months. Amount of subjects with good nutrition andmalnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children withclassical type of Down Syndromes were 99(96%) and translocation type were4(3.9%). Children with mild motoric development were 69.2%, intermediatemotoric development were 16.3%, and severe motoric development were 13.5%.Multivariate analysis showed risk factors correlates to motoric development werehead circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history ofasphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulationprograms (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency ofstimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of thefirst three years of life is crucial, because it is a basic for further development. Untilrecently, there are not study which conducted to correlates motoric capabilitiesDown Syndromes patients to factors that interfere its. In Indonesia, prevalence ofchild with Down Syndromes is quite high, there are no data depicted thatcorrelation;hence, this study was conducted in child with Down Syndromes so thatthey obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children withDown Syndromes and factors interfere degree of gross motoric development whichto determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children withDown Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics andMedical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo(RSCM) during August to September 2015. Data were obtained by their parents(auto-anamnesis) and medical records, anthropometric data comprised bodyweight, body height, and head circumference which were plotted to special growthcurve of children with Down Syndromes, gross motoric developments wereassessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions.Median subject was twelve months. Amount of subjects with good nutrition andmalnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children withclassical type of Down Syndromes were 99(96%) and translocation type were4(3.9%). Children with mild motoric development were 69.2%, intermediatemotoric development were 16.3%, and severe motoric development were 13.5%.Multivariate analysis showed risk factors correlates to motoric development werehead circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history ofasphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulationprograms (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency ofstimulation programs were risk factors of motoric development in children with Down Syndromes. "