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"Latar Belakang dan Tujuan: Proses inflamasi tidak dapat dihindari pada kehamilan, namun inflamasi yang berlebihan pada trimester pertama dapat menyebabkan morbiditas ibu dan bayi baru lahir. Penelitian ini bertujuan untuk mengevaluasi hubungan profil lipid dengan derajat inflamasi pada ibu hamil. Metode dan Desain Studi: Studi cross-sectional ini dilakukan dari bulan April hingga Oktober 2022 di Puskesmas Kramat Jati di Jakarta. 98 wanita hamil trimester pertama 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, bivariat dan multivariat untuk menentukan variabel independen yang paling signifikan. Hasil: Usia rata-rata partisipan adalah 28,39 tahun dan median kehamilan minggu ke-10 ditemukan 29,6% memiliki kadar kolesterol tinggi, 15,3% memiliki kadar trigliserida tinggi, 49% memiliki kadar LDL tinggi, dan 1% memiliki kadar LDL tinggi. rasio /HDL. Sebagian besar (85,7%) responden memiliki hs-CRP yang tinggi, sedangkan kadar CRP yang tinggi hanya ditemukan pada 37,8%. Analisis bivariat menunjukkan hubungan yang signifikan antara CRP dan trigliserida (p=0,026), sedangkan parameter lainnya tidak signifikan. Analisis multivariat menunjukkan hubungan paling signifikan antara CRP dan trigliserida (p=0,017). Studi ini menunjukkan bahwa risiko relatif CRP tertinggi adalah terhadap trigliserida (2,04), diikuti oleh kolesterol total (1,45) dan LDL (1,31). Kesimpulan: Peningkatan kadar trigliserida pada wanita hamil berhubungan dengan kemungkinan peningkatan CRP selama trimester pertama.

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Inflammatory processes are inevitable in pregnancy, however excessive inflammation in the first trimester can cause maternal and neonatal morbidity. This study aims to evaluate the relationship between lipid profile and degree of inflammation in pregnant women. Methods and Study Design: This cross-sectional study was conducted from April to October 2022 at Kramat Jati Community Health Center in Jakarta.  98 first trimester pregnant women 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, bivariate and multivariate analysis to determine the most significant independent variables. Results: The average age of participants was 28.39 years old and a median of the 10th week of pregnancy found that 29.6% had high cholesterol levels, 15.3% had high triglyceride 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=0.026), while the other parameters were not significant. The multivariate analysis was showed the most significant relationship between CRP and triglycerides (p=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). Conclusions: Elevated triglyceride level in pregnant women are associated with an increased likelihood of CRP elevation during the first trimester."

"[ABSTRAKIbu hamil risiko tinggi rentan mengalami kecemasan dan depresi yang berdampak pada kelekatannya dengan janin. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara dukungan sosial dengan kelekatan ibu dan janin pada ibu hamil risiko tinggi. Penelitian cross sectional ini melibatkan 108 ibu hamil risiko tinggi yang dipilih menggunakan consecutive sampling. Hasil penelitian menunjukkan bahwa terdapat hubungan antara dukungan sosial dengan kelekatan ibu dan janin pada ibu hamil risiko tinggi (p=0.003). Ibu dengan dukungan sosial tinggi berpeluang 3,9 kali mempunyai kelekatan tinggi dengan janinnya dibandingkan ibu yang dukungan sosialnya rendah setelah dikontrol depresi (OR=3.9; 95% CI=1.66-8.99). Hasil penelitian ini menegaskan bahwa aspek psikososial perlu lebih diperhatikan dalam perawatan ibu hamil sehingga status sejahtera bagi ibu dan bayi dapat dicapai.

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ABSTRACTHigh risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby.;High risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby.;High risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby., High risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby.]"

"Ketidaknyamanan fisik yang dirasakan selama kehamilan yang dapat menyebabkan berbagai dampak, salah satunya adalah dapat memperburuk kualitas tidur serta menimbulkan kecemasan pada ibu hamil. Oleh karena itu, penelitian ini memiliki tujuan untuk mengetahui hubungan antara ketidaknyamanan fisik selama kehamilan dengan kualitas tidur serta tingkat kecemasan pada ibu hamil trimester III di DKI Jakarta. Penelitian ini merupakan penelitian kuantitatif cross sectional dengan metode consecutive sampling untuk mengumpulkan total 115 sampel. Kuesioner yang digunakan dalam penelitian ini terdiri dari karakteristik pasien atau data demografi, kuesioner Maternal Physical Discomfort Scale (MPDS), Sleep Quality Index (PSQI), dan Pregnancy Related Anxiety Questionnaire (PRAQ). Mayoritas responden mengalami ketidaknyamanan fisik sedang (53,9%), kualitas tidur yang buruk (55,7%), serta tingkat kecemasan ringan (51,3%). Berdasarkan hasil uji korelasi spearman, didapatkan bahwa terdapat hubungan yang signifikan antara ketidaknyamanan fisik selama kehamilan dengan kualitas tidur (p value = 0,004) dan tingkat kecemasan (p value = 0,00). Hasil penelitian ini dapat digunakan sebagai acuan untuk mengembangkan asuhan keperawatan maupun program kesehatan pada ibu hamil terutama yang sudah memasuki trimester III yang berkaitan dengan ketidaknyamanan fisik, kualitas tidur, serta kecemasan selama kehamilan.

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The physical discomfort felt during pregnancy can cause various impacts, one of which is that it can worsen sleep quality and cause anxiety in pregnant women. Therefore, this study aims to determine the relationship between physical discomfort during pregnancy and sleep quality and anxiety levels in third trimester pregnant women in DKI Jakarta. This research is a quantitative cross-sectional study with consecutive sampling method to collect a total of 115 samples. The questionnaire used in this study consisted of patient characteristics or demographic data, the Maternal Physical Discomfort Scale (MPDS) questionnaire, the Sleep Quality Index (PSQI), and the Pregnancy Related Anxiety Questionnaire (PRAQ). The majority of respondents experienced moderate physical discomfort (53.9%), poor sleep quality (55.7%), and mild anxiety (51.3%). Based on the results of the Spearman correlation test, it was found that there was a significant relationship between physical discomfort during pregnancy and sleep quality (p value = 0.004) and anxiety levels (p value = 0.00). The results of this study can be used as a reference for developing nursing care and health programs for pregnant women, especially those who have entered the third trimester related to physical discomfort, sleep quality, and anxiety during pregnancy."

"[ABSTRAKPenelitian ini bertujuan untuk mengetahui hubungan asupan vitamin A dan kadar retinol dengan status anemia pada dua kelompok ibu hamil trimester tiga, yaitu kelompok anemia dan non anemia. Penelitian ini merupakan penelitian potong lintang yang dilaksanakan di sepuluh puskesmas kecamatan Jakarta Timur dan merupakan bagian dari penelitian besar Departemen Gizi Fakultas Kedokteran Universitas Indonesia yang berjudul “Peran Gizi, Faktor Maternal dan Pelayanan Kesehatan pada Ibu Hamil Trimester Ketiga terhadap Komposisi Mikrobiota Ibu dan Berat Lahir Bayi: Studi Kohort di Jakarta”. Pengambilan data dilakukan pada bulan April hingga Mei 2015. Sebanyak 113 subjek ibu hamil trimester tiga dengan usia kehamilan diatas 32 minggu ikut dalam penelitansetelah memenuhi kriteria penelitian dan dibagi dalam dua kelompok berdasarkan kadar hemoglobin yaitu anemia (Hb<11g/dL) dan non anemia (Hb≥11g/dL). Setelah itu dilakukan pengukuran antropometri, wawancara asupan, pemeriksaan hemoglobin, dan serum retinol. Data yang dikumpulkan meliputi karakteristik demografi, antropometri, asupan makanan (makronutrien dan mikronutrien), kadar hemoglobin, dankadar serum retinol. Rentang usia subjek dalam penelitian ini adalah 19-44 tahun. Sebagian besar subjek (59,6%) memiliki tingkat pendidikan menengah (lulus SMP atau SMA). Rerata usia kehamilan pada subjek penelitian ini adalah 34,32 ± 1,86 minggu pada kelompok anemia dan 35,18±1,73 minggu pada kelompok non anemia.Rerata asupan protein pada kedua kelompok ibu masih berada di bawah AKG yaitu <77g/hari. Rerata asupan lemak pada kelompok anemia lebih tinggi daripada kelompok non anemia (p=0,04). Asupan Fe kedua kelompok sudah sesuai dengan AKG yaitu 40mg/hari (p=0,82). Asupan folat pada kelompok anemia lebih rendahdan kurang dari AKG dibandingkan kelompok non anemia (p=0,16).Asupan vitamin B12, hampir tidak ada perbedaan rerata antara dua kelompok dan sudah sesuai dengan AKG. Median asupan vitamin A pada kelompok non anemia lebih tinggi dari kelompok anemia (p=0,52). Rerata kadar retinol pada kelompok anemia adalah 1,40±0,50 dan pada kelompok non anemia adalah 1,45±0,44. (p=0,55).Tidak didapatkan hasil yang bermakna setelah dilakukan analisis multivariat sebagai kontrol perancu.

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ABSTRACTThe aim of the study was to determine the relationship between vitamin A and retinol levels with anemia status in two groups of three trimester pregnant women, namely the anemic and non anemic. This was a cross-sectional study conducted in ten sub-district Government Health Centre in East Jakarta and which part of a large research department of Nutrition Faculty of Medicine, University of Indonesia, entitled "The Role of Nutrition, Maternal Factors and Maternal Health Services with the Composition of the Microbiota in Third Trimester Maternal and Infant Birth Weight : The study cohort in Jakarta". Data was collected from April untill May 2015. A total of 113 third trimester pregnant women with gestational age above 32 weeks (35.0 ± 1.8) were participated in research after met the study criterions. They were divided into two groups based on the levels of hemoglobin which were anemic (Hb<11g /dL) and non anemic(Hb≥ 11g / dL), and continue with anthropometric examination, interview and Hb measurement. The data collected included demographic characteristics, anthropometry, food intake (macronutrients and micronutrients), hemoglobin, and serum retinol. The age range of the subjects in this study was 19-44 years old. Most subjects (59.6%) had secondary education (graduated from high school or high school). The mean gestational age of the subjects was 34.32 ± 1.86 weeks in anemic group and 35.18 ± 1.73 weeks in non anemic. Mean of protein intake in both groups are still under RDA which < 77g/day. The mean of fat intake in anemic group was higher than non-anemic group (p=0.04). Iron intake in both groups are in accordance with the RDA which 40mg/day (p=0.82). Folate intake was lower in anemia group than non-anemic group (p=0.16). There was no difference between vitamin B12 intake in both group andwere in accordance with RDA. The median of vitamin A intake in non-anemic group was higher than non-anemic group (p = 0.52). The mean retinol serum levels in anemic group was 1.40 ± 0.50 and non-anemic group was 1.45 ± 0.44. (P = 0.55). No significant results obtained from multivariate analysis in order to control the confounders., The aim of the study was to determine the relationship between vitamin A and retinol levels with anemia status in two groups of three trimester pregnant women, namely the anemic and non anemic. This was a cross-sectional study conducted in ten sub-district Government Health Centre in East Jakarta and which part of a large research department of Nutrition Faculty of Medicine, University of Indonesia, entitled "The Role of Nutrition, Maternal Factors and Maternal Health Services with the Composition of the Microbiota in Third Trimester Maternal and Infant Birth Weight : The study cohort in Jakarta". Data was collected from April untill May 2015. A total of 113 third trimester pregnant women with gestational age above 32 weeks (35.0 ± 1.8) were participated in research after met the study criterions. They were divided into two groups based on the levels of hemoglobin which were anemic (Hb<11g /dL) and non anemic(Hb≥ 11g / dL), and continue with anthropometric examination, interview and Hb measurement. The data collected included demographic characteristics, anthropometry, food intake (macronutrients and micronutrients), hemoglobin, and serum retinol. The age range of the subjects in this study was 19-44 years old. Most subjects (59.6%) had secondary education (graduated from high school or high school). The mean gestational age of the subjects was 34.32 ± 1.86 weeks in anemic group and 35.18 ± 1.73 weeks in non anemic. Mean of protein intake in both groups are still under RDA which < 77g/day. The mean of fat intake in anemic group was higher than non-anemic group (p=0.04). Iron intake in both groups are in accordance with the RDA which 40mg/day (p=0.82). Folate intake was lower in anemia group than non-anemic group (p=0.16). There was no difference between vitamin B12 intake in both group andwere in accordance with RDA. The median of vitamin A intake in non-anemic group was higher than non-anemic group (p = 0.52). The mean retinol serum levels in anemic group was 1.40 ± 0.50 and non-anemic group was 1.45 ± 0.44. (P = 0.55). No significant results obtained from multivariate analysis in order to control the confounders.]"

"Berat lahir merupakan variabel yang dapat digunakan untuk memprediksi pertumbuhan bayi sedangkan lingkar kepala bayi baru lahir mencerminkan fungsi kognitif bayi untuk perkembangan berikutnya Anemia defisiensi besi pada ibu hamil berkontribusi terhadap timbulnya keluaran buruk terhadap kedua variabel tersebut Penelitian ini bertujuan untuk mengidentifikasi hubungan antara anemia defisiensi besi pada ibu hamil dengan berat dan lingkar kepala bayi baru lahir di Jakarta Timur Metode penelitian adalah potong lintang yang melibatkan 96 ibu hamil trimester 3 yang berusia 19 45 tahun Hasil menunjukkan bahwa prevalensi anemia defisiensi besi pada ibu hamil sebesar 40 2 sedangkan rerata berat lahir adalah 3128 338 gram dan nilai median lingkar kepala sebesar 33 1 cm Tidak ada hubungan signifikan antara anemia defisiensi besi dan berat lahir setelah dikontrol dengan beberapa variabel pengganggu adjusted 0 182 95 CI 306 35 p 0 159 Hasil lainnya adalah adanya hubungan tren menuju signifikan antara anemia defisiensi besi dengan lingkar kepala setelah dikontrol dengan paparan rokok metode persalinan dan jenis kelamin adjusted 0 164 95 CI 1 118 0 168 p 0 099 Ibu hamil dengan anemia defisiensi besi memiliki tren untuk mendapatkan bayi dengan lingkar kepala lebih besar daripada ibu hamil dengan anemia defisiensi zat gizi lainnya akan tetapi tidak ada hubungan signifikan terhadap berat lahir Oleh karena itu diperlukan penelitian lebih lanjut dengan jumlah subjek penelitian yang lebih besar untuk mengkonfirmasi hasil penelitian ini.

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Birth weight is a reliable predictor of infant growth while head circumference reflects a cognitive function of a child in later life Recently iron deficiency anemia has been postulated to contribute as a risk factor for the adverse outcomes of these parameters The objective was to identify a relationship between iron deficiency anemia among pregnant women and their infants rsquo birth weight and head circumference A cross sectional study was conducted involving 96 third trimesters of anemic pregnant women aged 19 45 years in East Jakarta The prevalence of iron deficiency among anemic pregnant women was 40 2 The mean of birth weight 3128 338 gram and the median of head circumference was 33 1 cm Iron deficiency anemia IDA did not significantly associate with birth weight after adjusted for secondhand smoke mother rsquo s education birth spacing delivery method vitamin C and B 12 intake adjusted 0 182 95 CI 306 35 p 0 159 While there was a borderline significant relationship between IDA and head circumference after adjusted for secondhand smoke delivery method and birth sex adjusted 0 164 95 CI 1 118 0 168 p 0 099 Pregnant women with IDA tended to have infants with larger head circumference than women with other nutritional anemia but did not show a relationship with birth weight of their newborns Further study is needed with larger subjects to confirm the results of these findings."

"Stunting berdasarkan tinggi badan anak di bawah normal setelah 1000 hari pertama kehidupan dapat dicegah dengan menangani faktor risiko stunting pada ibu hamil yakni gizi dan depresi selama kehamilan. Faktor-faktor yang berhubungan dengan faktor risiko stunting pada ibu hamil yakni kemampuan adaptasi ibu hamil dan dukungan sosial suami. Penelitian cross-sectional 118 ibu hamil dan suami dengan quota sampling. Hasil penelitian menunjukkan hubungan signifikan antara LiLA, adaptasi ibu hamil (fisiologis, fungsi peran, dan interdependen), dukungan sosial suami, pendidikan ibu hamil, pekerjaan ibu hamil, dan kehamilan direncanakan dengan depresi kehamilan serta hubungan signifikan antara pekerjaan ibu hamil dengan LiLA (p value<0,05). Temuan kejadian membuktikan tindakan preventif dan promotif perlu lebih ditingkatkan sehingga memberikan hasil yang efektif dengan dibuktikan oleh penelitian di kemudian hari.

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Stunting based on the child's height after the first 1000 days of life can be prevented by addressing the risk factors for stunting in pregnant women, namely nutrition and depression during pregnancy. Factors related to risk factors for stunting in pregnant women are the adaptability of pregnant women and husband's social support. This cross-sectional study of 118 pregnant women and husbands with quota sampling. The results showed a significant relationship between LiLA, adaptation of pregnant women (physiological, role function, and interdependent), husband's social support, education of pregnant women, work of pregnant women, and planned pregnancy with pregnancy depression as well as a significant relationship between the work of pregnant women and LiLA (p. value <0.05). The incident findings prove that preventive and promotive actions need to be further improved so as to provide effective results as proven by future research."

"Tidur merupakan kebutuhan dasar manusia yang harus dipenuhi. Ibu hamil mengalami adaptasi fisik dan psikososial, yang salah satunya mempengaruhi pemenuhan kebutuhan tidur selama masa kehamilan. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kecemasan dan kesejahteraan spiritual dengan kualitas tidur pada ibu hamil trimester tiga. Desain penelitian ini adalah cross-sectional. Sampel penelitian berjumlah 114 orang ibu hamil trimester tiga, yang dilakukan secara consecutive sampling. Instrumen yang digunakan adalah Pittsburg Sleep Quality Index untuk kualitas tidur, Spiritual Well-Being Scale untuk mengukur kesejaheraan spiritual, dan Zung-Self Anxiety Scale yang telah dimodifikasi untuk mengukur kecemasan. Analisis yang digunakan adalah chi-square. Hasil penelitian menunjukkan adanya hubungan antara kecemasan dengan kualitas tidur p value = 0,031 yaitu bahwa semakin tinggi kecemasan maka semakin buruk kualitas tidurnya dan adanya hubungan antara kesejahteraan spiritual dengan kualitas tidur p value = 0,001 yaitu bahwa semakin tinggi kesejahteraan spiritual maka semakin baik kualitas tidurnya. Direkomendasikan agar perawat dalam memberikan asuhan keperawatan kepada ibu hamil juga memperhatikan kesejahteraan spiritual, serta memberikan intervensi untuk menurunkan kecemasan, sehingga kualitas tidur ibu hamil meningkat.

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Sleep is a basic human need that must be fulfilled. Pregnant women experience physical and emotional changes that affect the fulfillment of sleep needs during pregnancy. This study aimed to identify the correlation between anxiety, spiritual well being and sleep quality in the third trimester pregnant women. The design of this study was cross sectional. The sample were 114 pregnant women selected by consecutive sampling. The instruments used were the Pittsburg Sleep Quality Index for sleep quality, the Spiritual Well Being Scale for measuring spiritual well being, and the Zung Self Anxiety Scale that had been modified to measure anxiety. Data were analyzed using chi square.

The results of the study showed a significant correlation between anxiety and sleep quality p value 0.031, the higher anxiety, the lower the quality of sleep also the correlation between spiritual well being and sleep quality p value 0.001 the higher spiritual well being, better the quality of sleep. It is recommended that nurses in providing nursing care for pregnant women to also pay attention to their spiritual well being, as well as giving intervention to decrease anxiety level, so that the pregnant womens quality of sleep can be improved."

"Latar Belakang : Pandemi COVID-19 merupakan sebuah kejadian dengan dampak luar biasa terutama pada populasi berisiko seperti ibu hamil. Indonesia sebagai salah satu negara dengan jumlah pasien COVID-19 tertinggi di dunia memiliki banyak kasus kehamilan dengan luaran maternal dan perinatal yang buruk akibat infeksi COVID-19. Namun, hingga saat ini belum terdapat studi yang secara komprehensif menilai faktor klinis dan non-klinis yang berpengaruh terhadap luaran buruk pada pasien hamil dengan COVID-19. Tujuan : Mengetahui faktor klinis dan non-klinis yang berhubungan dengan luaran buruk maternal dan perinatal pada ibu hamil dengan COVID-19. Metode : Penelitian kohort retrospektif dilakukan pada perempuan hamil yang terinfeksi COVID-19 yang dirawat Rumah Sakit Pusat Angkatan Darat (RSPAD) Gatot Soebroto selama periode Januari 2021 - April 2022. Pasien dengan data tidak lengkap dieksklusi dari penelitian. Faktor klinis yang dinilai adalah usia maternal, usia gestasi, beratnya gejala COVID-19 saat admisi, status obstetrik, status vaksinasi COVID-19, lama rawat instalasi gawat darurat, lama rawat inap biasa, lama rawat inap intensif, dan komorbiditas. Fakotr non-klinis yang dinilai adalah lama waktu sejak gejala hingga datang ke fasilitas pelayanan kesehatan, keengganan datang ke fasilitas pelayanan kesehatan, tingkat pendapatan, dan tingkat pendidikan. Hasil : Didapatkan sebanyak 79 subjek penelitian yang diikutsertakan dalam penelitian. Sebanyak 9 subjek mengalami luaran buruk berupa kematian ibu (n = 1), janin meninggal (n = 5), dan gejala COVID-19 berat (n = 6). Faktor klinis yang berpengaruh terhadap luaran yang buruk adalah usia maternal yang lebih tua, usia gestasi yang lebih muda, gejala COVID-19 yang lebih berat, serta durasi perawatan di instalasi perawatan intensif yang lebih lama (p < 0,05). Faktor non-klinis yang berpengaruh terhadap luaran yang buruk adalah lama gejala awal yang lebih lama, keberadaan kendala mencari pertolongan, dan pendapatan yang lebih rendah (p < 0,05). Kesimpulan : Luaran maternal dan perinatal yang lebih buruk pada kehamilan dengan COVID-19 terjadi akibat interaksi dari faktor klinis dan non-klinis. Diperlukan edukasi terhadap klinisi maupun masyarakat guna meningkatkan luaran pada kehamilan dengan COVID-19. Kata Kunci : COVID-19, infeksi, kehamilan, maternal, perinatal.

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Background: The COVID-19 pandemic is an event with a tremendous impact, especially on higher risk populations such as pregnant women. Indonesia as one of the countries with the highest number of COVID-19 patients in the world has many cases of pregnancy with adverse maternal and perinatal outcomes due to COVID-19 infection. However, there have been no studies that have comprehensively assessed clinical and non-clinical factors that influence adverse outcomes in pregnant patients with COVID-19.

Objective: To determine clinical and non-clinical factors associated with adverse maternal and perinatal outcomes in pregnant women with COVID-19.

Methods: A retrospective cohort study was conducted on pregnant women infected with COVID-19 who were treated at the Gatot Soebroto Army Central Hospital (RSPAD) during the period January 2021 - April 2022. Patients with incomplete data were excluded from the study. The clinical factors assessed were maternal age, gestational age, severity of COVID-19 symptoms upon admission, obstetric status, COVID-19 vaccination status, length of stay in the emergency department, length of regular hospitalization, length of intensive hospitalization, and comorbidity. The non- clinical factors assessed were the length of time from symptoms to arrival to health care facilities, reluctance to come to health care facilities, income level, and education level.

Results: There were 79 research subjects who were included in the study. A total of 9 subjects experienced adverse outcomes in the form of maternal death (n = 1), fetal death (n = 5), and severe COVID-19 symptoms (n = 6). Clinical factors that influenced poor outcomes were older maternal age, younger gestational age, more severe COVID-19 symptoms, and longer duration of treatment in intensive care (p < 0.05). The non- clinical factors that influenced the poor outcome were a longer duration of initial symptoms, the presence of obstacles in seeking help, and lower income (p < 0.05).

Conclusion: The worse maternal and perinatal outcomes in pregnancies with COVID-19 occur due to the interaction of clinical and non-clinical factors. Education for clinicians and the public is needed to improve outcomes in pregnancies with COVID- 19. Keywords: COVID-19, infection, maternal, perinatal, pregnancy"

"Latar Belakang: Kehamilan ektopik adalah suatu kondisi dimana blastokista tidak berimplantasi pada posisi yang tepat yaitu pada dinding endometrium. Setiap tahunnya, 0,03% ibu hamil di suatu negara mengalami kehamilan ektopik, sehingga mencapai 60.000 di seluruh dunia. Wanita paruh baya, yang menggunakan kontrasepsi, memiliki riwayat kehamilan ektopik, belum menikah, dan mungkin pernah menjalani operasi, mempunyai risiko lebih tinggi mengalami kehamilan ektopik. Kehamilan ektopik mempunyai dampak yang besar terhadap bayi dan ibu, sehingga penelitian ini berupaya untuk mengidentifikasi penyebab dan faktor risiko kehamilan ektopik khususnya di RSUPN dr. Cipto Mangunkusumo. Metode: Penelitian ini menggunakan rekam medis tahun 2021 - 2022 dari Departemen Obstetri & Ginekologi RSUPN dr. Cipto Mangunkusumo. Data pasien mencakup usia, status perkawinan, penggunaan kontrasepsi, riwayat kehamilan ektopik, riwayat kehamilan, dan riwayat operasi. Hasil: Karakteristik demografi usia (p = 0,015), riwayat kehamilan ektopik sebelumnya (p<0,001), dan riwayat bedah obstetri dan ginekologi (p = 0,019) menunjukkan perbedaan yang signifikan. Namun, status perkawinan (p = 0,17), penggunaan kontrasepsi (p = 0,14), dan riwayat kehamilan (p = 0,07) tidak memiliki perbedaan yang signifikan. Kesimpulan: Faktor risiko usia, riwayat kehamilan ektopik sebelumnya, dan riwayat bedah obstetri dan ginekologi mempunyai asosiasi yang signifikan terhadap terjadinya kehamilan ektopik.

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Introduction: Ectopic pregnancy is a condition where the blastocyst does not implant in the right position which is on the endometrial wall. Each year, 0.03% of pregnant women in a country have ectopic pregnancy, reaching 60.000 worldwide. Women in their middle age, who take contraception, have a history of ectopic pregnancy, are unmarried, and may have had surgery are at higher risk of ectopic pregnancy. Ectopic pregnancy has a major impact on the baby and mother, so this study seeks to identify the causes and risk factors of ectopic pregnancy, particularly in RSUPN dr. Cipto Mangunkusumo. Methods: This study includes 2021 - 2022 medical records from the Department of Obstetrics & Gynecology, RSUPN dr. Cipto Mangunkusumo, and its demography. Patients' data will include age, marital status, contraceptive use, history of ectopic pregnancy, history of pregnancy, and history of obstetric and gynaecologic surgery. Results: Risk factors’ of age (p = 0.015), history of previous ectopic pregnancy (p<0.001), and obstetrics and gynaecologic surgical history (p = 0.019) showed a significant difference. However, marital status (p = 0.17), contraceptive use (p = 0.14), and history of pregnancy (p = 0.07) were not significantly different. Conclusion: The risk factors of age, history of previous ectopic pregnancy, and obstetrics and gynaecologic surgical history had a significant association towards the occurrence of ectopic pregnancy."

"Latar Belakang: Persalinan prematur tetap menjadi perhatian kesehatan global yang signifikan, dengan berkontribusi pada kematian neonatal dan dampak kesehatan jangka panjang yang buruk. Indonesia juga terus menghadapi tingkat kejadian persalinan prematur yang tinggi, yang mengakibatkan Tingkat Kematian Neonatal (NMR) sebanyak 14 kematian per 1.000 kelahiran hidup. Mengingat sebagian besar kematian ini dapat dicegah, pemahaman terhadap faktor risiko merupakan langkah awal dalam mencegah persalinan prematur. Metode: Studi potong lintang analitik ini dilakukan dengan menggunakan data dari tahun 2021 yang berasal dari Departemen Obstetri dan Ginekologi, RSUPN Dr. Cipto Mangunkusumo. Faktor-faktor risiko yang mencakup usia, hipertensi, kehamilan ganda, riwayat persalinan prematur sebelumnya, dan diabetes, dianalisa hubungannya dengan persalinan prematur. Hasil: Studi ini mencakup 185 kasus persalinan prematur dan 185 kasus non-persalinan prematur. Usia rata-rata adalah 28,65 tahun (SD = 5,206). Perbedaan yang signifikan secara statistik teramati antara hipertensi (χ2(1) = 11,52, p < 0,001, Cramer’s V = 0,176, OR = 2,412), kehamilan ganda (χ2(1) = 6,58, p = 0,01, Cramer’s V = 0,133, OR = 9,409), dan riwayat persalinan prematur sebelumnya (χ2(1) = 10,25, p = 0,01, Cramer’s V = 0,166, OR = 2,107) dengan kejadian persalinan prematur. Perbedaan signifikan secara statistik dalam usia rata-rata tidak teramati antara wanita yang mengalami persalinan prematur dan yang tidak mengalami persalinan prematur (p = 0,872). Kelompok usia (p = 0,872) dan diabetes (p = 0,171) dilaporkan tidak memiliki perbedaan signifikan secara statistik terhadap kejadian persalinan prematur. Kesimpulan: Penelitian ini menunjukkan bahwa hipertensi, kehamilan ganda, dan riwayat persalinan prematur sebelumnya adalah faktor risiko terhadap kejadian persalinan prematur.

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Introduction: Preterm labor remains a significant global health concern, contributing to neonatal mortality and long-term adverse health outcomes. Indonesia also continues to face a high prevalence of preterm labor, resulting in a Neonatal Mortality Rate (NMR) of 14 deaths per 1,000 live births. Given that a substantial proportion of these deaths is preventable, an accurate assessment of risk factors represents the initial step in preventing preterm labor. Methods: This analytic cross-sectional study was conducted through utilizing data from the year 2021, with the data originating from the Department of Obstetrics and Gynecology, RSUPN Dr. Cipto Mangunkusumo. Risk factors which included age, hypertension, multiple gestations, history of previous preterm labor, and diabetes, were examined for their association with preterm labor. Results: The study included 185 cases of preterm labor and 185 non-preterm labor cases. Mean age was 28.65 years (SD = 5.206). A statistically significant difference was observed between hypertension (c2(1) = 11.52, p < 0.001, Cramer’s V = 0.176, OR = 2.412), multiple gestations (c2(1) = 6.58, p = 0.01, Cramer’s V = 0.133, OR = 9.409), and history of previous preterm labor (c2(1) = 10.25, p = 0.01, Cramer’s V = 0.166, OR = 2.107) with the occurrence of preterm labor. A statistically significant difference in mean ages were not observed between those that had preterm labor and those without preterm labor (p = 0.872). Age groups (p = 0.872) and diabetes (p = 0.171) was reported to not have statistically significant differences to the occurrence of preterm labor. Conclusion: This study illustrates hypertension, multiple gestations, and history of previous preterm labor, to be risk factors towards the occurrence of preterm labor."