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"Penelitian sebelumnya telah membuktikan adanya korelasi negatif antara kadar asam lemak trans (TFA) dan DHA ASI. Penelitian pada fibroblas manusia menunjukkan bahwa TFA dapat menurunkan availabilitas DHA dengan menghambat proses biosintesis DHA dari alpha-linolenic acid dan inkorporasinya pada lemak membran, termasuk ASI. Penelitian ini dirancang untuk mengetahui korelasi asupan TFA ibu menyusui terhadap kadar DHA ASI. Studi potong lintang dilakukan dengan menggunakan consecutive sampling yang melibatkan 80 orang subjek ibu menyusui sehat pada 1-6 bulan postpartum berusia 20-35 tahun di Puskesmas Cilincing, Jakarta Utara, dan Puskesmas Grogol Petamburan, Jakarta Barat, pada bulan Februari-April 2019 Asupan asam trans, DHA, asam lemak jenuh, dan asam lemak omega-3 dinilai dengan menggunakan food frequency questionnaire semi kuantitatif dan dihitung rasio asupan TFA-DHA. Spesimen ASI diambil secara post-feed pada pagi hari. Kadar DHA ASI diukur dengan menggunakan gas kromatografi tandem spektrometri massa. Korelasi TFA terhadap kadar DHA ASI dianalisis dengan uji korelasi Spearman. Hasil penelitian menunjukkan median asupan TFA adalah 167 (29-849) mg/hari atau >0,08 (0,01-0,38)% total energi. Asupan TFA seluruh subjek masih memenuhi rekomendasi American Heart Association (< 1% total energi). Median asupan DHA adalah 158,5 (13,9-719,7) mg/hari, 67,5% subjek berada dibawah rekomendasi Food and Agriculture Organization (200 mg/hari). Median rasio asupan TFA-DHA adalah 1,08 (0,17-18,06) dan median kadar DHA ASI subjek penelitian adalah >242 (89-865) µmol/l. Tidak didapatkan korelasi antara asupan TFA terhadap kadar DHA ASI (r=0,056, p=0,309), asupan DHA didapatkan memiliki korelasi positif sedang bermakna terhadap kadar DHA ASI (r=0,479, p <0,001), dan terdapat korelasi negatif lemah bermakna rasio asupan TFA-DHA terhadap kadar DHA ASI (r=-0,396, p <0,001). Penelitian ini menyimpulkan bahwa kadar DHA ASI tidak berkorelasi dengan asupan TFA, namun terdapat korelasi negatif lemah antara rasio asupan TFA-DHA terhadap kadar DHA ASI.

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Previous research has shown an inverse correlation between TFA and DHA in breast milk. Experimental data on human fibroblast showed that TFA could decrease the availability of DHA by inhibiting its biosynthesis from alpha-linolenic acid and incorporation to lipid membrane, including human milk. This study was designed to determine the correlation between maternal TFA intake and DHA content of mother's breast milk. This cross-sectional study was conducted at Cilincing Public Health Centre, North Jakarta, and Grogol Petamburan Public Health Centre, West Jakarta, from February to April 2019. Consecutive sampling method was used, 80 healthy lactating mothers at 1-6 postpartum ranging from >20-35 years old, participated in this study. Maternal TFA, DHA, saturated fat, and omega-3 intake was assessed using a semiquantitative food frequency questionnaire, and TFA-DHA intake ratio was calculated. Breast milk specimens were collected post-feed in the morning then breast milk DHA content was analyzed by Gas Chromatography with Mass Spectrometry. Correlation between maternal TFA intake and breast milk's DHA content was assessed using Spearman's test. Data showed the median value of TFA intake was 167 (29-849) mg/day, all subjects TFA intake still below the recommendation of AHA (<1% total energy) Median value of DHA intake was 158.5 (13.9-719.7) mg/day, 67,5% of subject was below Food and Agriculture Organization recommendation (200mg/day). The median value of TFA-DHA ratio was 1.08 (0.17-18.06), and a median value of breast milk's DHA content was 242 (89-865) µmol/l. This study showed no correlation between maternal TFA intake and breast milk's DHA content >(r=0.056, p=0.309), Maternal DHA intake showed a moderate positive correlation with breast milk DHA (r=0.479, p <0.001). There was a weak negative correlation between TFA-DHA intake ratio and breast milk DHA (r=-0.396, p <0.001). This study concluded that the DHA content of the mother's breastmilk was not correlated with maternal TFA intake alone, but it was negatively correlated with TFA-DHA intake ratio."

"Latar belakang. Epilepsi fokal merupakan jenis epilepsi terbanyak pada anak. Kemungkinan untuk terjadinya epilepsi intraktabel pada epilepsi fokal lebih besar dibandingkan dengan epilepsi umum. Data mengenai faktor risiko epilepsi fokal intraktabel masih sangat sedikit. Perlu dilakukan penelitian lebih lanjut untuk mengetahui strategi pengobatan dan konseling bagi pasien dan keluarga. Tujuan. (1) mendapatkan frekuensi terjadinya epilepsi intraktabel pada anak dengan epilepsi fokal. (2) mengetahui karakteristik pasien epilepsi fokal yang kontrol ke poliklinik Neurologi Anak. (3) mengetahui apakah usia awitan, etiologi epilepsi, frekuensi awal serangan, status perkembangan motor kasar awal, respon terapi awal, gambaran EEG awal, dan gambaran CT-Scan/MRI kepala dapat memprediksi kemungkinan terjadinya epilepsi intraktabel pada pasien anak dengan epilepsi fokal. (4) mengetahui apakah evolusi status perkembangan motor kasar, dan evolusi EEG epileptiform dapat memprediksi terjadinya epilepsi intraktabel. Metode penelitian. Desain penelitian adalah kohort retrospektif dan dilakukan poliklinik rawat jalan Neurologi Anak di RSCM sejak November 2013 sampai dengan Februari 2014 terhadap anak epilepsi fokal hingga usia 18 tahun, dengan lama pengobatan minimal 6 bulan. Faktor risiko dianalisis bivariat dan multivariat. Hasil penelitian. Angka kejadian epilepsi fokal intraktabel adalah 35 (39%).Usia subjek terbanyak adalah usia>3 tahun sebanyak 81(90%) subjek. Pada analisis bivariat didapat faktor risiko bermakna adalah etiologi kejang simtomatik (OR 6,12 IK95% 2,08-18,04), frekuensi kejang>5x/hari (OR 3,91 IK95% 1,43-10,75), respon awal terapi buruk (OR 233,14 IK95% 27,40-1983,27), EEG awal abnormal (OR 4,51 IK95% 1,82-11,17), MRI abnormal (OR 10,38 IK95% 2,91-37,06), evolusi status perkembangan motor kasar buruk (OR 21,62 IK95% 2,62-178,1), dan evolusi EEG epileptiform buruk (OR 25 IK95% 7,71-81,03). Pada analisis multivariat didapatkan respon awal terapi buruk dengan nilai OR136,00 (IK95% 14,79 sampai 1250,08), dan evolusi EEG epileptiform buruk dengan nilai OR 10,00 (1,68 sampai 59,35) merupakan faktor risiko yang berperan untuk menjadi epilepsi fokal intraktabel. Simpulan. Angka kejadian epilepsi fokal intraktabel sebanyak 39%. Faktor risiko yang berperan adalah respon terapi awal buruk, dan evolusi EEG epileptiform buruk.

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Background. Epilepsy focal is the most common type epilepsy in children. The chance to be intractable epilepsy is higher than general epilepsy. Therefore, study of the risk factors to predict intractable epilepsy is the utmost importance to conduct the treatment strategy and consult the patients and family.

Objective. (1) to determine the characteristic focal epilepsy in children (2) to determine the frequency of intractable focal epilepsy (3) to identify and analyze the association of early risk factors including the onset of seizure, frequency of seizure, etiology of epilepsy, gross motor developmental status, the response of antiepileptic drugs, the electroencephalogram (EEG), and magnetic resonance imaging (MRI) / computed tomography (CT) Scan findings with intractable focal epilepsy, (4) to identify and analyze the relationship between the evolution factors including the evolution of EEG epileptiform, and the evolution of gross motor development with intractable focal epilepsy.

Methods. Retrospective cohort study was conducted in child neurology outpatient clinics in Cipto Mangunkusumo Hospital Jakarta on November 2013 to February 2014. Inclusion criteria was children with epilepsy focal who was treated with antiepileptic drugs at least 6 month therapy until 18 years old age. Patients with febrile convulsions; central nervous system infections; neurodegenerative, neurometabolic diseases; and catastrophic epileptic syndromes with poor prognosis were excluded from the study. Data were analyzed using the IBM SPSS for Windowsv.17 software (IBM, New York, USA).

Results. The proportion of intractable focal epilepsy is 35 (39%). The most of children is >3 years old 81 (90%). Bivariate analysis showed that significantly early risk factors are symptomatic epileptic (OR = 6.12; 95%CI 2.08-18.04), frequency of seizure >5x/day (OR = 3.91; 95%CI 1.43-10,75), gross motor developmental delay (OR = 233.14; 95%CI 27.40-1983.27), early abnormal EEG wave (OR = 4.51; 95%CI 1.82-11.17), abnormal MRI (OR = 10.38; 95%CI 2.91-37.06), poor gross motor developmental evolution (OR = 21.62; 95%CI 2.62-178.1), and poor the EEG epileptiform evolution (OR = 25; 95%CI 7.71-81.03). Multivariate logistic regression analysis revealed that an initial non response to antiepileptic drugs (OR = 136.00; 95%CI 14.79-1250.08), and the poor evolution of EEG epileptiform (OR =10.00; 95%CI 1.68-59.35) were all found to be significant and independent risk factors for intractable focal epilepsy.

Conclusion. The present study reveals that the early non response to antiepileptic drugs, and poor of EEG epileptiform evolution are strongly associated with intractable focal epilepsy."

"ABSTRAKLatar belakang. Gangguan tidur merupakan gangguan penyerta pada anak gangguan spektrum autisme (GSA), yang memiliki prevalens tinggi serta dapat mengakibatkan perilaku negatif terhadap lingkungannya atau perilaku maladaptif eksternalisasi. Gangguan tidur pada anak GSA perlu dideteksi secara dini, karena bila tidak akan menyebabkan keterlambatan terapi dan menyebabkan anak makin berperilaku negatif serta menyebabkan stres pada keluarga.Tujuan. Mengetahui pola gangguan tidur dan gambaran perilaku maladaptif eksternalisasi pada anak GSA, serta mengetahui perbedaan rerata nilai indeks perilaku maladaptif eksternalisasi (v-scale), pada anak GSA dengan gangguan tidur dan tanpa gangguan tidur.Metode. Penelitian potong lintang analitik di klinik dan tempat terapi anak berkebutuhan khusus di Jakarta pada bulan Juni-Agustus 2014. Skrining gangguan tidur dengan kuesioner Sleep Disturbance Scale for Children (SDSC) dan penilaian perilaku maladaptif eksternallisasi dengan kuesioner Vineland-II dilakukan terhadap 40 anak GSA yang dipilih secara konsekutif. Subjek penelitian dibagi menjadi dua kelompok yaitu kelompok gangguan tidur (20 anak) dan kelompok tanpa gangguan tidur (20 anak).Hasil. Rentang usia dalam penelitian ini adalah 3-18 tahun dengan median usia 3,5 tahun. Proporsi terbanyak gangguan tidur pada anak GSA terdapat pada kelompok usia 3-5 tahun (15 dari 20 subjek). Pola gangguan tidur terbanyak pada anak GSA adalah gangguan memulai dan mempertahankan tidur (17 dari 20 subjek) diikuti oleh gangguan somnolen berlebihan (8 dari 20 subjek). Nilai median v-scale perilaku maladaptif eksternalisasi pada anak GSA adalah 18 (rentang 12-22), dan terdapat kecenderungan peningkatan nilai median v-scale perilaku maladaptif eksternalisasi seiring dengan peningkatan usia pada kedua kelompok. Nilai rerata v-scale perilaku maladaptif eksternalisasi pada kelompok GSA dengan gangguan tidur lebih tinggi dibandingkan kelompok tanpa gangguan tidur (18,8 dan 17,6 secara berurutan, mean difference 1,2; p 0,35 (p ≥ 0,05)).Simpulan. Proporsi terbanyak gangguan tidur pada anak GSA terdapat pada kelompok usia 3-5 tahun. Pola gangguan tidur terbanyak pada anak GSA adalah gangguan memulai dan mempertahankan tidur diikuti oleh gangguan somnolen berlebihan. Anak GSA dengan gangguan tidur memiliki nilai rerata indeks perilaku maladaptif eksternalisasi yang lebih tinggi dibandingkan tanpa gangguan tidur, namun tidak bermakna secara klinis dan statistik.

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ABSTRACTBackground. Sleep disorders is a comorbidity in Autism Spectrum Disorders (ASD), which has high prevalence and can cause negative behavior toward his surrounding or externalizing maladaptive behavior. Sleep disorders in ASD needs to be early detected, otherwise it will delay the treatment and children will behave more negative and cause the stress in family.Objectives. To identify sleep patterns and externalizing maladaptive behavior in children with ASD, and to identify the mean difference of index score of externalizing maladaptive behavior of (v-scale) in ASD children with or without sleep disorders.Methods. This study was analytical cross-sectional performed in the clinic and a therapy for children with special needs in Jakarta, in Juni-August 2014. Sleep disorders were screened using Sleep Disturbance Scale for Children (SDSC) questionnaire and externalizing maladaptive behavior was assessed using Vineland-II questioinnaire in 40 ASD children consecutively. They were divided into two groups, one group of sleep disorders (20 children) and other without sleep disorders (20 children).Results. Age range in this study was 3-18 years old, with median age of 3.5 years old. The majority of sleep disorders in ASD was in age range 3-5 years (15 of 20 subjetcs). The most frequent sleep disorders in ASD were difficulty in initiating and maintaning sleep (17 of 20 subjetcs), followed by disorder of excessive somnolence (8 of 20 subjetcs). The v-scale median score in ASD was 18 (range 12-22), and there was tendency of increased v-scale median score along with increased age. The mean of v-scale in externalizing maladaptive behavior in ASD with sleep disorders group was higher than without sleep disorders group (18.8 and 17.6 respectively, mean difference 1,2; p 0.35 ((p ≥ 0,05)).Conclusion. The majority of sleep disorders in ASD was in age range 3-5 years. The most frequent sleep disorders in ASD were difficulty in initiating and maintaning sleep, followed by disorder of excessive somnolence. Autism spectrum disorders children with sleep disorders has higher index externalizing maladaptive behavior mean than without sleep disorders, but was not meaningful clinically and statistically."

"Perkembangan kognitif merupakan kunci utama yang memberikan sumbangan pada kemampuan belajar di masa depan, kualitas sumber daya tenaga kerja, dan kemampuan seseorang secara keseluruhan. Umumnya anak dengan BBLR (berat badan lahir rendah) memiliki tingkat perkembangan yang lebih rendah dibandingkan anak dengan berat lahir normal. Tujuan penelitian ini untuk mengetahui hubungan antara berat lahir dengan perkembangan kognitif pada anak usia dibawah dua tahun (3-23 bulan).Penelitian ini menggunakan desain studi kohor prospektif. Populasi penelitian ini adalah anak baduta beserta ibunya yang menjadi sampel penelitian kohor tumbuh kembang anak. Pengambilan sampel dilakukan dengan mengambil keseluruhan sampel yang memenuhi kriteria inklusi dan eksklusi sehingga didapatkan 278 responden. Sebagian besar baduta (51,8%) memiliki perkembangan kognitif yang optimal dan sebagian besar juga memiliki berat lahir ≥ 3100 gram (58,6%).Hasil penelitian ini menunjukkan adanya hubungan yang signifikan antara berat lahir dengan perkembangan kognitif pada baduta 3-23 bulan dengan nilai p= 0,01 (RR 1,36; 95% CI: 1,06-1,73). Berdasarkan hasil analisis stratifikasi, variabel lain yang diduga turut memberikan pengaruh dalam hubungan antara berat lahir dengan perkembangan kognitif adalah pertumbuhan baduta berdasarkan kurva PB/U dengan nilai p=0,05 (RR 1,36; 95% CI: 1,05-1,75) dan status gizi ibu sebelum hamil p<0,05 (RR 1,42; 95% CI: 1,1-1,83).Berdasarkan hal ini, disarankan kepada para orangtua terutama ibu untuk memperhatikan tumbuh kembang anak antara lain dengan cara mengunjungi posyandu atau fasilitas kesehatan agar dapat mendeteksi adanya gangguan pada tumbuh kembang anak secara dini. Selain itu juga, dengan mempersiapkan kondisi tubuh dengan baik terutama bila merencanakan kehamilan dengan berkonsultasi tenaga kesehatan yang berkompeten.

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Cognitive development is a key factor contributing to the ability to learn in the future, the quality of labor resources, and the ability of a person as a whole. Generally, children with low birth weight (LBW) have a lower level of development than children with normal birth weight. The purpose of this study was to determine the relationship between birth weight with cognitive development in children under two years of age (3-23 months).

This study used a prospective cohort study design. The study population was under two years old children and their mother which is the sample of child development cohort study. Sampling was done by taking the overall sample who meet the inclusion and exclusion criteria to obtain 278 respondents. Most under two year child (51.8%) had optimal cognitive development, and most also have a birth weight ≥ 3100 g (58.6%).

The results showed a significant relationship between birth weight with cognitive development in under two years child (3-23 months) with a value of p = 0.01 (RR 1.36; 95% CI: 1.06 to 1.73). Based on the analysis of stratification, another variable that is thought to contribute to give effect in the relationship between birth weight with cognitive development is the growth curve of under two years child based on length/age with p = 0.05 (RR 1.36; 95% CI: 1.05 to 1 , 75) and the nutritional status of the mother before pregnancy p <0.05 (RR 1.42; 95% CI: 1.1 to 1.83).

Based on this, it is suggested to parents, especially mothers to pay attention to child growth and development, among others by visiting the neighborhood health center or health facilities in order to detect any disturbance in early child development. In addition, by preparing with good body condition, especially when planning a pregnancy to consult a competent health personnel."

"Latar belakang Kemampuan meminta (mand) dan menyebut (tact) adalah kemampuan yang perlu ditingkatkan pada awal terapi verbal behavior pada anak autisme. Metode telehealth oleh orangtua dapat memberikan terapi dini. Tujuan penelitian untuk melihat efektivitas pelatihan yang dilakukan orangtua terhadap peningkatan kemampuan komunikasi awal anak GSA dalam meminta (mand) dan menyebut (tact). MetodeUji klinis acak terkontrol terhadap anak autisme berusia 2-5 tahun. Penilaian kemampuan anak menggunakan instrumen verbal behavior milestones assessment and placement program. Orangtua kelompok perlakuan mendapat modul video pelatihan dan bimbingan dari terapis, sebelum memulai terapi selama 3 bulan pada anak. Penilaian kemampuan ulang dilakukan pada kedua kelompok di akhir periode.HasilTerdapat 40 subyek yang masuk ke dalam level 1 VBMAPP. Skor VB MAPP sesudah pemberian intervensi meningkat dari 13,83 menjadi 24,43. Peningkatan median skor mand 1 menjadi 2 dan median skor tact 1 menjadi 3 (p<0,001). Perbandingan peningkatan median skor mand antara kedua kelompok menunjukkan hasil bermakna (p=0,003). Kenaikan proporsi skor mand dan tact tampak lebih tinggi pada kelompok perlakuan.SimpulanPelatihan mand dan tact oleh orangtua pada anak autisme dengan menggunakan metode telehealth efektif dalam meningkatkan kemampuan anak meminta, dan bermakna secara klinis dalam meningkatkan kemampuan anak menyebut. Metode telehealth dapat diterima oleh orangtua.

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Background

Mand and tact is a skill in verbal behavior therapy that needs to be improved initially. The telehealth method are helpful for those in rural area. This study aim was to assess effectiveness of telehealth mand and tact training by parents on increasing the child’s mand and tact skill.

Methods

A randomized controlled clinical trial of 2-5 years old children with ASD. Assessment of children's milestones using verbal behavior milestones assessment and placement program. Parents in the intervention group received video modelling and guidance from a therapist before giving therapy for 3 months. Re-assessment was done in both groups at the end of the period.

Results

A total of 40 subjects with ASD in level 1 VBMAPP meet criteria. A significant increase in the VB MAPP score after the intervention, namely 13.83 to 24.43. Mand median score increased from 1 to 2, and the tact, 1 to 3 with p<0.001. Comparison of the increase in the median mand score between the two groups showed significant results (p = 0.003). The increase in the proportion of mand and tact scores was higher in intervention group.

Conclusion

Telehealth mand and tact training by parents for children with ASD effective in improving mand, and clinically meaningful in improving tact. The telehealth method can be accepted by parents."

"Latar belakang. Faktor risiko PJK dapat terjadi sejak masa kanak-kanak dan dapat dicegah. Gangguan pertumbuhan intrauterin dapat meningkatkan kemungkinan timbulnya faktor risiko PJK. Penelitian sebelum11Ya menunjukkan hasil yang tidak konsisten. Hanya satu penelitian serupa yang pernah dilaporkan di Indonesia. Tujuan. Mengidentifik.asi faktor-faktor risiko kardiovaskular pada anak usia 9-12 tahun dan mengetahui faktor-faktor yang memengaruhinya, dengan perhatian khusus pada berat lahir. Metode. Studi potong lintang dilakukan pada anak usia 9-12 tahun di 4 sekolah dasar di Jakarta Pusat. Berat lahir didapatkan dari catatan kelahiran yang dimiliki orangtua. Pada subjek dilakukan pemeriksaan fisis dan antropometris, pengukuran massa lemak tubuh, dan pengambilan darah vena untuk pemeriksaan glukosa puasa, kolesterol total, HDL, LDL, dan trigliserida. Pada subjek dilakukan juga analisis diet dengan metode three-day food recall dan penilaian tingkat aktivitas fisis dengan Physical Activity Questionnaire for Children (PAQ-C). Orangtua diminta mengisi kuesioner mengenai riwayat pemberian ASI dan kondisi sosioekonomi. Proporsi obesitas, hipertensi, glukosa puasa terganggu, dan dislipidemia ditentukan. Koefisien korelasi antara berat lahir dengan indeks massa tubuh (IMT), tekanan darah sistolik, tekanan darah diastolik, massa lemak tubuh., glukosa puasa, kolesterol total, HDL, LDL, dan trigliserida ditentukan dengan uji Spearman. Korelasi yang bermakna diuji dengan analisis multivariat dengan mengikutsertakan faktor kovariat durasi pembcrian ASI, durasi ASI eksklusif, asupan nutrisi, tingkat aktivitas fisis, dan penghasilan keluarga. · Hasil. Didapatkan 85 subjek, 49 (57,6%) perempuan. Median (rentang) berat lahir subjek 3000 (1500-4300) g; 6 (7,1%) subjek memiliki berat lahir <2500 g. Proporsi obesitas, hipertensi sistolik, hipertensi diastolik, glukosa puasa terganggu, dan dislipidemia berturut-turut 10,6%; 2,4%; 4%; 2,4%; dan 31,8%. Terdapat korehsi lemah yang bermakna secara statistika antara berat lahir dengan z-swre IMT (p=0,265; p=O,Ol4) dan persentil massa lemak tubuh (p=0,216; p=0,047). Tidak. ditemukan korelasi yang bermakna secara statistika antara berat lahir dengan variabel-variabel lainnya. Fak.tor kovariat yang memenuhi syarat untuk analisis multivariat adalah durasi total pemberian ASI, durasi ASI eksklusif, persentase asupan protein terhadap AKG, dan penghasilan keluarga. Pada regresi linear multipel, berat lahir masih berpengaruh terhadap z-score IMT (P=O,OOl; p=0,008) dan persentil massa lemak. tubuh (p=0,017; p=0,043) pada usia 9-12 tahun. Sim.pulan. Terdapat korelasi positif lemah yang bermak.na secara statistika antara berat lahir dengan IMT dan massa lemak. tubuh. Pengaruh berat lahir terhadap IMT dan massa lemak. tubuh tetap bermak.na apabila faktor pemberian ASI, asupan nutrisi, dan penghasilan keluarga diperhitungkan. Diperlukan penelitian kohort prospektif dengan memperhitungkan usia gestasi untuk menentukan dengan lebih tepat pengaruh berat lahir rendah, khususnya perturnbuhanjanin terganggu, terhadap faktor risiko kardiovaskular.

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Background. Risk factors of CHD may develop since childhood and are preventable. Intrauterine growth disturbance leads to programming of metabolic and endocrine systems, causing CHD risk factors to arise. Previous studies have shown inconsistent results. Only one such study has been reported in Indonesia Objectives. To identify cardiovascular risk factors in children 9-12 years old and their influencing factors, with specific attention to bi.rth weight. Methods. A cross-sectional study was done in 9-12-year-old children from 4 elementary schools in Central Jakarta. Birth weight was obtained from birth records submitted by parents. Physical examination, anthropometric measurement, determination of body fat percentage, and venous blood sampling were done to determine fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Dietary analysis was done by a three-day food recall. Subjects' physical activity level was assessed using the Physical Activity Questionnaire for Children (P AQ-C). Parents completed a questionnaire regarding breastfeeding history and socioeconomic conditions. The proportions of obesity, hypertension, impaired fasting glucose, and dyslipidernia were calculated. The Spearman test was done to determine the correlation between birth weight and body mass index (BMI), systolic and diastolic blood pressure, body fat percentage, fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Significant correlations were subjected to multivariate analysis incorporating total breastfeeding duration, exclusive breastfeeding duration, nutritional intake, physical activity level, and family income. Results. We obtained 85 subjects, 49 (57,6%) of which were female. Median (range) birth weight was 3000 (1500-4300) g; 6 (7,1%) had birth weight of <2500 g. The proportion of obesity, systolic hypertension, diastolic hypertension, impaired fasting glucose, and dyslipidemia was 10,6%; 2,4%; 4%; 2,4%; and 31,8%, respectively. A weak positive correlation was obtained between birth weight and BMI z-score (p=0,265; p=0,014); and between birth weight and body fat percentile (p=0,216; p=0,047). There was no statistically significant correlation between birth .veight and other variables. Covariates fulfilling significance criteria were total breastfeeding duration, exclusive breastfeeding duration, percentage protein intake to the local RDA, and family income. On multiple linear regression analysis, birth weight was still significantly related to BMI z-score (~=0,001; p=0,008) and body fat percentile (~=0,017; p=0,043) at 9-12 years of age when the covariates were considered. Conclusions. Birth weight is weakly and positively correlated with BMI and body fat percentage. The influence of birth weight on BMI and body fat percentage remains significant when breastfeeding history, nutritional intake, and family income are considered. A prospective cohort study incorporating gestational age is needed to determine the influence of low birth weight, particularly due to intrauterine growth disturbance, on cardiovascular risk factors."

"Latar belakang: Asuhan nutrisi optimal untuk bayi prematur bertujuan mengoptimalkan tumbuh kembang dan peningkatkan kualitas hidup bayi prematur. Asuhan nutrisi berupa penilaian masalah nutrisi, menentukan kebutuhan nutrisi, dan pemantauan pertumbuhan membutuhkan kurva pertumbuhan. Saat ini tidak ada kurva pertumbuhan standar untuk bayi prematur. Tujuan: Membandingkan laju pertumbuhan setiap minggu hingga maksimal usia 37 minggu pada bayi prematur yang diberikan nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st dan kurva Fenton, serta mengetahui hubungan antara sepsis, respiratory distress syndrome, riwayat hambatan laju pertumbuhan intrauterin dengan laju pertumbuhan berat badan . Metode: Pnelitian ini adalah uji klinis ajak tersamar ganda pada 93 bayi prematur usia gestasi 33-36 minggu. Perhitungan kebutuhan nutrisi dan pemantauan asupan dilakukan setiap hari serta pemantauan antropometri berupa berat badan, panjang badan, dan lingkar kepala dilakukan minimal satu kali dalam seminggu. Analisis uji-t dilakukan pada sebaran data normal Hasil: Pada bayi prematur yang diberikan nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st dan kurva Fenton tidak berbeda bermakna dalam hal laju kenaikan berat badan, panjang badan, dan lingkar kepala setiap minggu hingga maksimal usia 37 minggu. Pemberian nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st dibandingkan menggunakan kurva Fenton memberikan hasil lebih banyak bayi prematur yang mencapai berat badan lahir dalam waktu kurang dari 7 hari (33% vs 19%) dan lebih banyak bayi prematur yang tumbuh liniear sesuai dengan trajektori pertumbuhan yang harus dicapai, dengan indeks berat badan 39% vs 20%, panjang badan 55% vs 36%, dan lingkar kepala 59% vs 48%. Riwayat hambatan pertumbuhan intrauterin memiliki hubungan bermakna dengan laju pertumbuhan berat badan pada pasien yang mendapatkan nutrisi berdasarkan berat badan ideal menurut kurva Intergrowth-21st(p 0,003, IK 95% 2,326-10,239) Simpulan: Penggunaan kurva Intergrowth-21st lebih baik dibandingkan kurva Fenton dalam menentukan kebutuhan kalori dan pemantauan pertumbuhan bayi prematur, sehingga mencageha terjadinya hambatan laju pertumbuhan.

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Background: Nutrition implementation in premature babies goals are to optimize growth development and increase life quality. Nutritional implementation program including nutritional assessment, determine nutritional necessity or nutritional therapy, and monitor of premature babies' growth with standardized growth curve. Until recently, there is no standardize growth curve for premature baby. Objective: To compare growth velocity every week until maximum 37 weeks corrected age in premature infants who has been given nutritional implementation based on their ideal weight using Intergrowth-21 curve or Fenton curve. And, to correlate growth velocity and factors such as sepsis, respiratory distress syndrome, and intrauterine growth retardation. Methods: This is randomized double blinded clinical trial on 93 premature babies with gestational age range within 33-36 weeks. Daily nutritional intake and monitoring intake toleration were done. Anthropometric monitoring data were taken minimum every week. T-test analysis was used on normal data distribution. Results: There are no significant difference in weekly growth velocity (body weight, length, head circumference) in premature babies until 37 weeks corrected age who is given nutritional intake based on ideal body weight of Intergrowth-21st curve compare to Fenton curve. Intergrowth-21st curve shows more premature babies achieving babies' birth weight in less than 7 days (33% vs 19%) and more premature babies have linier growth according to their trajectory growth goals, with body weight index 39% vs 20%, body length 55% vs 36%, and head circumference 59% vs 48%. Intra uterine growth retardation and growth velocity has significant correlation in patients received nutrition implementation based on targeted ideal body weight according to  Intergrowth-21st curve (p 0,003, IK 95% 2,326-10,239). Conclusion: Intergrowth 21st curve has better result in determining nutritional necessity and monitoring growth of premature babies compare to Fenton curve in order to prevent slower growth velocity in premature babies."