FAKTOR-FAKTOR RISIKO YANG BERHUBUNGAN DENGAN KEMATIAN MATERNAL DI KABUPATEN GROBOGAN (Studi di Kabupaten Grobogan)

KUSTRIYAN, Wisnu Murti and Suhartono, Suhartono and Suryoputro, Antono (2019) FAKTOR-FAKTOR RISIKO YANG BERHUBUNGAN DENGAN KEMATIAN MATERNAL DI KABUPATEN GROBOGAN (Studi di Kabupaten Grobogan). Masters thesis, School of Postgraduate.

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Abstract

Kematian maternal merupakan masalah yang penting karena dari tahun 2014-2016 AKI di Kabupaten Grobogan masih di atas target nasional meskipun upaya penurunan AKI juga sudah dilakukan. Penelitian tentang kematian maternal sudah pernah dilakukan sebelumnya, tetapi studi mengenai faktor-faktor risiko kematian maternal dengan dilengkapi kajian kualitatif belum pernah dilakukan di Kabupaten Grobogan. Oleh karena itu akan dilakukan penelitian tentang faktor-faktor risiko yang berhubungan dengan kematian maternal di Kabupaten Grobogan. Tujuan penelitian ini adalah menganalisis faktor-faktor risiko yang berhubungan dengan kematian maternal. Jenis penelitian yang digunakan adalah penelitian observasional analitik, dengan rancangan atau desain studi kasus kontrol (case control study). Populasi penelitian terdiri dari populasi kasus dan populasi kontrol, yang selanjutnya akan diambil sebagai sampel penelitian. Sampel dalam penelitian ini sebanyak 49 kasus dengan perbandingan kasus kontrol adalah 1 : 1 sehingga total keseluruhan sampel adalah 98. Variabel terikat adalah kematian ibu dan variable bebas adalah komplikasi kehamilan, komplikasi persalinan, komplikasi nifas, riwayat penyakit ibu, status gizi ibu saat hamil, status anemia, pemeriksaan antenatal, pelaksanaan rujukan saat terjadi komplikasi, dan keterlambatan rujukan. Data primer dikumpulkan dari hasil wawancara dengan menggunakan kuesioner. Data sekunder dikumpulkan dari catatan kematian maternal, KMS ibu hamil, register kohort ibu hamil, catatan persalinan, dan dokumen otopsi verbal. Data dianalisis menggunakan uji chi-square dan regresi logistik dengan CI= 95 % atau α = 5%. Hasil penelitian menunjukkan bahwa ada pengaruh signifikan komplikasi kehamilan, komplikasi persalinan, komplikasi nifas, riwayat penyakit ibu, status gizi ibu saat hamil, status anemia, pemeriksaan antenatal, pelaksanaan rujukan saat terjadi komplikasi, dan keterlambatan rujukan terhadap kematian maternal di Kabupaten Grobogan dengan masing-masing nilai propbabilitas (p=0,003, OR=5,455), (p= 0,014, OR=6,026), (p=0,000 OR=17,763), (p=0,000 OR=8,903), (p=0,000 OR=17,333), (p=0,000 OR=13,473), (p=0,049 OR=3,257), (p=0,000 OR=7,125), (p=0,000 OR=10,800). Faktor resiko yang paling dominan yang menjadi prediktor terjadinya kematian maternal adalah komplikasi nifas, riwayat penyakit dan komplikasi kehamilan. Disarankan bagi dinas Kesehatan agar melakukan analisis situasi mengenai sistem rujukan baik di tingkat pelayanan kesehatan dasar dan rumah sakit serta prosedur penyediaan bank darah di tingkat pelayanan kesehatan rujukan. Kata kunci : kematian ibu, komplikasi kehamilan, komplikasi persalinan, komplikasi nifas, riwayat penyakit ibu, status gizi ibu saat hamil, status anemia, pemeriksaan antenatal, pelaksanaan rujukan saat terjadi komplikasi, dan keterlambatan rujukan Maternal mortality is an important problem because from 2014-2016 the MMR in Grobogan District is still above the national target even though efforts to reduce the MMR have also been carried out. Previous research has been carried out on maternal deaths, but studies of risk factors for maternal mortality with a qualitative study have not been conducted in Grobogan District. Therefore a study of risk factors related to maternal mortality will be carried out in Grobogan Regency. The purpose of this study was to analyze risk factors associated with maternal mortality. The type of research used was observational analytic research, with a case control study design or case (case control study). The study population consisted of the case population and the control population, which will then be taken as the study sample. The sample in this study were 49 cases with a case-control ratio of 1: 1 so that the total sample total was 98. The dependent variable was maternal mortality and independent variables were complications of pregnancy, labor complications, postpartum complications, history of maternal disease, maternal nutritional status during pregnancy, anemia status, antenatal examination, implementation of referral when complications occur, and late referrals. Primary data was collected from interviews using a questionnaire. Secondary data were collected from maternal death records, KMS of pregnant women, cohort registers of pregnant women, labor records, and verbal autopsy documents. Data were analyzed using chi-square test and logistic regression with CI = 95% or α = 5%. The results showed that there were significant effects of pregnancy complications, labor complications, postpartum complications, maternal disease history, maternal nutritional status during pregnancy, anemia status, antenatal examination, implementation of referrals in the event of complications, and late referral to maternal deaths in Grobogan District with each each propbability value (p = 0.003, OR = 5.455), (p = 0.014, OR = 6.026), (p = 0,000 OR = 17,763), (p = 0,000 OR = 8,903), (p = 0,000 OR = 17,333), (p = 0,000 OR = 13,473), (p = 0,049 OR = 3,257), (p = 0,000 OR = 7,125), (p = 0,000 OR = 10,800). The most dominant risk factors that are predictors of maternal deaths are puerperal complications, history of illness and complications of pregnancy. It is recommended for the Health Office to conduct a situation analysis of the referral system both at the level of basic health services and hospitals as well as procedures for providing blood banks at the referral health service level. Keywords: maternal mortality, pregnancy complications, labor complications, postpartum complications, maternal disease history, maternal nutritional status during pregnancy, anemia status, antenatal examination, implementation of referrals when complications occur, and late referrals.

Item Type:Thesis (Masters)
Uncontrolled Keywords:kematian ibu, komplikasi kehamilan, komplikasi persalinan, komplikasi nifas, riwayat penyakit ibu, status gizi ibu saat hamil, status anemia, pemeriksaan antenatal, pelaksanaan rujukan saat terjadi komplikasi, dan keterlambatan rujukan
Subjects:R Medicine > RG Gynecology and obstetrics
Divisions:School of Postgraduate > Master Program in Epidemiology
ID Code:81919
Deposited By:Mrs Ekana Perpus Pasca
Deposited On:26 Nov 2020 15:49
Last Modified:26 Nov 2020 15:49

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