DETERMINANT OF PREECLAMPSIA IN PREGNANT WOMEN AT RSUP PROF. DR DETERMINANT OF PREECLAMPSIA IN PREGNANT WOMEN AT RSUP PROF. DR. RD KANDOU MANADO (A SECONDARY DATA ANALYSIS FROM 2013)  

INTRODUCTION World Health Organization states that in 2013, there are 289,000 cases of maternal deaths , whereas the number decreased by about 45% since 1990 for as many 523,000 cases.

The causes of maternal mortality are bleeding 27%, hypertension in pregnancy (preeclampsia or eclampsia) 14%, and infection 11% (WHO, 2015).

In Indonesia the causes of maternal deaths are bleeding 20 In Indonesia the causes of maternal deaths are bleeding 20.3%, preeclampsia/eclampsia 27.1%, infection 7,1%, and abortus 0% (DEPKES RI, 2014), In North Sulawesi the causes of maternal deaths are bleeding 36%, eclampsia 29%, infection 4% (DINKES/Health Department) SULUT, 2012).

Preeclampsia is the onset of hypertension with proteinuria due to pregnancy, which happened after 20 weeks of gestation or shortly after delivery (Cunningham, Grant, Leveno, Gilstrap, Hautch, & Wenstrom, 2006). There are many factors related to the incidence of preeclampsia, such as age, gravida, parity, education, gestational age, pregnancy examination and excessive uterine distention (Maryanti, 2013).

The Statement of the Problems are: How is the distribution of the Preeclampsia event on pregnant mother in 2013 at RSUP Prof. Dr. R. D. Kandou? Is there a relationship between the age and Preeclampsia event on pregnant mother RSUP Prof. Dr. R. D. Kandou Manado? Is there a relationship between parity and preeclampsia event on pregnant mother in RSUP. Prof. Dr. R, D. Kandou? Is there a relationship between obesity and preeclampsia event on pregnant mother in RSUP Prof. Dr. R. D. Kandou Manado? which Factor that most related with preeclampsia events on pregnant mother in RSUP Prof. Dr. R. D. Kandou Manado?

The hypotheses in this study are Ha1: There is a significant correlation between the determinant of age and the incidence of preeclampsia in pregnant women at RSUP Prof. Dr. R. D. Kandou Manado. Ha2: There is a significant correlation between the determinant of parity and the incidence of preeclampsia at RSUP Prof. Dr. R. D. Kandou Manado. Ha3: There is a significant correlation between the determinant of obesity and the incidence of preeclampsia at RSUP Prof. Dr. R. D. Kandou Manado.

RESEARCH METHODS The research design used in this is observational analytic with Case Control approach. The study was conducted at RSUP Prof. Dr. R. D. Kandou Manado on selected pregnant women as needed (purposive sampling)

To answer the first statement of problem: analyzing the frequency distribution of preeclampsia frequency table is used; To answer the problem statement number two, three, and four: analyzing if there is a relationship between age, parity and obesity with the incidence of preeclampsia using statistic test of Non Parametric with Chi Square formula. To answer the fifth problem statement: analyzing the most related factor with the incidence of preeclampsia logistic regression formula is used.

Population and Sample The population in this study are pregnant women, with a total of 657. Samples are 167 people, in which are divided into two groups. 67 people in the case group and 67 people in the control group. The quantity of the samples was calculated with Lemeshow formula.

RESULTS AND DISCUSSIONS

Table 4.1 shows that respondents who suffered from preeclampsia were 84 respondents (50.0%) and 84 respondents (50.0%) who did not suffer from preeclampsia which made a total of 168 respondents. This is from the medical record data of 2013.

Tabel 4.3

Table 4.3, it was found that the age variable got Chi-Square value of 21.836 with p-value = 0,000 which means there is a significant relationship between age with the preeclampsia in pregnant women. The Contingency Coefficient value is 0.339 which shows weak relationship.

Further analysis found the value of OR (Odds Ratio) is 5 Further analysis found the value of OR (Odds Ratio) is 5.455, which means that pregnant women in the age of < 20 and > 35 years old, are 5 times more likely to suffer from preeclampsia compared with the age group of 20-35 years old pregnant women. Thus Ha1’s statement: there is a significant relationship between age with preeclampsia, is accepted. This shows that there is a significant relationship between the determinant of age with preeclampsia in pregnant women.

Changes parity nama tabel

Table 4.4, it was found that the parity variable got Chi-Square p-value = 0.245 which means statistically it can be said that there is no relationship between parity with the incidence of preeclampsia in pregnant women. Further analysis found the value of OR (Odds Ratio) 0.679 means that the probability of pregnant women with a parity of 1 and > 3 are likely 0.6 times more at risk of suffering from preeclampsia compared with pregnant women with parity 2-3.

Thus Ha2’s statement: there is a significant relationship between parity with preeclampsia, is rejected. This shows that there is no significant relationship between the determinant of parity with preeclampsia in pregnant women.  The difference between the results of the study and the theory is possible because the number of samples is less so that the results are not significant and there are factors other than parity associated with preeclampsia such as multiple pregnancy factors, education, history of hypertension, and previous preeclampsia history.

Insert obesitas tabel

Further analysis found the value of OR (Odds Ratio) 3,632 means that obese pregnant women 3 times more at risk of suffering from preeclampsia compared with mothers who are not obese. Thus Ha3’s statement: there is a significant relationship between obesity with preeclampsia, is accepted. This shows that there is a significant relationship between the determinant of obesity with preeclampsia in pregnant wome

 

it can be seen that after multivariate analysis using multiple logistic regression, the result is age is most related to preeclampsia in pregnant mother with Sig value of = 0.000 and Exp (B) 6.837 that is high for parity and obesity. From the results showed that age is the most related factor with the incidence of preeclampsia, this is because age greatly affect the physical and mental person during pregnancy

  CONCLUSION The incidence of preeclampsia in pregnant women at RSUP Prof. Dr. R. D. Kandou Manado in 2013 predominantly occurs in the range of age < 20 and > 35 years old, parity 1 and > 3, and in obesity pregnant women. There is a significant relationship between age with preeclampsia in pregnant women at RSUP Prof. Dr. R. D. Kandou Manado 2013 with significant value 0,000 < α = 0.05 (OR =5,455).

There is no significant relationship between parity with preeclampsia in pregnant women at RSUP Prof. Dr. R. D. Kandou Manado 2013 with significant value of 0.245 > α = 0.05 (OR = 0.679). There is a significant relationship between obesity with preeclampsia in pregnant women at RSUP Prof. Dr. R. D. Kandou Manado 2013 with significant value of 0,000 <α = 0.05 (OR = 3.632). Age is the most related factor with the incidence of preeclampsia in pregnant women at RSUP Prof. Dr. R. D. Kandou Manado 2013.

Recommendation For the community, through the results of this study is expected to increase public understanding about pregnancy health, especially to pregnant women who are planning to get pregnanti, especially those who are < 20 years old and > 35 years old, and to maintain weight during pregnancy in order not to become obese. For further researcher/researcher, is recommended to add more samples to the parity factor and examine other independent variables such as multiple pregnancies, education, previous preeclampsia history, and history of hypertension.