Main Article Content
Abstract
Background: Preeclampsia has been a major problem for obstetric care in Indonesia due to risks of preterm birth and lower Apgar score.
Objective: This study is to examine relationships of preeclampsia, preterm births, and Apgar Score.
Methods: This used an analytic study with retrospective case-control design in Dr. Soetomo Academic Hospital. A case group was taken by total sampling from medical records of all patients who had preterm delivery in 2017, and a control group of term deliveries was taken by random sampling. Then the data were analysed by using Chi-square test and Fisher’s Exact Test.
Results: There were 80 samples for each group. 63.75% of patients by age of 20-35 years were who delivered preterm birth, 40.00% had normal BMI, 40.00% were nulliparous, 92.50% did not have history of preterm labour, 50.00% had preeclampsia with severe features, and 46.25% had spontaneous vaginal delivery. Around 47.14% neonates from preeclamptic women were born at 32-<37 weeks gestation, 50.00% were born with low birth weight, 52.86% had the first minute Apgar score <7, and 72.86% had the fifth minutes Apgar score =7. The statistical analysis showed a significant relationship between the preeclampsia and the preterm birth (p<0.007; OR=2.54, 95% CI 1.34-4.83). The preeclampsia was also related to lower Apgar score at 1st minute (p<0.042; OR=2.03, 95% CI 1.07-3.85) and 5th minute (p<0.046; OR=2.42, 95% CI 1.08-5.41). Preterm neonates born from preeclamptic mothers were related to lower Apgar score at 1st minute (p<0.002; OR=5.82, 95% CI 1.99-17.02) and 5th minute (p<0.001; OR 17.31, 95% CI 2.15-139.54).
Conclusion: Preeclampsia could make pregnant women at risks of delivering preterm birth and neonates with low Apgar score.
Keywords
Article Details
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References
- World Health Organization. Preterm Birth Fact Sheets [Internet]. 2018. Available from: https://www.who.int/en/news-room/fact-sheets/detail/preterm-birth.
- Auger N, Le TUN, Park AL, Luo ZC. Association between maternal comorbidity and preterm birth by severity and clinical subtype: Retrospective cohort study. BMC pregnancy and childbirth. 2011;11(1):67-76.
- Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertension. 2014;4(2):97-104.
- American College of Obstetricians, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and gynecology. 2013:17-9.
- Brandão AHF, Félix LR, Do Carmo Patrício E, Leite HV, Cabral ACV. Difference of endothelial function during pregnancies as a method to predict preeclampsia. Archives of Gynecology and Obstetrics. 2014;290(3):471-7.
- Moore AG, Young H, Keller JM, Ojo LR, Yan J, Simas TAM, et al. Angiogenic biomarkers for prediction of maternal and neonatal complications in suspected preeclampsia. Journal of Maternal-Fetal and Neonatal Medicine. 2012;25(12):2651-7.
- Duley L. The Global Impact of Pre-eclampsia and Eclampsia. Seminars in Perinatology. 2009; 33:130–7.
- Bilano VL, Ota E, Ganchimeg T, Mori R, Souza JP. Risk factors of pre-eclampsia/eclampsia and its adverse outcomes in low- and middle-income countries: A WHO secondary analysis. PLoS One. 2014;9(3):e91198.
- Adisasmita A, Smith CV, El-Mohandes AAE, Deviany PE, Ryon JJ, Kiely M, et al. Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia. Maternal and Child Health Journal. 2015;19(7):1624-33.
- Bes B. Analisis Faktor Penyebab Kejadian ’Preeklampsia’ Ibu Hamil untuk Turunkan AKI. Unair News [Internet]. 2017; Available from: http://news.unair.ac.id/2017/07/31/analisis-faktor-penyebab-kejadian-preeklampsia-ibu-hamil-untuk-turunkan-aki/.
- Nurmalasari. The Correlations Of Early Ruptured Amnion, Placenta Previa, And Preeclampsia To Preterm Delivery Case In Dr. A. Dadi Tjokrodipo Public Hospital In Bandar Lampung In 2015. Jurnal Skala Kesehatan. 2015;6(2).
- Davies EL, Bell JS, Bhattacharya S. Preeclampsia and preterm delivery: A population-based case–control study. Hypertension in Pregnancy. 2016:35(4):510-19.
- Svenvik M, Brudin L, Blomberg M. Preterm Birth: A Prominent Risk Factor for Low Apgar Scores. Biomed Research International. 2015;2015:1-8.
- Mutianingsih R. Hubungan Preeklamsi Berat Dengan Kelahiran Preterm Di Rumah Sakit Umum Provinsi Nusa Tenggara Barat. Media Bina Ilmiah. 2014;8(3):6–13.
- American College of Obstetricians and Gynecologists, American Academy of Pediatrics. The Apgar Score (Committee Opinion No.644). Obstetrics and Gynecology. 2015;126:e52–e55.
- Ehrenstein V, Pedersen L, Grijota M, Nielsen GL, Rothman KJ, Sørensen H. Association of Apgar score at five minutes with long-term neurologic disability and cognitive function in a prevalence study of Danish conscripts. BMC Pregnancy Childbirth. 2009;9:14.
- Akbar MIA, Ernawati, Dachlan EG. The Hypertension in Pregnancy Problems in Indonesia. In: Dutch Foundation For Postgraduate Medical Courses In Indonesia “The Continuum of care in pre eclampsia mother-infant-child.” Surabaya; 2019.
- Susilo SA, Pratiwi KN, Fattah ANA, Irwinda R, Wibowo N. Determinants of low APGAR score among preeclamptic deliveries in Cipto Mangunkusumo Hospital: A retrospective cohort study in 2014. Medical Journal of Indonesia. 2015;4(3):183-9.
- Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet. 2012;379(9832):2162–72.
- Sungkar A, Fattah ANA, Surya R, Santoso BI, Zalud I. High preterm birth at cipto mangunkusumo hospital as a national referral hospital in Indonesia. Medical Journal of Indonesia. 2017;26(3):198-203.
- Fuchs F, Monet B, Ducruet T, Chaillet N, Audibert F. Effect of maternal age on the risk of preterm birth: A large cohort study. PLoS One. 2018;13(1):e0191002.
- Tellapragada C, Eshwara VK, Bhat P, Acharya S, Kamath A, Bhat S, et al. Risk factors for preterm birth and low birth weight among pregnant Indian women: A hospital-based prospective study. Journal of Preventive Medicine and Public Health. 2016;49(3):165-75.
- Chen KH, Chen IC, Yang YC, Chen KT. The trends and associated factors of preterm deliveries from 2001 to 2011 in Taiwan. Medicine (Baltimore). 2019;98(13):e15060.
- Maita L. Faktor Ibu yang Mempengaruhi Persalinan Prematur di RSUD Arifin Achmad Pekanbaru. Jurnal Kesehatan Komunitas. 2012;2(1):31-4.
- Kongwattanakul K, Saksiriwuttho P, Chaiyarach S, Thepsuthammarat K. Incidence, characteristics, maternal complications, and perinatal outcomes associated with preeclampsia with severe features and hellp syndrome. International Journal of Women's Health. 2018;10:371-7.
- Adeline ME, Laksana MAC, Atika S. Characteristic of Referral Patients With Severe Preeclampsia In Surabaya. Bimolecular and Health Science Journal. 2018;1(1):25-8.
- Wardhana MP. Buku Panduan Praktis Hipertensi Dalam Kehamilan. Divisi Kedokteran Fetomaternal Fakultas Kedokteran Universitas Airlangga. 2013.
- Sibai BM. Management of Late Preterm and Early-Term Pregnancies Complicated by Mild Gestational Hypertension/Pre-Eclampsia. Seminars in Perinatology. 2011;35(5):292-6.
- Snegovskikh V, Park JS, Norwitz ER. Endocrinology of parturition. Endocrinology and Metabolism Clinics of North America. 2006;35(1):173-91
- Aufdenblatten M, Baumann M, Raio L, Dick B, Frey BM, Schneider H, et al. Prematurity is related to high placental cortisol in preeclampsia. Pediatric Research. 2009;65(2);198-202.
- Eka Putra AN, Hasibuan S, Fitriyati Y. Hubungan Persalinan Preterm Pada Preeklampsia Berat Dengan Fetal Outcome Di RSU Islam Harapan Anda Tegal. Jurnal Kedokteran dan Kesehatan Indonesia. 2014;6(3): 113-9.
- Faridz AS, Wicaksono B, Dachlan EG, Widjiati W. Penurunan Progesterone-Induced Blocking Factor (PIBF) Sebagai Penanda Preeklampsia. Majalah Obstetri dan Ginekologi. 2016;24(1):13-8.
- Laresgoiti-Servitje E, Gómez-lópez N, Olson DM. An immunological insight into the origins of pre-eclampsia. Human Reproduction Update. 2010;16(5):510-24
- Szekeres-Bartho J, Polgar B. PIBF: The Double Edged Sword. Pregnancy and tumor. American Journal of Reproductive Immunology. 2010; 64(2): 77-86.
- Kiswatin. Pengaruh Preeklampsia Terhadap Kejadian Persalinan Preterm di VK IRD RSU Dr. Soetomo. Airlangga University; 2010.
- Tuffnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF, et al. Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. BJOG: An International Journal of Obstetrics and Gynaecology. 2005; 112(7): 875-80.
- Macdonald-Wallis C, Tilling K, Fraser A, Nelson SM, Lawlor DA. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: Findings from a prospective cohort. Hypertension. 2014;64(1):36-44.
- Vats K, Paul M. Study of fetal outcome in hypertensive disorders of pregnancy in a tertiary care maternity hospital of Delhi. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;5:3773-7.
- World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD-10) 19th revision. 10th ed. 2010.
- Elvedi-Gašparovic V, Beljan P, Ahmetaševic SG, Schuster S, Skrablin S. What affects the outcome of severe preeclampsia? Signa Vitae. 2015;10(Suppl 1):6-12.
References
World Health Organization. Preterm Birth Fact Sheets [Internet]. 2018. Available from: https://www.who.int/en/news-room/fact-sheets/detail/preterm-birth.
Auger N, Le TUN, Park AL, Luo ZC. Association between maternal comorbidity and preterm birth by severity and clinical subtype: Retrospective cohort study. BMC pregnancy and childbirth. 2011;11(1):67-76.
Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertension. 2014;4(2):97-104.
American College of Obstetricians, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and gynecology. 2013:17-9.
Brandão AHF, Félix LR, Do Carmo Patrício E, Leite HV, Cabral ACV. Difference of endothelial function during pregnancies as a method to predict preeclampsia. Archives of Gynecology and Obstetrics. 2014;290(3):471-7.
Moore AG, Young H, Keller JM, Ojo LR, Yan J, Simas TAM, et al. Angiogenic biomarkers for prediction of maternal and neonatal complications in suspected preeclampsia. Journal of Maternal-Fetal and Neonatal Medicine. 2012;25(12):2651-7.
Duley L. The Global Impact of Pre-eclampsia and Eclampsia. Seminars in Perinatology. 2009; 33:130–7.
Bilano VL, Ota E, Ganchimeg T, Mori R, Souza JP. Risk factors of pre-eclampsia/eclampsia and its adverse outcomes in low- and middle-income countries: A WHO secondary analysis. PLoS One. 2014;9(3):e91198.
Adisasmita A, Smith CV, El-Mohandes AAE, Deviany PE, Ryon JJ, Kiely M, et al. Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia. Maternal and Child Health Journal. 2015;19(7):1624-33.
Bes B. Analisis Faktor Penyebab Kejadian ’Preeklampsia’ Ibu Hamil untuk Turunkan AKI. Unair News [Internet]. 2017; Available from: http://news.unair.ac.id/2017/07/31/analisis-faktor-penyebab-kejadian-preeklampsia-ibu-hamil-untuk-turunkan-aki/.
Nurmalasari. The Correlations Of Early Ruptured Amnion, Placenta Previa, And Preeclampsia To Preterm Delivery Case In Dr. A. Dadi Tjokrodipo Public Hospital In Bandar Lampung In 2015. Jurnal Skala Kesehatan. 2015;6(2).
Davies EL, Bell JS, Bhattacharya S. Preeclampsia and preterm delivery: A population-based case–control study. Hypertension in Pregnancy. 2016:35(4):510-19.
Svenvik M, Brudin L, Blomberg M. Preterm Birth: A Prominent Risk Factor for Low Apgar Scores. Biomed Research International. 2015;2015:1-8.
Mutianingsih R. Hubungan Preeklamsi Berat Dengan Kelahiran Preterm Di Rumah Sakit Umum Provinsi Nusa Tenggara Barat. Media Bina Ilmiah. 2014;8(3):6–13.
American College of Obstetricians and Gynecologists, American Academy of Pediatrics. The Apgar Score (Committee Opinion No.644). Obstetrics and Gynecology. 2015;126:e52–e55.
Ehrenstein V, Pedersen L, Grijota M, Nielsen GL, Rothman KJ, Sørensen H. Association of Apgar score at five minutes with long-term neurologic disability and cognitive function in a prevalence study of Danish conscripts. BMC Pregnancy Childbirth. 2009;9:14.
Akbar MIA, Ernawati, Dachlan EG. The Hypertension in Pregnancy Problems in Indonesia. In: Dutch Foundation For Postgraduate Medical Courses In Indonesia “The Continuum of care in pre eclampsia mother-infant-child.” Surabaya; 2019.
Susilo SA, Pratiwi KN, Fattah ANA, Irwinda R, Wibowo N. Determinants of low APGAR score among preeclamptic deliveries in Cipto Mangunkusumo Hospital: A retrospective cohort study in 2014. Medical Journal of Indonesia. 2015;4(3):183-9.
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet. 2012;379(9832):2162–72.
Sungkar A, Fattah ANA, Surya R, Santoso BI, Zalud I. High preterm birth at cipto mangunkusumo hospital as a national referral hospital in Indonesia. Medical Journal of Indonesia. 2017;26(3):198-203.
Fuchs F, Monet B, Ducruet T, Chaillet N, Audibert F. Effect of maternal age on the risk of preterm birth: A large cohort study. PLoS One. 2018;13(1):e0191002.
Tellapragada C, Eshwara VK, Bhat P, Acharya S, Kamath A, Bhat S, et al. Risk factors for preterm birth and low birth weight among pregnant Indian women: A hospital-based prospective study. Journal of Preventive Medicine and Public Health. 2016;49(3):165-75.
Chen KH, Chen IC, Yang YC, Chen KT. The trends and associated factors of preterm deliveries from 2001 to 2011 in Taiwan. Medicine (Baltimore). 2019;98(13):e15060.
Maita L. Faktor Ibu yang Mempengaruhi Persalinan Prematur di RSUD Arifin Achmad Pekanbaru. Jurnal Kesehatan Komunitas. 2012;2(1):31-4.
Kongwattanakul K, Saksiriwuttho P, Chaiyarach S, Thepsuthammarat K. Incidence, characteristics, maternal complications, and perinatal outcomes associated with preeclampsia with severe features and hellp syndrome. International Journal of Women's Health. 2018;10:371-7.
Adeline ME, Laksana MAC, Atika S. Characteristic of Referral Patients With Severe Preeclampsia In Surabaya. Bimolecular and Health Science Journal. 2018;1(1):25-8.
Wardhana MP. Buku Panduan Praktis Hipertensi Dalam Kehamilan. Divisi Kedokteran Fetomaternal Fakultas Kedokteran Universitas Airlangga. 2013.
Sibai BM. Management of Late Preterm and Early-Term Pregnancies Complicated by Mild Gestational Hypertension/Pre-Eclampsia. Seminars in Perinatology. 2011;35(5):292-6.
Snegovskikh V, Park JS, Norwitz ER. Endocrinology of parturition. Endocrinology and Metabolism Clinics of North America. 2006;35(1):173-91
Aufdenblatten M, Baumann M, Raio L, Dick B, Frey BM, Schneider H, et al. Prematurity is related to high placental cortisol in preeclampsia. Pediatric Research. 2009;65(2);198-202.
Eka Putra AN, Hasibuan S, Fitriyati Y. Hubungan Persalinan Preterm Pada Preeklampsia Berat Dengan Fetal Outcome Di RSU Islam Harapan Anda Tegal. Jurnal Kedokteran dan Kesehatan Indonesia. 2014;6(3): 113-9.
Faridz AS, Wicaksono B, Dachlan EG, Widjiati W. Penurunan Progesterone-Induced Blocking Factor (PIBF) Sebagai Penanda Preeklampsia. Majalah Obstetri dan Ginekologi. 2016;24(1):13-8.
Laresgoiti-Servitje E, Gómez-lópez N, Olson DM. An immunological insight into the origins of pre-eclampsia. Human Reproduction Update. 2010;16(5):510-24
Szekeres-Bartho J, Polgar B. PIBF: The Double Edged Sword. Pregnancy and tumor. American Journal of Reproductive Immunology. 2010; 64(2): 77-86.
Kiswatin. Pengaruh Preeklampsia Terhadap Kejadian Persalinan Preterm di VK IRD RSU Dr. Soetomo. Airlangga University; 2010.
Tuffnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF, et al. Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. BJOG: An International Journal of Obstetrics and Gynaecology. 2005; 112(7): 875-80.
Macdonald-Wallis C, Tilling K, Fraser A, Nelson SM, Lawlor DA. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: Findings from a prospective cohort. Hypertension. 2014;64(1):36-44.
Vats K, Paul M. Study of fetal outcome in hypertensive disorders of pregnancy in a tertiary care maternity hospital of Delhi. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;5:3773-7.
World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD-10) 19th revision. 10th ed. 2010.
Elvedi-Gašparovic V, Beljan P, Ahmetaševic SG, Schuster S, Skrablin S. What affects the outcome of severe preeclampsia? Signa Vitae. 2015;10(Suppl 1):6-12.