Abstract

Dampak kehamilan pada remaja erat kaitannya dengan risiko kesehatan ibu dan bayi. Penelitian ini bertujuan untuk mengembangkan komposit indeks kesehatan ibu, indeks kesehatan bayi dan untuk menelaah pengaruh kehamilan remaja terhadap kesehatan ibu dan bayi. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012, dengan sampel 2.167 responden yang memenuhi syarat inklusi (wanita usia subur yang pernah melahirkan anak pertama sejak Januari 2007 sampai survei dilaksanakan). Analisis menggunakan Polychoric Principal Component Analysis untuk menentukan komposit indeks kesehatan ibu dan bayi, serta regresi logistik untuk mengetahui besar hubungan kehamilan remaja terhadap kesehatan ibu dan bayi. Kesehatan ibu dapat ditentukan melalui indikator status kesakitan ibu, akses layanan kesehatan, dan perilaku kesehatan. Kesehatan bayi dapat ditentukan melalui indikator status kesakitan bayi dan status gizi bayi. Kehamilan remaja dengan status pendidikan tinggi memiliki risiko kesehatan ibu lebih buruk 5,4 kali (95% CI = 1,3– 22,0) dibandingkan pada kehamilan dewasa. Kehamilan remaja memiliki risiko kesehatan bayi lebih buruk 1,3 kali (95% CI = 0,9 – 1,7) dibandingkan kehamilan dewasa setelah dikontrol oleh pekerjaan, sosial ekonomi, dan wilayah. Penelitian ini menyimpulkan bahwa risiko kehamilan remaja pada kesehatan ibu dan bayi lebih buruk dibandingkan usia dewasa. Impact of adolescent pregnancy is closely related to risk of maternal and infant health. This study aimed to develop composite maternal index, infant index, and analyze impact of adolescent pregnancy on maternal and infant health. This study used Indonesian Health Demographic Survey 2012 data with a sample of 2,167 respondents qualified for inclusion (women of childbearing age giving birth to their first child since January 2007 until the survey was conducted). Analysis used Polychoric Principal Component Analysis to produce composite index of maternal and infant health, and logistic regression to determine relation of adolescent pregnancy to maternal and infant health. Results showed that index of maternal health can be determined by indicator maternal morbidity, access to health care, and health behaviors. Infant health index can be determined by infant morbidity and nutritional status indicators. Adolescents with higher education level had 5.4 times higher risk (95% CI = 1.3 – 22.0) to have worse maternal health than adult pregnancies. Adolescent pregnancy had a risk 1.3 times (95% CI = 0.9 – 1.7) to have worse infant health than adult pregnancies after controlled by occupation, socioeconomic, and region. In conclusion, the risk of adolescent pregnancy on maternal and infant health is worse than adult.

References

1. Kementrian Kesehatan Republik Indonesia. Profil kesehatan Indonesia 2015. Jakarta: Kementerian Kesehatan Republik Indonesia; 2015.

2. Administraiton HRaS. Women’s health USA 2010: maternal mortality. United State: 2010.

3. Canada H. Special report on maternal mortality and severe morbidity in Canada—enhanced surveillance: the path to prevention. 2004.

4. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. Bjog. 2011;118 Suppl 1:1-203.

5. Sullivan E, Hall B, King EJ. Maternal deaths in Australia 2003–2005. Canberra: Australian Institute of Health and Welfare; 2008.

6. Nove A, Matthews Z, Neal S, Camacho AV. Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries. The Lancet Global Health. 2014; 2(3): e155-e64.

7. Olausson PO, Cnattingius S, Haglund B. Teenage pregnancies and risk of late fetal death and infant mortality. British Journal of Obstetrics and Gynaecology: An International Journal of Obstetrics & Gynaecology. 1999; 106 (2): 116-21.

8. Phipps MG, Sowers M, DeMonner SM. The risk for infant mortality among adolescent childbearing groups. Journal Womens Health (Larchmt). 2002; 11(10): 889-97.

9. Kingston D, RN H, Chalmers. Comparison of adolescent, young adult, and adult women’s maternity experiences and practices. Journal of The American Academy of Pediatric. 2012; 129(5): e1228-37.

10. Thaithae S, Thato R. Obstetric and perinatal outcomes of teenage pregnancies in Thailand. Journal Pediatric Adolescent Gynecology. 2011; 24(6): 342-6.

11. Latifah L, Anggraeni MD. Hubungan kehamilan pada usia remaja dengan kejadian prematuritas, berat bayi lahir rendah dan asfiksia. Kesmas Indonesia. 2013; 6 (01): 26-34.

12. Purba EM. Hubungan kehamilan usia remaja dengan kejadian BBLR di Kabupaten Gunungkidul Daerah Istimewa Yogyakarta Tahun 2015 [Thesis]. Yogyakarta: Universitas Gajah Mada; 2015.

13. Maryani H, Kristiana L, Notobroto HB. Indeks kesehatan ibu tingkat provinsi di Indonesia berdasarkan data Riskesdas 2010. Laporan Kajian Kementerian Kesehatan Republik Indonesia. Surabaya: Kementerian Kesehatan Republik Indonesia; 2012.

14. McCarthy J, Maine D. A framework for analyzing the determinants of maternal mortality. Studies in Family Planning. 1992; 23(1): 23-33.

15. Osorio AM, Bolancé C, Alcañiz M. Measuring intermediary determinants of early childhood health: A composite index comparing colombian departments. Child Indicators Research. 2013; 6(2): 297-319.

16. Solar O, Irwin AA. A conceptual framework for action on the social determinant of health. Social Determinant of Health Discussion Paper 2 (Policy and Practice). Geneva: World Health Organization; 2010.

17. Stanger-Hall KF, Hall DW. Abstinence-only education and teen pregnancy rates: why we need comprehensive sex education in the United State. PloS one. 2011; 6(10): e24658.

18. Kohler PK, Manhart LE, Lafferty WE. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal Adolescent Health. 2008; 42(4): 344-51.

19. Kawakita T, Wilson K, Grantz KL, Landy HJ, Huang C-C, Gomez-Lobo V. Adverse maternal and neonatal outcomes in adolescent pregnancy. Journal Pediatrics Adolescent Gynecology. 2016; 29(2): 130-6.

20. Gibbs CM, Wendt A, Peters S, Hogue CJ. The impact of early age at first childbirth on maternal and infant health. Pediatric and Perinatal Epidemiology. 2012; 26: 259-84.

21. Kementerian Kesehatan Republik Indonesia dan Ministry of Health Japan International Cooperation Agency. Petunjuk teknis penggunaan buku kesehatan ibu dan anak. Jakarta: Kementerian Kesehatan Republik Indonesia dan Ministry of Health Japan International Cooperation Agency; 2015.

22. Rosa D. Faktor determinan status serum vitamin A ibu nifas di Kabupaten Pandeglang (analisis data sekunder 2008) [Tesis]. Depok: Universitas Indonesia; 2012.

23. Ahmad SM, Hossain MI, Bergman P, Kabir Y, Raqib R. The effect of postpartum vitamin A supplementation on breast milk immune regulators and infant immune functions: study protocol of a randomized, controlled trial. Trials. 2015; 16: 129.

24. Departemen Kesehatan Republik Indonesia. Panduan manajemen suplementasi vitamin A. In: Masyarakat Deutsche Botanische Gesellschaft, editor. Jakarta: Departemen Kesehatan Republik Indonesia; 2009.

25. Sukesih S. Faktor-faktor yang berhubungan dengan pengetahuan ibu hamil mengenai tanda bahaya dalam kehamilan di puskesmas Tegal Selatan Kota Tegal tahun 2012 [Skripsi]. Depok: Universitas Indonesia; 2012.

26. Pathak P, Singh P, Kapil U, Singh Raghuvanshi R. Prevalence of iron, vitamin A, and iodine deficiencies amongst adolescent pregnant mothers. The Indian Journal of Pediatrics. 2003; 70(4): 299-301.

27. Story M, Hermanson J. Nutrient needs during adolescence and pregnancy. Nutrition and the Pregnant Adolescent: a practical reference guide. Minneapolis: Center for Leadership, Education, and Training in maternal and Child Nutririon, University of Minnesota; 2012. p.37-46.

28. Sarminah. Faktor-faktor yang berhubungan dengan kunjungan antenatal care di provinsi Papua tahun 2010 [Skripsi]. Depok: Universitas Indonesia; 2012.

29. Tachman T. Faktor-faktor yang mempengaruhi utilisasi penolong persalinan oleh tenaga kesehatan di Indonesia [Tesis]. Depok: Universitas Indonesia; 2008.

30. Rahman MM, Haque SE, Zahan MS. Factors affecting the utilisation of postpartum care among young mothers in Bangladesh. Health and Social Care in the Community. 2011; 19(2): 138-47.

31. Development USAfI. Postpartum care: Levels and determinants in developing countries. Maryland US: United States Agency for International Development; 2006.

32. World Health Organization. Position paper on mainstreaming adolescent pregnancy in effort to make pregnancy safer. Geneva, Switzerland: World Health Organization; 2010.

33. Xi-Kuan C, Shi Wu W, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. International Journal of Epidemiology. 2007; 36: 368-73.

34. Singh L, Rai RK, Singh PK. Assessing the utilization of maternal and child health care among married adolescent women: evidence from India. Journal of Biosocial Science. 2012; 44(1): 1-26.

35. Yozwiak JA. Postpartum depression and adolescent mothers: A review of assessment and treatment approaches. Journal Pediatric Adolescent Gynecology. 2010; 23(3): 172-8.

36. de Vienne CM, Creveuil C, Dreyfus M. Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: a cohort study. European Journal of Obstetrics Gynecology and Reproductive Biology. 2009; 147(2): 151-6.

37. Chen XK, Wen SW, Fleming N, Yang Q, Walker MC. Increased risks of neonatal and postneonatal mortality associated with teenage pregnancy had different explanations. Journal of Clinical Epidemiology. 2008; 61(7): 688-94.

38. Raatikainen K, Heiskanen N, Verkasalo PK, Heinonen S. Good outcome of teenage pregnancies in high-quality maternity care. The European Journal of Public Health. 2006; 16(2): 157-61.

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