PENGARUH IBU HAMIL PEROKOK PASIF TERHADAP KEJADIAN LAHIR MATI DI KOTA AMBON

Abstract

PENGARUH IBU HAMIL PEROKOK PASIF TERHADAP
KEJADIAN LAHIR MATI DI KOTA AMBON

Magdalena Paunno1, Ova Emillia2, Abdul Wahab3

ABSTRACT

Background: Intervention in the care for pregnant women can reduce antenatal mortality until 75%.
Antenatal Care (ANC) in Ambon municipality is categorized good if compared from the mean rate of
national level, that is, Visit 1 (89%) and Visit 4 (87.76%); however, the incidence of stillbirths in Ambon
is still considered high. Data about the incidence of stillbirths in three hospitals of Ambon showed that
there were 44.2 stillbirths per 1000 live births while national data in 2003 showed that there were only
9.6 stillbirths per 1000 live births. The direct cause of stillbirth is hypoxia, that is, the lack of oxygen
in a pregnant woman’s body due to the exposure of cigarette smoke. In Ambon municipality, 65% of
households have 1 active smoker and almost all of the smokers (90%) smoke inside the house. This rate
of course exceeds the national rate. In addition, other factors causing stillbirth are the quality of antenatal
care, age, parity, anemia and women’s educational level.
Objective: To study whether passive smoking during pregnancy is a risk factor of the incidence of stillbirths.
Method: This was an observational study with case-control study design. Study sites were in three hospitals
of Ambon municipality, namely Dr. M. Haulussy District Hospital, Al-Fatah Hospital, and Sumber Hidup
Hospital. Subjects were divided into two groups which were case and control with comparison of 1:1 (69
stillbirths as case and 69 live births as control) from January to December 2007. Samples were taken using
non probability sampling which was determined with quota sample. The analysis of quantitative data
used univariable analysis, bivariable analysis with chi-square test (χ²) and stratification, and multivariable
analysis with logistic regression.
Result and Discussion: There was a significant relationship between passive smoking during pregnancy
and the incidence of stillbirth based on bivariable analysis with OR=3.36 (95% CI=1.20-5.41) while based
on multivariable analysis with OR=2.8 (1.01-7.94). Other risk factors that affected the incidence of stillbirth
were the quality of antenatal care with OR=3.2 (95% CI=1.39-7.52) and anemia during pregnancy with
OR=2.3 (95% CI=1.20-5.41). Meanwhile, stratification analysis showed that non anemic women during
pregnancy was significantly related to stillbirths with OR=5.7 (95% CI 1.10-55.22). However, age, parity and
education were not the risk factors of the incidence of stillbirth in Ambon.
Conclusion: Passive smoking during pregnancy was a risk factor of the incidence of stillbirth in Ambon
municipality. Other factors that caused the incidence of stillbirths were the quality of antenatal care and
anemia. However, age, and parity were not the risk factors of the incidence of stillbirths in Ambon.

Keywords: pregnant woman, passive smoking, stillbirth

INTISARI

Latar belakang: Intervensi pada perawatan ibu hamil dapat menurunkan kematian perinatal hingga 75%.
ANC di Kota Ambon dikategorikan baik, bila dilihat angka rata-rata secara nasional yaitu K1 89%, K4 87,76%
namun, kejadian lahir mati sangat tinggi dibanding angka nasional. Salah satu penyebab langsung lahir
mati adalah hypokxia yaitu kekurangan oksigen dalam tubuh ibu, akibat dari ibu hamil terpapar asap
rokok. Di Kota Ambon, 65% rumah tangga mempunyai 1 orang perokok, dan hampir semua perokok (90%)
merokok di rumah. Angka ini lebih tinggi dari angka nasional. Faktor lain menyebabkan lahir mati adalah
kualitas antenatal care, umur, paritas anemia ibu selama hamil, pendidikan ibu yang rendah.
Tujuan: Penelitian ini untuk mengetahui apakah ibu hamil perokok pasif merupakan faktor risiko kejadian
lahir mati.
Metode: Penelitian observasional dengan rancangan kasus-kontrol. Lokasi penelitian pada 3 RS di Kota
Ambon yaitu: RSUD dr. M. Haulussy, RS. Al-Fatah, RS. Sumber Hidup. Subjek penelitian 1:1 69 lahir mati
(kasus) dan 69 lahir hidup (kontrol) pada bulan Januari sampai dengan bulan Desember 2007. Pengambilan
sampel dengan cara non probability sampling, ditentukan secara quota sample . Analisis data terdiri
dari analisis univariabel, analisis bivariabel menggunakan uji chi-square (χ²), stratifikasi serta analisis
multivariabel menggunakan regresi logistik.
Hasil dan Pembahasan: Ada hubungan yang bermakna antara ibu hamil perokok pasif dengan kejadian
lahir mati. Analisis bivariabel OR=3,36 (95% CI=1,20-5,41) analisis multivariabel OR=2,8 (1,01-7,94). Faktor
risiko lain yang mempengaruhi kejadian lahir mati adalah: Kualitas antenatal care mempunyai nilai OR=3,2
(95% CI=1,39-7,52), ibu hamil anemia OR=2,3 (95% CI=1,20-5,41) dan pendidikan OR=2,42 ( 1,15-5,10).
Saat analisis strativikasi, ibu tidak anemia mempunyai hubungan bermakna dengan lahir mati OR=5,7 (95%
CI 1,10-55,22). Umur, paritas dan pendidikan bukan merupakan faktor risiko lahir mati di Kota Ambon.
Kesimpulan : Ibu hamil perokok pasif merupakan faktor risiko terhadap kejadian lahir mati di Kota Ambon.
Faktor lain yang menyebabkan lahir mati adalah kualitas antenatal care dan anemia ibu hamil.
Kata kunci: ibu hamil, perokok pasif, lahir mati.

1 Air Selobar Community Health Center, Ambon Health Office, Maluku Province
2 Obstetric and Gynecology Division, Faculty of Medicine,
Gadjah Mada University, Yogyakarta
3 Maternal and Child Health-Reproductive Health, Graduate Program,
Faculty of Medicine, Gadjah Mada University, Yogyakarta