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Obesitas dan resistensi insulin merupakan faktor risiko terjadinya preeklampsia

Abstract

 

Pendahuluan: Preeklampsia merupakan salah satu dari tiga penyebab kematian utama ibu hamil di Indonesia, selain perdarahan dan infeksi. Berdasarkan data dari Profil Kesehatan Indonesia 2013, hipertensi dalam kehamilan (salah satunya preeklampsia) menyumbang sebanyak 30% dari angka kematian ibu pada tahun 2010. Preeklampsia masih menjadi “Disease of Theory†dimana tidak terdapat kepastian tentang mekanisme terjadinya. Salah satu yang diduga berperan dalam terjadinya preeklampsia adalah resistensi insulin. Sementara itu, obesitas merupakan salah satu penyebab terjadinya resistensi insulin. Obesitas ditentukan dengan menghitung indeks massa tubuh (IMT) trimester I, sedangkan resistensi insulin dihitung dengan rumus Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). 

Metode: Sebuah penelitian observasional analitik case-control dilakukan dengan melibatkan 54 ibu hamil yang datang ke Poliklinik dan IRD Kebidanan dan Kandungan RSUP Sanglah Denpasar, dengan usia kehamilan di atas 20 minggu. Penelitian ini dilakukan pada bulan Maret sampai Agustus 2018. 

Hasil: Dari hasil penelitian didapatkan obesitas merupakan faktor risiko terjadinya preeklampsia sebesar 25 kali (OR = 25,30, IK 95% = 6,00-46,66, p = 0,001) dibandingkan tidak obesitas. Resistensi insulin merupakan faktor risiko terjadinya preeklampsia sebesar 4 kali (OR = 3,95, IK 95% = 1,07-14,65, p = 0,033) dibandingkan tidak resistensi insulin. 

Kesimpulan: Sehingga dapat disimpulkan bahwa obesitas dan resistensi insulin merupakan faktor risiko terjadinya preeklampsia. 

 

Introduction: Preeclampsia is one of the three main causes of death for pregnant women in Indonesia, in addition to bleeding and infection. Based on data from the 2013 Indonesian Health Profile, hypertension in pregnancy (including preeclampsia) accounts for as much as 30% of the maternal mortality rate in 2010. Preeclampsia is still a “disease of theoryâ€, there is no certainty about the mechanism of its occurrence. One suspected role in the occurrence of preeclampsia is insulin resistance. Meanwhile, obesity is one of the causes of insulin resistance. Obesity is determined by calculating the body mass index (BMI) on first trimester, while insulin resistance is calculated by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). 

Methods: An analytical observational of case-control study done by involving 54 pregnant women who came to Midwifery Polyclinic and Emergency Unit of Sanglah General Hospital Denpasar with more than 20 weeks gestational age. This study has been conducted in March until August 2018. 

Results: From the study result, it was found that obesity had 25 times higher risk for the occurrence of preeclampsia compared to not obese patient (OR = 25.30, CI 95% = 6.00-46.66, p = 0.001). While insulin resistance had 4 times higher risk for the occurrence of preeclampsia compared to not insulin resistance (OR = 3.95, CI 95% = 1.07-14.65, p = 0.033). 

Conclusion: Therefore it can be concluded that obesity and insulin resistance were risk factors for the occurrence of preeclampsia. 


References

  1. Kemenkes. Profil Kesehatan Indonesia 2013. Jakarta: Kementerian Kesehatan RI. 2014.
  2. Oka, A., & Surya, I. G. Profil Penderita Hipertensi Dalam Kehamilan di RSUP Sanglah Denpasar Periode 1 Januari 2002 - 31 Desember 2003. Penelitian Deskriptif PPDS-I Obgin FK UNUD/RSUP Sanglah Denpasar. 2004.
  3. Sudarmayasa, I. M., & Surya, I. G. Profil Penderita Hipertensi Dalam Kehamilan di RSUP Sanglah Denpasar Periode 1 Januari 2004 - 31 Desember 2005. Penelitian Deskriptif PPDS-I Obgin FK UNUD/RSUP Sanglah Denpasar. 2006.
  4. Lidapraja, H. S., & Surya, I. G. Profil Penderita Hipertensi Dalam Kehamilan di RSUP Sanglah Denpasar Tahun 2009-2010. Penelitian Deskriptif PPDS-I Obgin FK UNUD/RSUP Sanglah Denpasar. 2011.
  5. Cunnigham, F.G., Leveno, K.J., Bloom, S.L., Spong, C. Y., Dashe, J. S., Hoffman, B. L., Casey, B.M., Sheffield, J.S. Williams Obstetrics 24th Edition. McGraw Hill Education. 2014.
  6. Angsar, M. D. Hipertensi Dalam Kehamilan. In A. B. Saifuddin, T. Rachimhadhi, & G. H. Wiknjosastro, Ilmu Kebidanan Sarwono Prawirohardjo (pp. 530-561). Jakarta: PT. Bina Pustaka Sarwono Prawirohardjo. 2009.
  7. Redman, C. W., Jacobson, S.-L., & Russell, R. Hypertension in pregnancy. In R. O. Powrie, M. F. Greene, & W. Camann, de Swiet's Medical Disorders in Obstetric Practice 5th Edition (pp. 153-181). Singapore: Wiley-Blackwell. 2010.
  8. Adnyana IBP, Liwang F, Negara KS, Manuaba IBP, Bhargah A, Prabawa IPY. Clinical risk factor of preeclampsia: a five-year retrospective study in Bali Royal Hospital, Bali-Indonesia. Gineco.eu. 2018;14(3):89-93.
  9. Catalano, P. M. Obesity, Insulin Resistance, and Pregnancy Outcome. Reproduction Vol. 140, 365-371. 2010.
  10. Roberts, J. M., Bodnar, L. M., Patrick, T. E., & Powers, R. W. The Role of Obesity in Preeclampsia. National Institutes of Health (NIH) Public Access, 6-16. 2011.
  11. Lewis, F., Modeste, N., Singh, P., Batech, M., Tonstad, S., & Mataya, R. Excess Maternal Body Weight and Preeclampsia/Eclampsia Risk among Women in San Bernardino County, 2007-2008. Journal of Food and Nutrition Vol. 1. 2014.
  12. Sohlberg, S., Stephansson, O., Cnattingius, S., & Wikstrom, A.-K. Maternal Body Mass Index, Height, and Risk of Preeclampsia. American Journal of Hypertension Vol. 25 No. 1, 120-125. 2012.
  13. Yazdani, S., Yosofniyapasha, Y., Nasab, B. H., Mojaveri, M. H., & Bouzari, Z. Effect of Maternal Body Mass Index on Pregnancy Women and Newborn Weight. BMC Research Notes. 2012.
  14. Samuels-Kalow, M. E., Funai, E. F., Buhimschi, C., Norwitz, E., Perrin, M., Calderon-Margalit, R., Deutsch, L., Paltiel, O., Friedlander, Y., Manor, O., Harlap, S. Prepregnancy Body Mass Index, Hypertensive Disorders of Pregnancy, and Long-Term Maternal Mortality. American Journal of Obstetric & Gynecology, 490-492. 2007.
  15. Rozikhan. Faktor-Faktor Risiko Terjadinya Preeklampsia Berat di Rumah Sakit dr.H.Soewondo Kendal. Dipetik Mei 1, 2015, dari Diponegoro University Institutional Repository: http://www.eprints.undip.ac.id
  16. Medicina 2019; 50(3): 493-497 | doi: 10.15562/Medicina.v50i3.713 497
  17. ARTIKEL ASLI
  18. Hanum, H., & BD, F. Faktor Risiko yang Berhubungan dengan Kejadian Preeklampsia pada Ibu Bersalin di RSUP dr.M.Djamil Padang Tahun 2013. Dipetik Mei 1, 2015, dari e-Journal STIKes Mercubaktijaya: http://www.journal.mercubaktijaya.ac.id
  19. Yu, C., Teoh, T., & Robinson, S. Obesity in Pregnancy. BJOG Vol 113, 1117-1125. 2006.
  20. Lynch, A. M., Eckel, R. H., Murphy, J. R., Gibbs, R. S., West, N. A., Giclas, P. C. Prepregnancy Obesity and Complement System Activation in Early Pregnancy and the Subsequent Development of Preeclampsia. American Journal of Obstetrics & Ginekologi Vol.206, 428.e1-8. 2012.
  21. Szarka, A., Rigo Jr, J., Lazar, L., Beko, G., & Molvarec, A. Circulating Cytokines, Chemokines, and Adhesion Molecules in Normal Pregnancy and Preeclampsia Determined by Multiplex Suspension Array. BioMed Central Immunology Vol.11, 1-9. 2010.
  22. Walker, J. Inflammation and Preeclampsia. Pregnancy Hypertension Vol.1, 43-47. 2011.
  23. Abhari, F. R., Andarieh, M. G., Farokhfar, A., Ahmady, S. Estimating Rate of Insulin Resistance in Patients with Preeclampsia Using HOMA-IR Index and Comparison with Nonpreeclampsia Pregnant Women. BioMed Research International. 2014.
  24. Antuna-Puente, B., Disse, E., Rabasa-Lhoret, R., Laville, M., Capeau, J., Bastard, J. P. How can we measure insulin sensitivity/resistance?. Diabetes & Metabolism 37, 179-188. 2011.
  25. Wallace, T. M., Levy, J. C., Matthews, D. R. Use and Abuse of HOMA Modeling. Diabetes Care Vol 27 No 6, June 2004.

How to Cite

Perdana, R. A., Surya, I., & Sanjaya, I. H. (2019). Obesitas dan resistensi insulin merupakan faktor risiko terjadinya preeklampsia. Medicina, 50(3). https://doi.org/10.15562/medicina.v50i3.713

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