JURNAL MECONIUM ASPIRATION SYNDROME
Faktor risiko kematian neonatus dengan sindrom aspirasi mekonium di Instalasi Maternal-Perinatal
ABSTRACT : Background : Meconium aspiration still become big problem to newborn babies. Around 5-15% newborn babies with meconium-stained amniotic fluid will develop respiratory distress. At least 3-5% babies with meconium aspiration syndrome can not survive. The severity of the disease depends on the aspirated meconium quantity. We only can see the clinical symptoms and results from other examination, i.e. chest radiograph and blood gas analysis. Objectives : determine factors that can influence mortality of meconium aspiration syndrome patient that hospitalized at Maternal-Perinatal Installation Dr Sardjito Hospital and calculate the contribution of each factor. Study design : case-control Material and method : data was collected from medical records from 2003 to June 2006. Variables that assumed as risk factor of death will be identified and recorded. Data was analyzed with univariate and multivariate statistic analysis. Result : Total number subject was 117 babies, 35 babies were death case (case) and 76 babies could survive (control). Six babies were excluded because discharged from hospital againts medical advice. Based on univariate analysis, variable that identified as risk factor were outborn baby, non-specialist delivery attendent, low APGAR score minute 5 at first admission, low body temperature (<36,5°C), low pH (<7,25) and abnormal leucocyte count (<12.000/ L or > 26.000/ L). After adjusment with multivariate analysis from all variables, the remaining risk factor were low APGAR score (1-3) at 5 minute (OR = 6,65 IK 95% 1,03 – 43,12), low pH (<7,25) at first admission (OR = 4,71 IK 95% 1,51 – 14,69), outborn baby (OR 4,48 IK 95% 1,03 – 19,47) and abnormal leucocyte count (OR = 4,31 IK 95% 1,26 – 14,73). Conclusion : low APGAR score (1-3) at 5 minute, low pH (<7,25) at first admission, outborn babies and abnormal leucocyte count will increase risk for death among babies suffered from meconium aspiration syndrome.