Hubungan antara peningkatan berat badan pada kehamilan dengan kejadian preeklamsia
DOI: https://doi.org/10.33024/hjk.v19i8.1414
Kehamilan Peningkatan Berat Badan Preeklamsia
Abstract
Background: The incidence of maternal deaths due to preeclampsia and other type of hypertension in pregnancy in Indonesia has increased from 26.74% in 2010 to 42% in 2014. In 2019, hypertension in pregnancy is still one of the three main causes of maternal death in Indonesia (33.07%). Many factors have contributed to the increased incidence of preeclampsia in pregnant women. One of the risk factors that can cause hypertension in pregnancy is excessive gestational weight gain in pregnant women.
Purpose: To determine the relationship between excessive gestational weight gain and the incidence of preeclampsia.
Method: An analytic observational study using case-control study design to compare the proportion of subjects with excessive gestational weight gain during pregnancy between preeclampsia and non preeclampsia group. Sampling method using a consecutive sampling technique within patient with preeclampsia in Dr. Sardjito General Hospital and non preeclampsia patient in Tegalrejo Primary Health Care, Yogyakarta.
Results: The proportion of subjects who experienced an excessive gestational weight gain during pregnancy that exceeded the IOM recommendations was higher in the preeclampsia group than in the non-preeclampsia group, OR= 2.67 (95%CI, 1.18 – 6.03) and p value = 0.017. There was a significant relationship between excessive gestational weight gain exceeded IOM recommendations and the incidence of preeclampsia (p <0.05). There was no difference in the proportion of nulliparous subjects between the preeclampsia and non- preeclampsia groups, OR= 1.61 (95%CI, 0.78 – 3.35) and p value = 0.196.
Conclusion: The incidence of preeclampsia is more common in mothers with excessive gestational weight gain exceeding the IOM recommendation. During pregnancy, blood pressure and control for gestational weight gain need to be evaluated periodically so it does not exceed the IOM recommendation.
Keywords: Gestational Weight Gain; Preeclampsia; Pregnancy.
Pendahuluan: Insidensi kematian maternal akibat preeklamsia dan penyakit hipertensi lainnya di Indonesia telah meningkat dari 26,74% pada tahun 2010 menjadi 42% pada tahun 2014. Berdasarkan data tahun 2019, penyebab kematian ibu akibat hipertensi dalam kehamilan masih merupakan 3 besar penyebab utama kematian ibu di Indonesia yaitu sebesar 33.07%. Banyak faktor yang menyebabkan meningkatnya insiden preeklamsia pada ibu hamil. Salah satu faktor risiko yang dapat menyebabkan terjadinya hipertensi pada kehamilan adalah peningkatan berat badan yang berlebihan pada ibu hamil.
Tujuan: Untuk mengetahui hubungan peningkatan BB pada kehamilan yang melebihi rekomendasi IOM dengan kejadian preeklamsia.
Metode: Penelitian observasional analitik dengan desain case control untuk membandingkan proporsi subjek yang mengalami peningkatan BB selama kehamilan melebihi rekomendasi IOM antara kelompok preeklamsia dan tidak preeklamsia. Metode sampling dengan consecutive sampling pada pasien preeklamsia di RSUP Dr. Sardjito dan pasien tidak preeklamsia di Puskesmas Tegalrejo periode tahun 2021-2022.
Hasil: Proporsi subjek yang mengalami peningkatan BB pada kehamilan yang melebihi rekomedasi IOM lebih tinggi pada kelompok preeklamsia dibandingkan pada kelompok tidak preeklamsia, OR= 2.67 (CI 95%, 1.18 – 6.03) dan nilai p = 0.017. Terdapat hubungan yang bermakna antara peningkatan BB melebihi rekomendasi IOM dengan kejadian preeklamsia. Tidak ditemukan perbedaan proporsi subjek nullipara antara kelompok preeklamsia dan kelompok tidak preeklamsia, OR= 1.61 (CI 95%, 0.78 – 3.35) dan nilai p = 0.196.
Simpulan: Kejadian preeklamsia lebih sering terjadi pada ibu dengan peningkatan BB melebihi rekomendasi IOM. Selama masa kehamilan tekanan darah perlu dievaluasi berkala dan mengontrol peningkatan BB agar tidak melebihi rekomendasi IOM.
Kata Kunci: Kehamilan; Peningkatan Berat Badan; Preeklamsia.
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References
Afifah, T., Tejayanti, T., Saptarini, I., Rizkianti, A., Usman, Y., Senewe, F. P., & Pangaribuan, L. (2016). Maternal death in Indonesia: follow-up study of the 2010 Indonesia population census. Indonesian Journal of Reproductive Health, 7(1), 1-13.
Bdolah, Y., Elchalal, U., Natanson-Yaron, S., Yechiam, H., Bdolah-Abram, T., Greenfield, C., & Hochner-Celnikier, D. (2024). Relationship between nulliparity and preeclampsia may be explained by altered circulating soluble fms-like tyrosine kinase 1. Hypertension in pregnancy, 33(2), 250-259.
Beketie, E. D., Tafese, W. T., Shiferaw, B. Z., Tilahun, G. A., Gebretsadik, M. A., Suraj, K. D., & Teke, N. E. (2022). Determinants of preeclampsia among mothers attending perinatal care in Gurage zone public hospitals, Ethiopia, matched case control study. International Journal of Africa Nursing Sciences, 17, 100453.
Bodnar, L. M., Himes, K. P., Abrams, B., Parisi, S. M., & Hutcheon, J. A. (2018). Early-pregnancy weight gain and the risk of preeclampsia: A case-cohort study. Pregnancy hypertension, 14, 205-212.
Catov, J. M., Ness, R. B., Kip, K. E., & Olsen, J. (2017). Risk of early or severe preeclampsia related to pre-existing conditions. International journal of epidemiology, 36(2), 412-419.
Cedergren, M. (2016). Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. International Journal of Gynecology & Obstetrics, 93(3), 269-274.
Chasan-Taber, L., Silveira, M., Waring, M. E., Pekow, P., Braun, B., Manson, J. E., & Markenson, G. (2016). Gestational weight gain, body mass index, and risk of hypertensive disorders of pregnancy in a predominantly Puerto Rican population. Maternal and child health journal, 20(9), 1804-1813.
Dalfra, M. G., Burlina, S., & Lapolla, A. (2022). Weight gain during pregnancy: A narrative review on the recent evidences. Diabetes Research and Clinical Practice, 188, 109913.
Dey, M., Arora, D., Narayan, N., & Kumar, R. (2023). Serum cholesterol and ceruloplasmin levels in second trimester can predict development of pre-eclampsia. North American journal of medical sciences, 5(1), 41.
Fitriani, H., Kumala, T. F., & Rosmiati, N. (2019). The Relationship Between Weight Gain In Pregnancy And Preeclampsia. Journal of Maternity Care and Reproductive Health, 2(3).
Gathiram, P., & Moodley, J. J. C. J. O. A. (2016). Pre-eclampsia: its pathogenesis and pathophysiolgy: review articles. Cardiovascular journal of Africa, 27(2), 71-78.
González-Plaza, E., Bellart, J., Martínez-Verdú, M. Á., Arranz, Á., Luján-Barroso, L., & Seguranyes, G. (2022). Pre-pregnancy overweight and obesity prevalence and relation to maternal and perinatal outcomes. Enfermeria Clinica (English Edition), 32, S23-S30.
He, X. J., Dai, R. X., & Hu, C. L. (2020). Maternal prepregnancy overweight and obesity and the risk of preeclampsia: A meta-analysis of cohort studies. Obesity research & clinical practice, 14(1), 27-33.
Hutcheon, J. A., Stephansson, O., Cnattingius, S., Bodnar, L. M., Wikström, A. K., & Johansson, K. (2018). Pregnancy weight gain before diagnosis and risk of preeclampsia: a population-based cohort study in nulliparous women. Hypertension, 72(2), 433-441.
Jääskeläinen, T., Heinonen, S., Kajantie, E., Kere, J., Kivinen, K., Pouta, A., & Laivuori, H. (2016). Cohort profile: the finnish genetics of pre-eclampsia consortium (FINNPEC). BMJ open, 6(11), e013148.
Johnson, J., Clifton, R. G., Roberts, J. M., Myatt, L., Hauth, J. C., Spong, C. Y., & Sorokin, Y. (2023). Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines. Obstetrics & Gynecology, 121(5), 969-975.
Lisonkova, S., & Joseph, K. S. (2023). Incidence of preeclampsia: risk factors and outcomes associated with early-versus late-onset disease. American journal of obstetrics and gynecology, 209(6), 544-e1.
Łoniewska, B., Michalczyk, K., Podsiadło, K., Adamek, K., Michalczyk, B., Tousty, P., & Łoniewski, I. (2022). Analysis of the influence of pre-pregnancy BMI and weight gain during pregnancy on the weight of healthy children during the first 2 years of life: a prospective study. Children, 9(10), 1431.
Lopez-Jaramillo, P., Barajas, J., Rueda-Quijano, S. M., Lopez-Lopez, C., & Felix, C. (2018). Obesity and preeclampsia: common pathophysiological mechanisms. Frontiers in physiology, 9, 1838.
Luo, J., Fan, C., Luo, M., Fang, J., Zhou, S., & Zhang, F. (2020). Pregnancy complications among nulliparous and multiparous women with advanced maternal age: a community-based prospective cohort study in China. BMC pregnancy and childbirth, 20(1), 581.
Macdonald-Wallis, C., Tilling, K., Fraser, A., Nelson, S. M., & Lawlor, D. A. (2023). Gestational weight gain as a risk factor for hypertensive disorders of pregnancy. American journal of obstetrics and gynecology, 209(4), 327-e1.
Mayrink, J., Souza, R. T., Feitosa, F. E., Rocha Filho, E. A., Leite, D. F., Vettorazzi, J., & Cecatti, J. G. (2019). Incidence and risk factors for Preeclampsia in a cohort of healthy nulliparous pregnant women: a nested case-control study. Scientific reports, 9(1), 9517.
Mostello, D., Chang, J. J., Allen, J., Luehr, L., Shyken, J., & Leet, T. (2020). Recurrent preeclampsia: the effect of weight change between pregnancies. Obstetrics & Gynecology, 116(3), 667-672.
Nien, J. K., Mazaki-Tovi, S., Romero, R., Erez, O., Kusanovic, J. P., Gotsch, F., & Hassan, S. S. (2017). Adiponectin in severe preeclampsia. Journal of perinatal medicine, 35(6), 503.
Opitasari, C., & Andayasari, L. (2024). Parity, education level and risk for (pre-) eclampsia in selected hospitals in Jakarta. Health Science Journal of Indonesia, 5(1), 35-39.
Pardo, F., Silva, L., Sáez, T., Salsoso, R., Gutiérrez, J., Sanhueza, C., & Sobrevia, L. (2025). Human supraphysiological gestational weight gain and fetoplacental vascular dysfunction. International journal of obesity, 39(8), 1264-1273.
Phipps, E., Prasanna, D., Brima, W., & Jim, B. (2016). Preeclampsia: updates in pathogenesis, definitions, and guidelines. Clinical Journal of the American Society of Nephrology, 11(6), 1102-1113.
Rodems, B. N., Raymundo, M., Walker, J. J., North, R. A., Baker, L. M. M., Simpson, N. A., & Philip, N. (2024). Early Pregnancy Prediction of Preeclampsia in Nulliparous Women, Combining Clinical.
Shao, Y., Qiu, J., Huang, H., Mao, B., Dai, W., He, X., & Zhang, Y. (2017). Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC pregnancy and childbirth, 17(1), 400.
Sumulyo, G., Iswari, W. A., Pardede, T. U., Darus, F., Puspitasari, B., Santana, S., & Endjun, J. J. (2017). Diagnosis dan tatalaksana preeklampsia berat tidak tergantung proteinuria. Cermin Dunia Kedokteran, 44(8), 398953.
Thagaard, I. N., Hedley, P. L., Holm, J. C., Lange, T., Larsen, T., Krebs, L., & Christiansen, M. (2019). Leptin and Adiponectin as markers for preeclampsia in obese pregnant women, a cohort study. Pregnancy hypertension, 15, 78-83.
Wang, Y., Li, B., & Zhao, Y. (2022). Inflammation in preeclampsia: genetic biomarkers, mechanisms, and therapeutic strategies. Frontiers in immunology, 13, 883404.
Wulandari, D., Sartika, R. D., Achadi, E. L., & Susanna, D. (2018). Does Excessive Gestational Weight Gain Contribute to Preeclampsia?. KnE Life Sciences, 37-42.
Yushida, Y., & Zahara, E. (2020). The risk factors toward preeclampsia events of pregnant women in meureubo and johan pahlawan community health center west aceh. Open Access Macedonian Journal of Medical Sciences, 8(E), 670-673.
Zhang, S., Qiu, X., Qin, J., Song, X., Liu, Y., Wei, J., & Jiang, Y. (2022). Effects of maternal pre-pregnancy BMI and gestational weight gain on the development of preeclampsia and its phenotypes: a prospective cohort study in China. Journal of Clinical Medicine, 11(19), 5521.
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