Gatot Irawan Sarosa, Gatot Irawan
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RISK FACTORS OF NEONATAL HYPOGLYCEMIA Yunarto, Yuliana; Sarosa, Gatot Irawan
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (212.516 KB) | DOI: 10.14238/pi59.5.2019.252-6

Abstract

Background Hypoglycemia is the most common metabolic issue in newborns and should be treated as soon as possible to prevent complications of neurologic impairment, mental retardation, developmental delay, and cardiovascular disorders. Objective To assess maternal, fetal, and neonatal factors for identifying infants at risk of developing neonatal hypoglycemia. Methods This  case-control study was conducted in the Perinatal Unit of Dr. Kariadi Hospital, Semarang, Central Java. A total of 123 newborns with blood glucose <47 mg/dL comprised the case group and 123 newborns without hypoglycemia comprised the control group. Characteristics of infants, maternal age, maternal pregnancy-related conditions, as well as fetal and neonatal factors were recorded and analyzed for possible relationships with hypoglycemia. Results Out of 677 newborns, hypoglycemia was found in 123 (18.2%) infants (59 male, 64 female). In the case group, 58 (47.1%) were preterm, 38 (30.9%) very preterm, and 8 (6.5%) extremely preterm infants. Factors associated with neonatal hypoglycemia were prematurity (OR 6.537; 95%CI 3.543 to 12.063; P <0.001), low birth weight (OR 2.979; 95% CI 1.532 to 5.795; P<0.001), small for gestational age (OR 1.805; 95% CI 1.054 to 3.095; P=0.031), and birth asphyxia(OR 3.386; 95% CI 1.945 to 5.895; P<0.001). In multivariate regression analysis, prematurity and low birth weight remained the significant factors associated with neonatal hypoglycemia. Conclusion  Prematurity and low birth weight are significant risk factors associated with neonatal hypoglycemia. Routine screening and monitoring of blood glucose is recommended for preterm newborns and infants with low birth weight
Risiko Gangguan Pendengaran pada Neonatus Hiperbilirubinemia Sarosa, Gatot Irawan; Putranti, Alifiani Hikmah
Sari Pediatri Vol 12, No 4 (2010)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.4.2010.222-7

Abstract

Latar belakang. Menurut data WHO tahun 2007, diperkirakan prevalensi gangguan pendengaran padapopulasi penduduk Indonesia 4,2%, salah satu penyebab gangguan pendengaran adalah hiperbilirubinemiapada neonatus. Identifikasi dini gangguan pendengaran dan intervensi optimal pada usia enam bulanpertama dapat mencegah gangguan bicara dan bahasa, prestasi akademik, hubungan personal sosial, danemosional pada anak.Tujuan. Membuktikan dan menganalisis risiko hiperbilirubinemia terhadap terjadinya gangguanpendengaran pada neonatus.Metode. Dilakukan penelitian kohort pada 36 neonatus dengan hiperbilirubinemia di RS Dr. Kariadi,Maret 2009 – Maret 2010, terdiri dari 18 kelompok kasus dengan kadar bilirubin indirek >12 mg/dl dan18 kelompok kontrol dengan kadar bilirubin indirek <12 mg/dl. Subyek penelitian dipilih menggunakanmetode consecutive sampling. Dicatat data klinis, laboratorium, dilakukan tymphanometri, OtoAcusticEmission (OAE) dan Brainstem Evoked Response Audiometry (BERA) pertama serta OAE dan BERA tigabulan kemudian. Analisis dilakukan dengan uji Chi-square, uji Mc Nemar dan uji t tidak berpasangan.Hasil. Kejadian gangguan pendengaran pada pemeriksaan BERA awal sebanyak 9 kasus (25%) dan 3 kasus(8,3%) pada pemeriksaan BERA kedua, secara statistik tidak bermakna (p>0,05). Pada pemeriksaan BERAawal, rerata kadar bilirubin indirek tidak berbeda bermakna (p>0,05) antara neonatus dengan gangguanpendengaran 14,1 8+6,289 mg/dl dan neonatus tanpa gangguan pendengaran (11,29+2,995) mg/dl. Nilairisiko relatif (RR) 2,0 (p>0,05; 95% CI 0,6-6,8), namun secara statistik tidak bermakna.Kesimpulan. Kejadian gangguan pendengaran pada neonatus dengan hiperbilirubinemia adalah 25%.Kadar bilirubin indirek >12 mg/dl belum dapat disimpulkan sebagai faktor risiko gangguan pendengaranpada neonatus dengan hiperbilirubinemia.
Pengaruh Asfiksia Neonatal Terhadap Gangguan Pendengaran Sarosa, Gatot Irawan; Putranti, Alifiani Hikmah; Setyarini, Tri Kartika
Sari Pediatri Vol 13, No 1 (2011)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp13.1.2011.5-13

Abstract

Latar belakang. Kejadian gangguan pendengaran di negara maju 1–3 dari 1000 kelahiran hidup, sedangkan prevalensi gangguan pendengaran di Indonesia ±4,2%, penyebabnya antara lain asfiksia. Identifikasi dini usia 3 bulan pertama kehidupan dan intervensi optimal 6 bulan pertama mencegah gangguan bicara, bahasa, kognitif, personal sosial, emosional, perilaku, akademik dan keterbatasan kesempatan kerja.Tujuan. Membuktikan asfifi ksia sebagai faktor risiko gangguan pendengaran sensorineural dengan mempertimbangkan prematuritas, obat ototoksik, dan ventilator mekanik.Metode. Penelitian observasional dengan rancangan kohort prospektif di RSUP Dr. Kariadi Semarang bulan Desember 2009 – November 2010. Subjek penelitian 68 neonatus terdiri dari 34 neonatus kelompok asfiksia dan 34 neonatus tanpa asfiksia Pemilihan subjek secara consecutive sampling, dicatat data klinis, laboratorium, dilakukan timpanometri, oto acustic emission (OAE) pertama usia <1 bulan dan OAE kedua dan brainstem evoked response audiometry (BERA) usia 3 bulan. Analisis statistik dengan uji Chi-square, uji Mc Nemar dan uji t tidak berpasangan, regresi logistik.Hasil. Kejadian gangguan pendengaran 35,3% pada asfiksia berdasarkan OAE pertama (p=0,003; RR:6,0; 95%CI:1,5-24,8), menjadi 20,6% pada OAE kedua (p=0,15). Gangguan pendengaran pada asfiksia berat 57,1% berdasarkan OAE pertama (p=0,003), menjadi 28,6% pada OAE kedua (p=0,16). Gangguan pendengaran sedang pada asfiksia 11,8% berdasarkan BERA (p=0,14). Faktor risiko prematuritas pada OAE pertama dan kedua p=1,00. Obat ototoksik, ventilator mekanik dan gangguan pendengaran pada OAE pertama (p=0,005; RR:4,4; 95%CI:1,3-14,3 dan p=0,03; RR:3,5; 95%CI:1,5-8,2). Analisis multi variat faktor risiko gangguan pendengaran untuk asfiksia (OR 1,3; 95%CI 0,1 - 19,9; p=0,84), obat ototoksik (OR 3,7; 95%CI 0,3 - 55,0; p=0,34), ventilator mekanik (OR 1,5; 95%CI 0,2-10,2;p=0,69)Kesimpulan. Asfiksia merupakan faktor risiko gangguan pendengaran usia kurang dari satu bulan. Gangguanpendengaran terbanyak pada asfiksia berat. Obat ototoksik dan ventilator mekanik merupakan faktor risikogangguan pendengaran usia kurang dari satu bulan. Prematuritas dan asfiksia, obat ototoksik, ventilatormekanik secara bersama-sama belum dapat disimpulkan sebagai faktor risiko gangguan pendengaran.
General Movements pada Bayi dengan Riwayat Hiperbilirubinemia Pattinama, Patricia A.; Putranti, Alifiani Hikmah; Sarosa, Gatot Irawan
Sari Pediatri Vol 14, No 2 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp14.2.2012.122-9

Abstract

Latar belakang. Deteksi dini gangguan perkembangan neurologis pada bayi muda sulit dilakukan. Hiperilirubinemia merupakan salah satu penyebab terjadinya gangguan perkembangan pada anak. Pemeriksaan kualitas general movements(GMs) pada usia fidgety(3 bulan) memiliki nilai prediksi terhadap gangguan perkembangan.Tujuan.Menilai pengaruh hiperbilrubinemia terhadap terjadinya abnormal GMs. Metode.Penelitian kohort dilanjutkan dengan nested case controlpada 44 bayi yang lahir di RSUP Dr.Kariadi, Semarang pada September 2009 sampai dengan Februari 2010. Subyek penelitian terdiri dari kelompok I 22 bayi dengan kadar BIS (bilirubin indirek serum) >12 mg/dl dan kelompok II 22 bayi dengan kadar BIS <12 mg/dl, pada kedua kelompok dilakukan pemeriksaan GMs dengan rekaman video menggunakan standarisasi metode Prechtl pada usia 3 bulan. Analisis hasil rekaman dilakukan oleh ahli. Hasil dari kelompok normal dan kelompok abnormal, dilakukan nested case controlGMs abnormal adalah kelompok kasus dan kelompok kontrol GMs normal berdasarkan skala Likert. Abnormal GMs apabila skor d5. Diteliti hubungan hiperbilirubinemia dengan GMs abnormal. Uji statistik dengan chi-square, Receiver operating curve(ROC), dan multivariat regresi logistik.Hasil. Rerata kadar BIS pada kelompok I 15,0±3,43 mg/dL dan rerata kadar BIS pada kelompok II 8,5±1,68 mg/dL. Pada kedua kelompok terdapat neonatus dengan GMs normal dan abnormal. Rerata kadar BIS pada kelompok abnormal GMs (kelompok kasus) 15,6±4,18 mg/dL, sedangkan kelompok kontrol 9,8±2,63 mg/dL dengan p<0,001. Analisis kurva ROC menunjukkan luas area dibawah kurva ROC untuk kadar BIS 0,92. Kadar BIS neonatal dapat digunakan sebagai prediktor GMs abnormal dengancut-off point BIS 12,67 mg/dL. Kesimpulan.Kadar BIS neonatal t12 mg/dL dapat digunakan sebagai prediktor GMs abnormal.
Radiologic imaging of congenital gastrointestinal anomalies in infants Zabidi, Leny; Sarosa, Gatot Irawan; Prabowo, Farah
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (144.806 KB) | DOI: 10.14238/pi52.6.2012.341-5

Abstract

Background Congenital gastrointestinal anomalies may manifestsigns or symptoms in the first few days of life, most commonly inthe fonn of obstructions. Radiologic imaging plays an importantrole in diagnosis confirmation and surgical correction plans. Mostcases may be diagnosed by plain radiographs alone, but cr scansand MRI may be needed to make accurate diagnoses, especiallyin difficult cases.Objective To report radiologic imaging findings in infants Mthcongenital gastrointestinal anomalies.Methods For this retrospective, cross????sectional study we tooksecondary data from medical records of infants 'With congenitalgastrointestinal anomalies in Dr. Kariadi Hospital, Semarang,Indonesia from January 2010 - June 2011. Diagnosis of congenitalanomalies was confirmed by clinical manifestation and radiologicimaging. Radiologic findings were reviewed by a single radiologiston duty at that time. Data is presented in the form of frequencydistribution.Results Subjects consisted of 50 males and 23 females. The mostcormnon complaints were vorrritingin 14 subjects (19%), alxlominaldistension in 31 subjects (43%), and fecal passage dysfunction in28 subjects (38%). Radiologic imaging of subjects with congenitalgastrointestinal anomalies revealed the folloMng conditions: analatresia in 28 subjects (38%), congenital megacolon in 21 subjects(29%), esophageal atresia in 14 subjects (19%), duodenal atresia in9 subjects (12%), and pyloric atresia in 1 subject (2%).Conclusion Using radiologic imaging of infants with congenitalgastrointestinal anomalies, the most to least common conditionsfound were anal atresia, congenital megacolon, esophagealatresia, duodenal atresia, and pyloric atresia. [Paediatr Indones.2012;52:341-5].
Linear growth patterns in small for gestational age and preterm infants after zinc supplementation Setiawan, Caecilia Nancy; Sarosa, Gatot Irawan; Setiawati, Mexitalia
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (196.635 KB) | DOI: 10.14238/pi55.1.2015.23-8

Abstract

Background Low birth weight (LBW) infants are at risk for growth disturbances due to intrauterine zinc deficiency. Zinc supplementation is expected to improve the linear growth of LBW babies. Objective To assess the effect of zinc supplementation on linear growth in preterm and small for gestational age (SGA) infants. Methods This quasi-experimental study had a pre- and post-test design. Subjects were LBW infants hospitalized in Kariadi Hospital during March-December 2011, consisted of SGA and preterm neonates. All subjects were given 5 mg of zinc syrup daily for 3 months. Subjects’ head circumference, weight, and length were measured monthly. Serum zinc levels were measured before and after supplementation. Data were analyzed with Chi-square test, independent T-test, and general linear model repeated measure. Results A total of 61 subjects were enrolled consisted of 31 preterm and 30 SGA neonates. Mean serum zinc levels in the preterm group were 168.2 (SD 54.5) μg/dL pre-supplementation and 163.6 (SD 50.7) μg/dL post-supplementation (P=0.049), while mean serum zinc levels in the SGA group were 174.8 (SD 46.6) μg/dL pre-supplementation and 167.4 (SD 49.4) μg/dL post-supplementation (P=0.271). Median percentage preterm weight and length increased from 87.3 to 102.4% in the third month (P&lt;0.001) and from 95.8 to 103.9% in the third month (P&lt;0.001), respectively. Median percentage SGA weight and length increased from 73.5 to 98.3% in the third month (P&lt;0.001) and from 94.5 to 102.2% in the third month (P&lt;0.001), respectively. Conclusion Both, the preterm and SGA infants exhibit catch-up growth after three months of zinc supplementation. [
CORRELATION BETWEEN NUCLEATED RED BLOOD CELLS AND PULSE OXYGEN SATURATION IN NEONATAL ASPHYXIA Sarosa, Gatot Irawan; Rahmadi, Farid A.; Kosim, Muhammad Sholeh; Rahardjani, Kamilah B.
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (140.83 KB) | DOI: 10.14238/pi54.6.2014.314-7

Abstract

Background Neonatal asphyxia is the major cause of neonatal death at a rate of approximately 23%. The incidence of asphyxia is higher in developing countries, due to limited availability of perinatology facilities. Hypoxia due to asphyxia is characterized by low pulse oxygen saturation (Sp02), which basic health care facilities are unable to monitor. The number ofnucleated red blood cells (nRBCs) in asphyxia increases in order to compensate for the hypoxia. Few studies have reported on nRBCs as they relate to pulse oxygen saturation in neonatal asphyxia. Objective To assess for a correlation between nRBCs and pulse oxygen saturation in neonatal asphyxia. Methods In this cross-sectional study, asphyxia was assessed by way of Apgar scores; pulse oxygen saturation was monitored by pulse oximetry; and nRBCs were determined by blood smears. Statistical analysis used was Spearman's test. Results Subjects were 41 neonates with asphyxia, 15 of whom had 5th minute Apgar scores S 6. Subjects with Apgar scores S 6 had significantly higher umbilical venous nRBC counts [20.0 (SD 13.09) /100 white blood cell] than subjects with Apgar score &gt; 6 [8.81 (SD 8.71) /100 white blood cell] ; (P = 0.004). Subjects with Apgar S 6 had significantly lower 5th minute Sp02 values [76.46 (SD 6.17) %] than subjects with Apgar scores &gt; 6 [87.03 (SD 6.29)]; (P &lt; 0.0001). Spearmans' test revealed a significant correlation between higher nRBC counts and lower pulse oxygen saturation (r = -0.804; P&lt;0.0001) . Conclusion In asphyxia neonatorum there is a correlation between umbilical vein nRBC counts and the 5th minute Sp02. As such, we recommend using nRBC examinations to predict pulse oxygen saturation as a means to assess the severity ofhypoxia in peripheral areas where pulse oximetry machines may be unavailable.