Gestational diabetes mellitus (GDM) Research Papers (original) (raw)

Abstrak: Insiden obesitas dalam kehamilan telah meningkat secara signifikan dalam beberapa dekade terakhir. Pada wanita hamil, obesitas meningkatkan risiko terjadinya komplikasi pada kondisi ibu dan bayi berupa penyakit preeklampsia, diabetes melitus gestasional, perdarahan saat persalinan, pembedahan caesar, hingga kelahiran prematur. Tatalaksana obesitas pada wanita usia reproduktif perlu dimulai saat perencanaan kehamilan, terutama melalui penerapan gaya hidup sehat seperti pola nutrisi makanan seimbang dan aktivitas fisik. Sayangnya bukti manfaat dari studi intervensi yang diterbitkan tampaknya terbatas dan belum mendekati pengkajian yang sesuai dengan keadaan sosiodermografi di Indonesia. Penelitian ini bertujuan untuk mengetahui efektivitas intervensi dari pengaturan gaya hidup sehat pada wanita hamil dengan obesitas terhadap penurunan angka kejadian penyakit dan penyulit pada kehamilan. Penelitian dilakukan dengan meninjau beberapa literatur secara sistematis dan meta analisis menurut kriteria PRISMA dilanjutkan dengan pengolahan data statistik menggunakan Review Manager (RevMan; Versi 5.0). Dari 185 literatur didapatkan 41 studi RCT (total sampel 13.389 orang) dan 8 studi non-RCT (total sampel 1.668 orang) yang memenuhi kriteria inklusi penelitian. Analisis statistik dari sampel RCT menunjukkan adanya kecenderungan penurunan risiko pada ke-empat variabel yaitu preeklamsia (OR 0.87, 95% CI [0.74, 1.02], 11.013 orang, Chi 2 60.49, df 27, p 0.00002, I 2 55%), diabetes melitus gestasional (OR 0.87, 95% CI [0.75, 1.00], 6.402 orang, Chi 2 37.23, df 21, p 0.002, I 2 44%), perdarahan post partum (OR 0.84, 95% CI [0.72, 0.98], 5.128 orang, Chi 2 23.51, df 7, p 0.001, I 2 70%) dan pembedahan caesar (OR 0.89, 95% CI [0.81, 0.97], 10.707 orang, Chi 2 34.35, df 28, p 0.19, I 2 18%). Kata Kunci : intervensi gaya hidup sehat, kehamilan obesitas, penyulit kehamilan Abstract: The incidence of obesity in pregnancy has increased significantly in the past few decades resulting in improved pregnancy complications of preeclampsia, gestational diabetes mellitus, post partum hemorrhagic, caesarean section and premature birth. The ideal intervention should begin during the pre-pregnancy stages, especially through the impelementation of healthy lifestyles such as balanced dietary nutrition planning and physical activities. Recent published intervention studies appears to be limited and has not approached the sociodemographic situation in Indonesia. This study aims to determine the effectiveness of modification lifestyle interventions in obese pregnant women to reducing the prevalence of pre-eclampsia, gestational diabetes mellitus, post partum hemorrhagic and caesarean section delivery. The study was conducted by undertaking a systematic review and meta-analysis according to PRISMA criteria followed by processing statistical data using Review Manager (RevMan; Version 5.0). Of the 185 literature found 41 RCT studies (total sample of 13,389 people) and 8 non-RCT studies (total sample of 1,668 people) who met the study inclusion criteria. Statistical analysis of RCT samples shows a tendency for risk reduction in all four variables, preeclampsia (OR 0.87, 95% CI [0.74, 1.02], 11.013 people, Chi 2 60.49, df 27, p 0.00002, I 2 55%), gestational diabetic mellitus (OR 0.87, 95% CI [0.75, 1.00], 6.402 people, Chi 2 37.23, df 21, p 0.002, I 2 44%), post partum hemorrhagic (OR 0.84, 95% CI [0.72, 0.98], 5.128 people, Chi 2 23.51, df 7, p 0.001, I 2 70%) and cesarean section (OR 0.89, 95% CI [0.81, 0.97], 10.707 people, Chi 2 34.35, df 28, p 0.19, I 2 18%).