Pengaruh Waktu Pengikatan Tali Pusat terhadap Indeks Eritrosit Bayi Baru Lahir

Abstract

Background. The infant will be separated from the placenta by clamping and cutting the umbilical cord at the time of birth. The difference timing of umbilcal cord clamp could have impact to the newborn infant. A meta-analysis study showed that delayed cord clamping for a minimum 2 minutes is beneficial to the newborn, also it has been socializated by the Health Department of Republic Indonesia. Unfortunately, there were only few studies which demonstrated the effect of timing of cord clamping on red cell indices values in newborn term infants. Objective. We aimed to investigate whether a difference of timing of cord clamping might have impact on red cell indices values in normal-weight, newborn term infants. Methods. A randomized, single blind trial study was conducted on March to June 2009, at two general hospitals in Medan, North Sumatera province, which eligible newborn infants were randomly assigned to early cord clamping = ECC (15 seconds after delivery) in the first group or delayed cord clamping = DCC (2 minutes after delivery) in the second group. The infants were placed on the mother’s abdomen before the umbilical cord were clamped and red cell indices values were measured from the umbilical cord blood. Results. Totally 60 infants were eligible which consist of 30 infants of each group. From red cell indices values, we found mean MCV value was 101.76 (4.03) fL in the ECC and 103.95 (4.27) fL in the DCC group (95% CI: -4.338 ? -0.042; P=0.046), mean MCH value was 35.02 (1.52) pg in the ECC and 35.21 (1.61) pg in the DCC group (95% CI: -1.000 ? 0.616; P=0.635), mean MCHC value was 34.24 (0.93) g/dL in the ECC and 34.51 (0.79) g/dL in the DCC group (95%CI: -0.716 ? 0.176; P=0.230), mean RDW value was 16.46 (0.92)% in the ECC and 16.34 (0.85)% in the DCC group (95%CI: -0.338 ? 0.578; P=0.602). Conclusion. There was a significant difference on MCV value between early and delayed cord clamping.

Latar belakang. Bayi dipisahkan dari plasenta dengan cara dilakukan pengikatan dan pemotongan tali pusat pada saat dilahirkan. Perbedaan waktu pengikatan tali pusat dapat memberikan dampak pada bayi baru lahir. Suatu studi meta-analisis menunjukkan bahwa penundaan pengikatan tali pusat selama minimal 2 menit bermanfaat untuk bayi baru lahir, dan hal ini telah disosialisasikan oleh Departemen Kesehatan Republik Indonesia. Namun, hanya sedikit penelitian yang membahas pengaruh waktu pengikatan tali pusat terhadap indeks eritrosit pada bayi baru lahir. Tujuan. Mengetahui pengaruh waktu pengikatan tali pusat terhadap indeks eritrosit bayi baru lahir. Metode. Suatu penelitian uji klinis acak sederhana tersamar tunggal yang dilakukan sejak bulan Maret sampai Juni 2009, di dua RSU di Medan, propinsi Sumatera Utara, dilakukan pada bayi baru lahir yang memenuhi kriteria dimana bayi diacak, terbagi dua kelompok, yaitu kelompok I yang dilakukan pengikatan tali pusat dini (15 detik setelah lahir) atau tertunda (2 menit setelah lahir) pada kelompok II. Bayi diletakkan di atas perut ibu sebelum dilakukan pemotongan tali pusat dan nilai indeks eritrosit bayi diukur dari darah vena umbilikal. Hasil. Dari total 60 bayi, diperoleh 30 bayi di setiap kelompok. Nilai rerata MCV pada kelompok I 101,76 (4,03) fL dan 103,95 (4,27) fL pada kelompok II (95% CI: -4,338 ? -0,042; P=0,046), rerata MCH 35,02 (1,52) pg pada kelompok I dan 35,21 (1,61) pg pada kelompok II (95% CI: -1,000 ? 0,616; P=0,635), rerata MCHC 34,24 (0,93) g/dL pada kelompok I dan 34,51 (0,79) g/dL pada kelompok II (95%CI: -0,716 ? 0,176; P=0,230), rerata RDW 16,46 (0,92)% pada kelompok I dan 16,34 (0,85)% pada kelompok II (95%CI: -0,338 ? 0,578; P=0,602). Kesimpulan. Ada perbedaan bermakna pada nilai MCV antara pengikatan tali pusat dini dan tertunda. en_U