Hubungan Obesitas Maternal Prakehamilan dengan Kejadian Preeklampsia di Surakarta

Sari

ABSTRACT

Preeclampsia is a pregnancy‑specific hypertensive disorder characterized by hypertension and proteinuria after 20 weeks of gestation and remains a major cause of maternal and perinatal morbidity and mortality. Pre‑pregnancy maternal obesity is a key modifiable risk factor, but evidence from primary care settings is still limited. To examine the association between pre‑pregnancy maternal obesity and the incidence of preeclampsia among pregnant women at Posyandu Merdisiwi. An analytical observational study with a case–control design was conducted on 34 mothers, consisting of 17 cases with preeclampsia and 17 controls without preeclampsia selected by consecutive sampling. Data were obtained from medical records and structured interviews. Pre‑pregnancy obesity was defined using body mass index (BMI), and preeclampsia was diagnosed based on standard criteria of blood pressure ≥140/90 mmHg and proteinuria at gestational age ≥20 weeks. Data were analyzed using the chi‑square test and odds ratio (OR) with a 95% confidence interval. Pre‑pregnancy obesity was more frequent in the preeclampsia group (64.7%) than in the control group (17.6%). Obese mothers before pregnancy had a significantly higher risk of preeclampsia than non‑obese mothers (OR 8.56; 95% CI 1.85–39.59; p < 0.01). High‑risk maternal age and anemia also showed significant associations, while gravidity, occupation, and education did not. Pre‑pregnancy maternal obesity is strongly associated with preeclampsia. Integrating preconception weight management, early risk assessment, and closer antenatal surveillance for obese women is essential to reduce preeclampsia in primary care.

Keywords: Preeclampsia, Pregnant Women, Pre‑Pregnancy Obesity, Maternal Health, Primary Care.

ABSTRAK

Preeklamsia adalah gangguan hipertensi spesifik kehamilan yang ditandai hipertensi dan proteinuria setelah 20 minggu kehamilan dan masih menjadi penyebab penting morbiditas dan mortalitas maternal serta perinatal di negara berkembang. Obesitas maternal prakehamilan dikenal sebagai faktor risiko yang dapat dimodifikasi, namun bukti di tingkat pelayanan primer masih terbatas. Menganalisis hubungan obesitas maternal prakehamilan dengan kejadian preeklamsia pada ibu hamil di Posyandu Merdisiwi. Penelitian observasional analitik dengan rancangan kasus–kontrol pada 34 ibu, terdiri atas 17 kasus preeklamsia dan 17 kontrol tanpa preeklamsia yang dipilih secara consecutive sampling. Data diperoleh dari rekam medis dan wawancara terstruktur. Obesitas prakehamilan ditentukan berdasarkan indeks massa tubuh (IMT), sedangkan preeklamsia ditegakkan menurut kriteria tekanan darah ≥140/90 mmHg dan proteinuria pada usia kehamilan ≥20 minggu. Analisis menggunakan uji chi‑square dan odds ratio (OR) dengan interval kepercayaan 95%. Proporsi obesitas prakehamilan lebih tinggi pada kelompok preeklamsia (64,7%) dibandingkan kontrol (17,6%). Ibu dengan obesitas prakehamilan memiliki risiko jauh lebih tinggi mengalami preeklamsia dibandingkan yang tidak obes (OR 8,56; IK 95% 1,85–39,59; p < 0,01). Usia berisiko dan anemia juga berhubungan bermakna, sedangkan gravida, pekerjaan, dan pendidikan tidak. Obesitas maternal prakehamilan berhubungan kuat dan signifikan dengan kejadian preeklamsia. Pengendalian berat badan prakonsepsi, skrining risiko dini, dan pemantauan antenatal lebih intensif pada ibu obes perlu diintegrasikan ke dalam layanan kesehatan ibu rutin.

Kata Kunci: Preeklamsia, Ibu Hamil, Obesitas Prakehamilan, Kesehatan Ibu, Pelayanan Primer.