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Background In vitro fertilisation (IVF) offers a solution for infertility but poses increased obstetrical and perinatal risks, including higher rates of preterm birth, low birth weight and congenital anomalies. Particularly, IVF-related multiple pregnancies face significantly higher risks for preterm birth and prolonged hospital stays. This study compares neonatal outcomes between IVF and natural conception, as well as between singleton and IVF-related multiple pregnancies over the past decade.Method This retrospective study reviewed the medical records of babies born at Cipto Mangunkusumo Kencana Hospital from 2013 to 2023. Neonatal morbidities (hypothermia, hypoglycaemia, respiratory distress, circulation problems, sepsis, congenital anomalies, all stages of intraventricular haemorrhage and retinopathy of prematurity of all babies, neonatal intensive care unit (NICU) admission and length of stay) were dependent variables, with the mode of conception as the independent variable.Result Of 609 subjects, 169 were IVF conceptions and 435 natural conceptions. The IVF group had higher rates of prematurity (27.8% vs 10.8%, p

Abstract Background Indonesia has high numbers of preterm birth, i.e., around 600,000 preterm births annually. It imposes a significant burden on the Indonesia’s healthcare system. Indonesia therefore requires its own evidence-based reference to manage premature neonates and ex-preterm infants who subsequently survived. No long-term study on preterm infants in Indonesia has been conducted, therefore we aim to evaluate growth and development on ex-preterm infants until the pre-pubertal stage. Methods We at the Cipto Mangunkusumo General Hospital (CMGH) designed a prospective cohort study of preterm infants, i.e., the Cohort of Indonesian Preterm Infants for Long-term Outcomes (CIPTO) study. At least 500 subjects will be recruited with an estimation of two-year recruitment (i.e., the recruitment phase will be completed before 2024). The CIPTO study will observe long-term outcomes of ex-preterm infants, primarily on growth and developmental milestones until 8 years old. Aims of this study are to determine the ex-preterm outcomes and to generate an evidence-based reference of preterm care for ensuring optimum outcomes. The pre-specified long-term outcomes in this study are survival rates, growth outcomes, neurodevelopmental outcomes, feeding behavior, as well as hearing and vision impairments. Growth and neurodevelopmental outcomes will be assessed at 0, 2, 4, 6, 9, 12, 15, 18 and 24 months of corrected age as well as at 3, 4, 5, 6, 7 and 8 years old. Discussion The CIPTO study is the first prospective cohort in Indonesia focusing on preterm infants born at the CMGH. With a follow up until 8 years old, this study may provide useful insights to generate an evidence-based, Indonesia’s health care reference in managing premature infants and ensuring the optimum outcomes of ex-preterm infants.

Abstract Background Neonatal jaundice is a transitional phenomenon affecting three out of five full-term newborns globally. Ursodeoxycholic acid could be beneficial in neonatal jaundice needing phototherapy. Methods We searched PubMed, EBSCO, ProQuest, and Cochrane Library up to August 21st, 2021, for articles to be reviewed. Meta-analysis using random-effects model was performed. Results Eight studies involving 1116 neonates were chosen in this review; however, only five studies were included for meta-analysis. Phototherapy duration was significantly lower in the interventional group with high heterogeneities. Subgroup analysis of the phototherapy duration based on the risk of bias resulted in a shorter duration (mean difference (MD) = –17.82; 95% CI = –20.17 to –15.47; p =

BackgroundPostnatal growth failure (PGF) frequently occurred among preterm infants with malnutrition. The decline in a weight-for-age z-score of ≥1.2 has been proposed to define PGF. It was unknown whether this indicator would be useful among Indonesian preterm infants.MethodsInfants of

Latar belakang. Thalassemia dan diabetes mellitus tipe-1 (DM tipe-1) merupakan penyakit kronik yang banyak didapatkan pada anak dan remaja di Indonesia. Adanya penyakit kronik pada remaja dapat berisiko meningkatkan terjadinya masalah psikososial 2-6 kali dibandingkan populasi sehat. Masalah psikososial pada remaja sulit dikenali sehingga perlu dilakukan evaluasi secara rutin. The strengths and difficulties questionnaire (SDQ) adalah instrumen yang praktis dan mudah digunakan untuk mendeteksi masalah tersebut. Tujuan. Mengetahui besaran masalah psikososial pada remaja dengan penyakit kronik di RS. Cipto Mangunkusumo, Jakarta. Metode. Desain potong lintang pada 140 remaja (100 thalassemia mayor dan 40 DM tipe-1), usia 10-18 tahun. Subyek diminta untuk mengisi kuesioner SDQ (laporan mandiri). Hasil. Prevalensi total skor abnormal pada remaja thalassemia mayor adalah 8%, dan DM tipe-1 adalah 15%. Tidak ada skor abnormal pada aspek perilaku pro-sosial kedua penyakit, dan aspek hubungan dengan teman sebaya DM tipe-1. Tidak didapatkan perbedaan bermakna antara diagnosis penyakit, jenis kelamin, dan tingkat pendidikan subyek pasien DM terhadap luaran hasil SDQ. Kesimpulan. Masalah psikososial lebih banyak didapatkan pada remaja DM tipe-1 dibandingkan thalassemia mayor.

BackgroundAll sectors are affected due to COVID-19 pandemic occurring worldwide, including the education industry. School closure had been taking place for more than a year in Indonesia. Despite the controversies, Indonesian government had decided to begin school reopening.ObjectivesThis study aims to assess parental readiness for school reopening, and factors affecting parental attitude toward school reopening.MethodsA cross-sectional study using online questionnaire distributed via official Indonesian Pediatric Society (IPS) official social media account collected between March and April 2021. The questionnaire contained the general characteristics of study participants, parents' knowledge, and perspectives on COVID-19, and health protocols for school reopening.ResultsA total of 17,562 responses were collected, of which 55.7% parents were ready to send their children to school should school reopens. Factors significantly contribute to parental decision to keep their child at home were: presence of vulnerable population at home [OR = 1.18 (1.10–1.27), p < 0.001], children with comorbidities [OR = 2.56 (2.29–2.87), p < 0.001], perception of COVID-19 as a dangerous disease [OR = 28.87 (14.29–58.33), p < 0.001], experience with COVID-19 positive cases in the community [OR = 1.75 (1.61–1.90), p < 0.001], COVID-19 related death in the community [OR = 2.05 (1.90–2.21), P < 0.001], approval for adult COVID-19 vaccination [OR = 1.69 (1.53–1.87), p < 0.001], and ownership of private transportation [OR = 1.46 (1.30–1.66), p

Preterm neonates are born with fewer functional nephrons, rendering them vulnerable to secondary insult. These insults are associated with acute kidney injury (AKI); thus, structural damage must be detected as early as possible. Urinary L-type fatty acid-binding protein (u-LFABP) has been proposed as a highly suitable kidney injury biomarker during prematurity. We aimed to analyze the use of POC u-LFABP in critically ill, very preterm neonates. This study was conducted at the neonatal intensive care unit (NICU), Dr. Cipto Mangunkusumo General Hospital, from November to December 2020. Baseline characteristics were recorded from electronic medical records. u-LFABP examination utilized stored urine samples from a previous study and was performed using a LFABP POC test kit. The proportion of abnormal u-LFABP (83.3%) was highest at 72 hours. Neonates with older gestational age (0–48 hours; p=0.017) and higher birth weight (0–48 hours; p=0.022, 72 hours; p=0.013) had normal u-LFABP levels. Neonates exposed to nephrotoxic agents showed higher proportion of abnormal u-LFABP (0–48 hours; p=0.006). Longer invasive mechanical ventilation (IMV) period was observed in neonates with abnormal u-LFABP levels at 0–48 hours (7.44 ± 7.9 vs. 1.50 ± 2.9 days; p=0.011). We found an association between complication rates and poorer disease outcome trends with abnormal u-LFABP; however, this relationship was not supported statistically. In conclusion, this study demonstrated that u-LFABP can be detected using bedside POC kit in critically ill very preterm neonates and those exposed to nephrotoxic agents may be at risk for kidney injury, confirmed by abnormal u-LFABP levels.

Background Acute diarrhea is a common health problem in Indonesia. During acute diarrhea, changes in gut microbiota are marked by decrease beneficial microbes Bifidobacterium and Lactobacillus, and increased pathogenic bacteria Enterobacter and Clostridium. Such microbial imbalances are known as dysbiosis. Treatment with probiotics may help repair dysbiosis, quicken healing time, and decrease complications. Objective To assess for dysbiosis during acute diarrhea, and determine if it can be normalized by probiotic treatment. Methods This placebo-controlled, unblinded clinical trial was performed in Budhi Asih District Hospital, Jakarta, from January to March 2018. Twenty-four children age 6-24 months with acute diarrhea and 12 healthy children were enrolled. First fecal specimen was collected for all subjects and analyzed using non-culture real time PCR to count the population of Lactobacillus, Bifidobacterium, Enterobacter, Clostridium, and all bacteria. Children with diarrhea were assigned to probiotic or placebo treatment for 5 days and the second fecal specimen was analyzed two weeks after the diarrhea subsided. Results Prior to treatment, significant higher amounts of Lactobacillus were observed in children with acute diarrhea than in healthy controls [median (interquartile range/IR): 1.52x103 (1.22x104) vs. 6.87x10 (2.41x102), respectively; proportion in percentage (from total bacteria population): 0.044% vs. 0.003%, respectively]. However, median (IR) Clostridium was significantly higher in healthy controls than in children with acute diarrhea [2.37x102 (4.64x103) vs. 4.67 (1.50x102), respectively (P

Background: Indonesia has a high number of COVID-19 cases and mortalities relative to not only among the Asia Pacific region but the world. Children were thought to be less affected by the virus compared to adults. Most of the public data reported combined data between adults and children. The Indonesian Pediatric Society (IPS) was involved in the COVID-19 response, especially in the area of child health. One of IPS's activities is collecting data registries from each of their chapters to provide a better understanding of COVID-19 in children.Objective: The objective of this study was to share the data of suspected and confirmed COVID-19 cases in children from IPS's COVID-19 data registry.Method: This is a retrospective study from the IPS's COVID-19 registry data. We collected the data of COVID-19 in children during March to December 2020 from each of the IPS chapters. We analyzed the prevalence, case fatality rate (CFR), age groups, diagnosis, and comorbidities of the children diagnosed with COVID-19.Result: As of December 21, 2020, there were 35,506 suspected cases of children with COVID-19. In total, there were 522 deaths, with a case fatality ratio (CFR) of 1.4. There were 37,706 confirmed cases with 175 fatalities (CFR 0.46). The highest mortality in confirmed COVID-19 cases was from children ages 10–18 years (42 out of 159 cases: 26%). The most common comorbidity and diagnosis found were malignancy (17.3%) and respiratory failure (54.5%).Conclusion: The CFR of confirmed COVID-19 cases in children in Indonesia is high and should be a major public concern.

Abstract Background This study compares the minimally invasive Bilistick and a noninvasive method with standard Total Serum Bilirubin (TSB) measurement in preterm newborns receiving phototherapy. We assess the agreement of Transcutaneous Bilirubinometer (TcB) and Bilistick bilirubin measurements with standard TSB measurement in preterm infants receiving phototherapy. Methods Bilirubin was measured by using TcB and Bilistick in 94 preterm infants in RSCM Jakarta Neonatal Ward from October 2016 to March 2017, with gestational ages of

Latar belakang. Apne berulang sering terjadi pada bayi prematur. Kejadian ini dapat menimbulkan hipoksemia dan bradikardi , bila keadaannya semakin memburuk maka membutuhkan resusitasi dengan ventilasi tekanan positif. Obat golongan metilxantin (kafein dan teofilin) telah digunakan untuk mencegah apne. Tujuan. Untuk mengetahui efek dan keamanan kafein dibandingkan teofilin pada bayi preamtur dengan periodik apne. Metode. Penelusuran pustaka database elektronik : Pubmed, Cochrane, dan Highwire Hasil. Hasil telaah sistematis menunjukkan kejadian takikardia dan intoleransi minum lebih sedikit pada kelompok kafein dengan Relative Risk (RR) 0,17; 95 % Interval kepercayaan (IK) 0,04, 0,72; risk difference (RD) -0,29; 95 % IK -0,47, - 0,10. Studi klinis acak mendapatkan Tidak ada hubungan bermakna antara dosis pemberian kafein dan aminofilin pada konsentrasi plasma keduanya, kecuali pada kelompok kafein pada hari tertentu. Kesimpulan. Aminofilin dan kafein memiliki efektivitas yang sama dalam mengatasi apne pada bayi prematur. Efek toksisitas kafein lebih rendah dibandingkan aminofilin.

Background Improving breastfeeding in sick infants is essential. During the neonatal care, health care staff play an important role in promoting breastfeeding. Therefore, it is important to study in depth how healthcare staff can improve breastfeeding practice in sick neonates. Objective To compare breastfeeding rates in sick infants before and after a focused group discussion (FGD) of health care staff on how to improve breastfeeding. Methods This study was an operational study using FGD and in-depth interviews as an intervention. A fish bone diagram was used to assess problems that may prevent mothers from breastfeeding their sick infants. Breastfeeding achievement was compared before and after the FGD. Results Of 257 sick infants, 177 subjects were in the before FGD group and 80 subjects were in the after FGD group. Significantly more after FGD subjects were breastfed during hospitalization than before FGD subjects [97.5% vs. 82.9%, respectively; (x2 =9.43; P=0.002)]. Breastfeeding initiation within 0-4 hours of birth was also significantly higher in the after FGD group [10 (12.5%) vs. 6 (3.5%), respectively; (x2 = 52.5; P

Latar belakang.Perawatan metode kanguru (PMK), yaitu perawatan skin to skin contactbayi dengan ibu 24 jam dalam sehari. Keuntungan metode ini bayi tidak mengalami hipotermia, tanda vital stabil, pemberian ASI ekslusif lebih mudah, kenaikan berat badan lebih cepat, ikatan antara ibu dan bayi lebih kuat, lama rawat menjadi lebih pendek, dan kejadian infeksi nosokomial juga menurun pada bayi yang dirawat. Tujuan.Mengetahui apakah edukasi yang terus menerus oleh tenaga kesehatan tentang PMK berdampak lebih baik pada pertumbuhan neonatus kurang bulan (NKB), apakah PMK dapat menunjang perkembangan (berat badan, panjang badan, dan lingkar kepala) NKB menjadi optimal, serta apakah PMK dapat mempromosikan pemberian ASI. Metode.Penelitian pre-eksperimental dengan subyek sesuai kriteria inklusi bayi prematur usia gestasi