EARLY MORTALITY AND PRIMARY

CAUSES OF DEATH IN MOTHERS

OF CHILDREN WITH
INTELLECTUAL DISABILITY OR
AUTISM SPECTRUM DISORDER: A
RETROSPECTIVE COHORT STUDY

Jenny Fairthorne, Geoff Hammond, Jenny

Bourke, Peter Jacoby, Helen Leonard

Pembimbing :
dr. Adriesti Herdaetha, Sp. KJ

Disusun Oleh :
Anggun Dewi Monika, S.ked

J510155026

Dzaky Haidar Afif, S.ked

J510155058

Muhammad Fadhil Ilhami, S.ked

Okky Wellianasari B, S.ked
Umi Yuliani, S.ked

J510155065
J510155038

J510155057

Pendahuluan
Untuk

beberapa hal, tingkat gangguan

kesehatan pada ibu telah terbukti bervariasi
sesuai dengan jenis kecacatan anak mereka.
Ibu dengan gangguan kejiwaan sebelumnya
sekitar dua kali lebih mungkin untuk memiliki
anak dengan ASD.
Banyak fasilitas kesehatan mental di negara
maju yang ditutup, sehingga anak dengan
kecacatan intelektual terpaksa dirawat sendiri
oleh ibunya di rumah.

Tujuan
Memperkirakan

tingkat ketahanan hidup

dan risiko kematian pada ibu dari anakanak dengan cacat intelektual.
Meneliti sejauh mana gangguan
kejiwaan dapat menjelaskan perbedaan
angka kematian yang diamati.
Mengidentifikasi penyebab utama
kematian pada ibu dari anak-anak
dengan intelektual cacat atau ASD dan
memperkirakan bagaimana risiko
dibandingkan dengan ibu-ibu anak-anak
tanpa cacat ini.

METODE
Populasi

penelitian
seluruh wanita yang melahirkan anak hidup di
Australia Barat pada tahun 1983 2005.
Kelompok

ibu
Dibagi menjadi 6 kelompok kasus inti :
- Cacat intelektual ringan tidak diketahui penyebabnya
- Cacat intelektual berat tidak diketahui penyebabnya
- Sindrom down
- Cacat intelektual diketahui penyebabnya (bukan
sindrom down)
- ASD dengan cacat intelektual
- ASD tanpa cacat intelektual

Analisis

Kaplan-Meier -> menghitung

kelangsungan hidup ibu

Penyebab
infeksi

Kematian :

atau parasit,
kanker,
diabetes,
penyakit kardiovaskular,
penyakit pernapasan,
pneumonia dan influenza,
penyakit pencernaan,
penyakit ginjal,
komplikasi kehamilan,
misadventure,
Penyebab lainnya,
genetik dan kelainan kongenital,
gangguan mental.

Hasil

Penyebab kematian
Tiga penyebab utama kematian :
kanker (N=1,452)
kecelakaan (N=843)
dan penyakit kardiovaskular
(N=433)

Peningkatan perbandingan resiko kematian akibat

kanker

1,41

(95% CI: 1.1, 1.8) untuk ibu

dari anak-anak dengan cacat
intelektual
1,54 (95% CI: 0.8, 2.9) untuk ibu
dari anak-anak dengan ASD

Perbandingan resiko untuk kematian

karena penyakit cardiovascular
2,6

(95% CI: 1.8, 3.9) pada ibu

dari anak-anak dengan cacat
intelektual
2,52 (95% CI: 1.7, 3.7) pada ibu
dari anak-anak dengan cacat
intelektual atau ASD

kematian karena kecelakaan,

Terdapat

peningkatan secara
signifikan perbandingan risiko
terdapat pada ibu dari anak-anak
dengan cacat intelektual atau ASD
[1,75 (95% CI: 1.3, 2.4)]
Cacat intelektual [1,95 (95% CI:
1.4, 2.7)].
Pada analisis tidak menunjukkan
nilai cells dengan jumlah angka
lima atau kurang jadi hasil dapat

DISKUSI
Risiko

kematian Ibu dari semua kelompok kasus

memiliki peningkatan risiko kematian selama
masa penelitian. ketika disesuaikan usia ibu pada
indeks kelahiran dan SES, semua perbandingan
resiko berkurang tapi tetap meningkat.
Adanya perbedaan signifikan pada rasio resiko
untuk kematian pada :
Ibu dari anak-anak dengan cacat intelektual yang
diketahui penyebabnya ( bukan sindrom Down)
Ibu dari anak-anak dengan cacat intelektual ringan
Ibu dari anak-anak dengan ASD dan cacat
intelektual.

DISKUSI (LANJUTAN)
Faktor

kelainan genetik menjadi risiko

kematian yang tinggi pada ibu dari anak-anak
dengan cacat intelektual yang diketahui
penyebabnya (bukan syndrom down)
Hal ini membuktikan bahwa ibu yang memiliki
gangguan kejiwaan memiliki dampak yang
lebih pada kematian daripada dia memiliki
anak dengan cacat intelektual atau ASD
Hipotesis bahwa peningkatan ini mungkin
berhubungan dengan peningkatan stres
membesarkan anak yang cacat tersebut


Dampak untuk masa depan

Penggabungan

data yang sesuai

dari pendaftar ASD dari tempat lain
mungkin memberikan pemahaman
yang lebih besar dari faktor
peningkatkan angka kematian pada
ibu dari anak-anak dengan ASD
Dengan cara ini, layanan informasi
dan pencegahan mungkin
dikembangkan yang bertujuan
meningkatkan kesehatan dan
kelangsungan hidup dari semua

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