Author : Trianawati
Pembimbing 1/2 : Prof.dr. Siswanto Agus Wilopo, SU,MSc.Sc/dr. Citra Indriati, MPH.
Penguji : dr. Lutfan Lazuardi, MKes,PhD.
Abstract :
Background: Lactation Amenorrhea Method (LAM) tend to increase birth spacing. Exclusive breastfeeding in Indonesia, 15.3% an effect on resumption of ovulation is quicker and the duration of postpartum amenorrhea is shorter, so we need additional contraception is safe for breastfeeding women. Progestin Only Pills (POP) are better choice, beside prolonged the duration of lactation amenorrhea. POP in generic as lynestrenol and levonorgestrel expected can produced in Indonesia cheaper cost and be nationaly family planning programme.
Objective: To identify effect of lynestrenol pill contraception and levonorgestrel (LNG) to breastfed quality, lactation and the duration of postpartum amenorrhea. Method: The study was a mixed randomized clinical trial with parallel design. Subject of the study were mothers that breastfed for 6 months after postpartum, 20-35 years old, pill family planning and pill non contraindication. Sample size was based on Log rank test median survival time and incidence rate drop out between hormonal and non hormonal contraception, divided into three groups with total samples of 107 respondents. Subjects were observed within 6 months, evaluated every month. Data analysis used chi square, oneway anova, survival analysis Kaplan-Meier method, log rank test and cox proportional hazard model. Result: Use of LNG pill contraception HR=1.46(95%CI=0.67-3.18) and lynestrenol pill HR=0.85(95%CI=0.37-1.97), lactation HR=1.23(95%CI=0.66- 2.31), casein HR=0.83(95%CI=0.38-1.82), lactose HR=0.87(95%CI=0.66-1.15), lipid HR=0.80(95%CI=0.62-1.04) and calcium HR=1.0(95%CI=0.98-1.02) were insignificant to the duration of postpartum amenorrhea than non hormonal contraception.
Conclusion: There is clinical effect duration of postpartum amenorrhea and duration of breastfeeding between use of lynestrenol pill and levonorgestrel pill than non hormonal contraception. There is clinical effect duration of postpartum amenorrhea to breastfed quality and lactation.
INTISARI:
Latar Belakang: Metode Amenore Laktasi (MAL) penting dalam mengatur jarak kelahiran. Rendahnya cakupan ASI eksklusif di Indonesia (15.3%) terkait dengan kembalinya ovulasi lebih cepat dan durasi amenore postpartum lebih singkat, sehingga ibu postpartum perlu metode kontrasepsi lain yang aman selama menyusui. Progestin Only Pills (POP) merupakan pilihan yang tepat, disamping dapat memperpanjang amenore laktasi postpartum. Dengan demikian POP dalam bentuk generik lynestrenol dan levonorgestrel diharapkan dapat diproduksi di Indonesia dengan harga terjangkau dan menjadi program KB nasional.
Tujuan: Mengetahui pengaruh kontrasepsi pil lynestrenol dan LNG terhadap kualitas dan pemberian ASI serta durasi amenore pospartum. Metode: Jenis penelitian menggunakan mixed randomized clinical trial rancangan paralel. Subjek penelitian adalah ibu 6 minggu postpartum dan menyusui, usia 20-35 tahun, ingin KB pil dan tidak kontraindikasi pil. Besar sampel menggunakan logrank test median survival time dan incidence rate drop out antara KB hormonal dan non hormonal, dibagi 3 kelompok dengan sampel 107 responden. Subjek diikuti sampai 6 bulan ke depan, dievaluasi setiap bulannya. Analisis menggunakan Chi Square, Oneway Anova, Survival Analysis metode Kaplan-Meier, Log-rank test dan Cox proportional hazard model. Hasil: Penggunaan pil LNG HR=1.46(95%CI=0.67-3.18) dan pil lynestrenol HR=0.85(95%CI=0.37-1.97), status pemberian ASI HR=1.23(95%CI=0.66-2.31), kadar kasein HR=0.83(95%CI=0.38-1.82), laktosa HR=0.87(95%CI=0.66-1.15), lemak HR=0.80(95%CI=0.62-1.04) dan kalsium HR=1.0(95%CI=0.98-1.02) tidak memperpanjang durasi amenore postpartum dibanding non hormonal/IUD.
Kesimpulan: Ada perbedaan klinis durasi amenore postpartum dan durasi pemberian ASI saja antara pengguna pil LNG dan lynestrenol dibandingkan non hormonal/IUD. Ada perbedaan klinis durasi amenore postpartum berdasarkan kualitas dan pemberian ASI.
Electronic Theses
