Obesitas dan Kadar Serum Tumor Necrosis Factor Alpha (TNF-?) Maternal yang Tinggi pada Ibu Hamil sebagai Faktor Risiko Terjadinya Persalinan Preterm
DOI:
https://doi.org/10.58344/locus.v5i7.5922Keywords:
Persalinan Preterm, Obesitas Maternal, TNF-?, Sitokin Proinflamasi, Faktor RisikoAbstract
Persalinan preterm merupakan kelahiran yang terjadi sebelum usia kehamilan 37 minggu dan menjadi penyebab utama morbiditas serta mortalitas neonatal secara global. Obesitas maternal dan peningkatan sitokin proinflamasi, khususnya Tumor Necrosis Factor Alpha (TNF-?), diduga berperan penting dalam patogenesis persalinan preterm. Penelitian ini bertujuan untuk membuktikan obesitas dan kadar TNF-? serum maternal yang tinggi sebagai faktor risiko independen terjadinya persalinan preterm. Penelitian analitik observasional dengan desain nested case-control study ini melibatkan 54 ibu hamil yang dibagi menjadi 27 kelompok kasus (persalinan preterm) dan 27 kelompok kontrol (hamil preterm tanpa persalinan). Kadar TNF-? serum diukur menggunakan metode ELISA. Analisis statistik dilakukan dengan uji chi-square dan regresi logistik multivariat. Hasil menunjukkan obesitas secara signifikan meningkatkan risiko persalinan preterm (OR 3,400; 95% CI 1,111–10,402; p=0,029). Kadar TNF-? tinggi (?82 ng/L) juga merupakan faktor risiko signifikan (OR 4,600; 95% CI 1,247–16,967; p=0,017). Pada analisis multivariat, TNF-? ?82 ng/L (OR 5,217; 95% CI 1,304–20,864; p=0,020) dan obesitas (OR 3,849; 95% CI 1,151–12,865; p=0,029) terbukti sebagai faktor risiko independen. Terdapat korelasi positif sangat kuat antara TNF-? dan obesitas (r=0,905; p<0,001). Disimpulkan bahwa obesitas dan kadar TNF-? maternal yang tinggi merupakan faktor risiko independen persalinan preterm dan memerlukan skrining rutin dalam pemantauan antenatal.
References
Chawanpaiboon, S., Vogel, J. P., Moller, A.-B., Lumbiganon, P., Petzold, M., Hogan, D., Landoulsi, S., Jampathong, N., Kongwattanakul, K., & Laopaiboon, M. (2019). Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. The Lancet Global Health, 7(1), e37–e46.
Cornish, R. P., et al. (2024). Maternal pre-pregnancy body mass index and risk of preterm birth: a collaboration using large routine health datasets. BMC Medicine, 22(1), 1–13. https://doi.org/10.1186/s12916-023-03230-w
Dai, F. F., Hu, M., Zhang, Y. W., Zhu, R. H., Chen, L. P., Li, Z. D., … Cheng, Y. X. (2022). TNF-?/anti-TNF-? drugs and its effect on pregnancy outcomes. Expert Reviews in Molecular Medicine, 24. https://doi.org/10.1017/ERM.2022.18
Damanik, A. T. B., et al. (2024). Kadar Tumor Necrosis Factor Alpha (TNF-?) serum maternal yang tinggi pada ibu hamil sebagai faktor risiko terjadinya persalinan preterm. Intisari Sains Medis, 15(2), 663–669. https://doi.org/10.15562/ism.v15i2.2030
Etil, T., et al. (2023). Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital. BMC Pregnancy and Childbirth, 23(1), 1–9. https://doi.org/10.1186/s12884-023-06163-7
Jafarzadeh, L., Danesh, A., Sadeghi, M., Heybati, F., & Hashemzadeh, M. (2013). Analysis of relationship between tumor necrosis factor alpha gene (G308A polymorphism) with preterm labor. International Journal of Preventive Medicine, 4(8), 896.
Khanna, D., et al. (2022). Obesity: A chronic low-grade inflammation and its markers. Cureus, 14(2). https://doi.org/10.7759/cureus.22711
Kementerian Kesehatan RI. (2018). Riset Kesehatan Dasar (RISKESDAS) 2018. Badan Penelitian dan Pengembangan Kesehatan.
Liu, K., Chen, Y., Tong, J., Yin, A., Wu, L., & Niu, J. (2022). Association of maternal obesity with preterm birth phenotype and mediation effects of gestational diabetes mellitus and preeclampsia. BMC Pregnancy and Childbirth, 22(1), 1–9. https://doi.org/10.1186/S12884-022-04780-2
Pendeloski, K. P. T., Ono, E., Torloni, M. R., Mattar, R., & Daher, S. (2017). Maternal obesity and inflammatory mediators: A controversial association. American Journal of Reproductive Immunology, 77(5). https://doi.org/10.1111/AJI.12674
Riva'i, S. B., et al. (2014). Role of nuclear factor kappa beta, tumor necrosis factor ?, and cyclooxygenase-2 in preterm labor. Medical Journal of Indonesia, 23(4), 213–217. https://doi.org/10.13181/mji.v23i4.1005
Romanowska-Próchnicka, K., Felis-Giemza, A., Olesi?ska, M., Wojdasiewicz, P., Paradowska-Gorycka, A., & Szukiewicz, D. (2021). The role of TNF-? and anti-TNF-? agents during preconception, pregnancy, and breastfeeding. International Journal of Molecular Sciences, 22(6), 1–22. https://doi.org/10.3390/IJMS22062922
Sobczyk, K., et al. (2022). Does maternal obesity affect preterm birth? Documentary cohort study of preterm in firstborns—Silesia (Poland). Children, 9(7), 1–10. https://doi.org/10.3390/children9071007
Su, X. J., et al. (2020). Prepregnancy overweight and obesity are associated with an increased risk of preterm birth in Chinese women. Obesity Facts, 13(2), 237–244. https://doi.org/10.1159/000506688
Sukma, H. A. D., & Tiwari, S. (2021). Risk factors for premature birth in Indonesia. Jurnal Biometrika dan Kependudukan, 10(1), 61–67. https://doi.org/10.20473/jbk.v10i1.2021.61-67
Sulistyowati, S., Zakia, Y., & Khasan, S. (2016). High MMP-9 and TNF-? expression increase in preterm premature rupture of membranes. Universa Medicina, 35(1), 33. https://doi.org/10.18051/univmed.2016.v35.33-39
Theron C. Gilliland, W. G. W. (2016). TNF-? as an adipokine. In Adipokines (pp. 119–127). CRC Press.
Umeigbo, B. C., et al. (2020). Outcomes of preterm labor and preterm births: A retrospective cross-sectional analytical study in a Nigerian single center population. Obstetrics and Gynecology Research, 3(1), 17–28. https://doi.org/10.26502/ogr031
Waldenström, U., et al. (2017). Short- and long-term effects of caesarean section on the mother: a population-based study. BJOG, 124(8), 1297–1305.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 I Made Aryasa Mugi Raharja, A.A. Gede Putra Wiradnyana , I Wayan Artana Putra
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
