Electronic Theses and Dissertation

Tumor necrosis factor alpha (TNF-α) merupakan sitokin pro-inflamasi yang berperan dalam regulasi respon imun dan apoptosis seluler selama kehamilan. Kadar TNF-α yang berlebihan telah dikaitkan dengan peningkatan risiko abortus akibat gangguan implantasi, disrupsi trofoblas, serta penurunan toleransi imun ibu terhadap janin. Penelitian ini merupakan studi kohort prospektif yang bertujuan menilai hubungan antara kadar TNF-α pada usia kehamilan trimester pertama dengan kejadian abortus. Sampel diambil dengan metode consecutive sampling di 4 fasilitas kesehatan primer di Kota Banda Aceh, melibatkan 41 subjek yang menjalani pemeriksaan dan ultrasonografi di Poli Kesehatan Ibu dan Anak (KIA). Pengukuran kadar TNF-α dilakukan melalui analisis sampel darah yang dikirim ke Laboratorium Prodia. Subjek kemudian diikuti hingga usia kehamilan lebih dari 20 minggu untuk menilai keberlanjutan kehamilan. Data dianalisis menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan sebanyak 16 subjek mengalami abortus pada trimester pertama (39,0%) sedangkan sebanyak 25 subjek berlanjut dengan kehamilan normal(61%). Analisis bivariat menunjukkan terdapat hubungan signifikan antara kadar TNF-α trimester pertama dengan kejadian abortus (p = 0,024). Hasil penelitian ini menunjukkan kadar median TNF-α pada kelompok ibu hamil yang mengalami abortus sebesar 1,249 (min-maks 0,675–4,799), sedangkan pada ibu dengan kehamilan berlanjut kadar mediannya sebesar 0,814 (min-maks 0,373–3,786). Kadar TNF-α pada kelompok abortus menunjukkan nilai lebih tinggi dibandingkan dengan ibu dengan kehamilan berlanjut. Mayoritas abortus terjadi pada usia kehamilan 10 minggu (37,5%). Hasil dari penelitian ini menunjukkan bahwa peningkatan kadar TNF-α berhubungan dengan peningkatan risiko abortus.

Tumor necrosis factor alpha (TNF-α) is a pro-inflammatory cytokine that regulates immune responses and cellular apoptosis during pregnancy. Elevated TNF-α levels have been associated with an increased risk of miscarriage due to implantation failure, trophoblast disruption, and reduced maternal immune tolerance toward the fetus. This prospective cohort study aimed to assess the relationship between TNF-α levels in the first trimester of pregnancy and the incidence of miscarriage. Samples were collected using a consecutive sampling method from 4 primary healthcare facilities in Banda Aceh, involving 41 subjects undergoing examinations and ultrasonography at maternal and child health clinics. TNF-α levels were measured through blood sample analysis at the Prodia Laboratory. Subjects were followed up until beyond 20 weeks of gestation to assess pregnancy continuation. Data were analyzed using the Mann-Whitney test. The results showed that a total of 16 subjects (39.0%) experienced miscarriage in the first trimester and 25 subjects continue with normal pregnancy. Bivariate analysis revealed a significant association between first-trimester TNF-α levels and miscarriage incidence (p = 0.024). The results of this study showed that the median level of TNF-α in pregnant women who experienced abortion was 1.249 (range: 0.675–4.799), while in women with ongoing pregnancies, the median level was 0.814 (range: 0.373–3.786). The TNF-α level in the abortion group was higher compared to that in women with ongoing pregnancies. Most cases occurred at 10 weeks of gestation (37.5%). This result indicates that an increase in TNF-α levels is associated with an elevated risk of abortion.