Electronic Theses and Dissertation

Latar Belakang : Kadar selenium serum yang rendah merupakan salah satu penyebab dari sindrom preeklampsia yang diakibatkan oleh enzim gluthation peroxidase tidak dapat bekerja secara optimal sehingga antioksidan secara efektif tidak dapat menekan stres oksidatif yang ada pada ibu hamil. Beberapa penelitian menunjukkan bahwa kadar selenium serum lebih rendah pada ibu hamil dengan preeklampsia dibandingkan kehamilan normal.
Metode : Penelitian ini menggunakan desain case-control dengan metode consecutive sampling yang melibatkan 80 ibu hamil trimester ketiga, terdiri dari 40 subjek preeklampsia dan 40 subjek kehamilan normal. Pemeriksaan kadar selenium serum dilakukan menggunakan metode Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Analisis data dilakukan dengan uji Mann-Whitney untuk perbandingan perbedaan rata-rata dan model prediksi preeklampsia dengan uji regresi logistik multivariat (metode enter).
Hasil : Kadar selenium pada kelompok preeklampsia secara signifikan lebih rendah dibanding kontrol (62,20 µg/L [24,12–387,11] vs. 111,80 µg/L [66,76–233,87]; dengan nilai p = 0,002). Analisis yang dilakukan berdasarkan karakteristik usia ibu hamil, jumlah paritas, status IMT serta usia kehamilan juga menunjukkan perbedaan bermakna (p < 0,05). Namun setelah dilakukan uji regresi logistik multivariat, didapatkan kadar selenium yang lebih rendah secara signifikan pada ibu dengan preeklampsia dibandingkan hamil normal pada trimester ketiga (adjusted OR = 175,5; 95% CI 9,02–3 415,3; p = 0,001), namun hanya berdasarkan karakteristik IMT (adjusted OR = 469,9; 95% CI 13,02–16 953,0; p = 0,001) dan karakteristik usia kehamilan ≤34 minggu (adjusted OR = 52,2; 95% CI 2,52–1 082,5; p = 0,011) yang memiliki perbedaan secara signifikan berdasarkan karakteristik ibu hamil.
Kesimpulan : Terdapat perbedaan yang signifikan antara kadar selenium serum ibu hamil dengan preeklampsia dan kehamilan normal pada trimester ketiga. Hasil ini mendukung peran selenium sebagai faktor protektif terhadap preeklampsia dan dapat menjadi dasar pertimbangan dalam upaya pencegahan dan intervensi gizi selama kehamilan.

Kata Kunci: Preeklampsia, Selenium, Kehamilan Trimester Ketiga, Antioksidan

Background : The lower serum selenium levels are one of the causes of preeclampsia syndrome which is caused by the glutathione peroxidase enzyme not being able to work optimally so that antioxidants cannot effectively suppress oxidative stress in pregnant women. Several studies have shown that serum selenium levels are lower in pregnant women with preeclampsia compared to those with normal pregnancies. Methods : This study employed a case-control design with consecutive sampling involving 80 third-trimester pregnant women, consisting of 40 with preeclampsia and 40 with normal pregnancies. Serum selenium levels were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Data analysis was performed using a Mann-Whitney test to compare mean values and a multivariate logistic regression model (enter method) was used to identify independent predictors of preeclampsia. Results : The serum selenium level in the preeclampsia group was significantly lower than in controls (62.20 µg/L [24.12–387.11] vs. 111.80 µg/L [66.76–233.87]; with a p-value = 0.002). Subgroup analyses by maternal age, parity, BMI category and gestational age also demonstrated statistically significant differences (all p < 0.05). In the multivariable analysis using logistic regresion, we found that the serum selenium levels were significantly lower in mothers with preeclampsia compared to normal pregnancies in the third trimester (adjusted OR = 175.5; 95% CI 9.02–3 415.3; p = 0.001), but only based on BMI characteristics (adjusted OR = 469.9; 95% CI 13.02–16 953.0; p = 0.001) and characteristics of gestational age ≤34 weeks (adjusted OR = 52.2; 95% CI 2.52–1 082.5; p = 0.011) which has significant differences based on the characteristics of pregnant women. Conclusion : There are a significant difference in serum selenium levels between third-trimester pregnant women with preeclampsia and those with normal pregnancies. These results support the role of selenium as a protective factor against preeclampsia and can be the basis for consideration in prevention efforts and nutritional interventions during pregnancy. Keywords: Preeclampsia, Selenium, Third Trimester Pregnancy, Antioxidant