Electronic Theses and Dissertation

Latar Belakang : Abortus merupakan berakhirnya kehamilan sebelum usia 20 minggu dengan prevalensi sekitar 10–20% dari seluruh kehamilan yang terdeteksi secara klinis di dunia, termasuk ±15% di Indonesia. Ketidakseimbangan imunologis dan inflamasi sistemik berperan dalam gangguan implantasi dan perkembangan plasenta. Parameter inflamasi sistemik seperti Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), dan Systemic Inflammatory Response Index (SIRI) berpotensi sebagai biomarker non-invasif. Zink sebagai mikronutrien esensial juga berperan dalam fungsi imun dan perkembangan janin.
Metode : Penelitian analitik observasional dengan desain kasus-kontrol ini dilakukan di RSUD dr. Zainoel Abidin Banda Aceh pada Mei–November 2025. Subjek berjumlah 88 orang, terdiri atas 44 pasien abortus dan 44 kehamilan normal trimester pertama. Data meliputi NLR, PLR, SII, SIRI, dan kadar zink. Analisis menggunakan uji Mann–Whitney atau uji t independen sesuai distribusi data serta regresi logistik multivariat.
Hasil : Nilai NLR, SII, dan SIRI secara signifikan lebih tinggi pada kelompok abortus dibandingkan kehamilan normal (p < 0,05). Rerata PLR dan kadar zink lebih tinggi pada kelompok abortus, namun tidak berbeda bermakna (p > 0,05). Analisis multivariat menunjukkan NLR memiliki asosiasi terkuat (OR = 12,31), dan SII (OR = 1,98).
Kesimpulan : NLR, SII, dan SIRI berpotensi sebagai biomarker untuk mengidentifikasi risiko abortus pada trimester pertama, sedangkan PLR dan kadar zink tidak menunjukkan perbedaan bermakna. NLR merupakan parameter dengan kekuatan asosiasi paling tinggi.

Kata kunci : Abortus, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, Systemic Immune-inflammation Index, Systemic Inflammatory Response Index, kadar Zink.

Background: Abortion, defined as pregnancy loss before 20 weeks of gestation, occurs in 10–20% of clinically recognized pregnancies worldwide, including approximately 15% in Indonesia. Dysregulated immune responses and excessive systemic inflammation are key contributors to impaired implantation and abnormal placentation. Systemic inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) have been proposed as non-invasive predictors of adverse pregnancy outcomes. Zinc, an essential micronutrient, also plays a critical role in immune regulation and fetal development. Methods: This analytical observational case–control study was conducted at Dr. Zainoel Abidin General Hospital, Banda Aceh, from May to November 2025. A total of 88 participants were included, comprising 44 women with abortion and 44 with normal first-trimester pregnancies. Data on NLR, PLR, SII, SIRI, and zinc levels were collected and analyzed using the independent t-test or Mann–Whitney U test based on data distribution. Multivariate analysis was also performed. Results: NLR, SII, and SIRI were significantly higher in the abortion group compared to the normal pregnancy group (p < 0.05). Although PLR and zinc levels were higher in the abortion group, these differences were not statistically significant (p > 0.05). Multivariate analysis showed that NLR had the strongest association with abortion (OR = 12,31) and followed by SII (OR = 1,98). Conclusion: NLR, SII, and SIRI may serve as useful biomarkers for identifying the risk of abortion in early pregnancy, whereas PLR and zinc levels showed no significant association. NLR demonstrated the strongest predictive value. Keywords: Abortion, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, Systemic Immune-Inflammation Index, Systemic Inflammatory Response Index, Zinc.