Electronic Theses and Dissertation

Latar Belakang: Luaran persalinan merupakan salah satu indikator penting kesehatan maternal dan neonatal. Persalinan kurang bulan masih menjadi penyebab utama morbiditas dan mortalitas neonatal di dunia. Aktivasi inflamasi maternal diketahui berperan dalam proses persalinan dan dapat memengaruhi luaran kehamilan. Platelet-to-Lymphocyte Ratio (PLR) dan feritin merupakan biomarker inflamasi yang mudah diperoleh dan berpotensi digunakan untuk mengevaluasi kondisi inflamasi maternal yang berhubungan dengan luaran persalinan.
Tujuan: Mengetahui hubungan nilai Platelet-to-Lymphocyte Ratio (PLR) dan kadar feritin dengan luaran persalinan di RSUD dr. Zainoel Abidin Banda Aceh. Metode: Penelitian ini merupakan studi observasional analitik dengan desain cross-sectional. Penelitian dilakukan pada 66 ibu hamil yang memenuhi kriteria inklusi dan eksklusi. Data diperoleh dari rekam medis dan hasil pemeriksaan laboratorium. Analisis data dilakukan secara univariat, bivariat menggunakan regresi logistik, analisis Receiver Operating Characteristic (ROC) untuk menentukan nilai cut-off, serta analisis multivariat menggunakan regresi logistik. Besarnya hubungan dinyatakan dalam Odds Ratio (OR) dengan interval kepercayaan 95%.
Hasil: Nilai PLR berhubungan secara bermakna dengan luaran persalinan (OR=1,013; IK95%: 1,002–1,025; p=0,025). Analisis ROC menunjukkan nilai Area Under the Curve (AUC) sebesar 0,632 dengan nilai cut-off 134,4, sensitivitas 54,2%, dan spesifisitas 76,2%. Kadar feritin juga berhubungan secara bermakna dengan luaran persalinan (OR=1,016; IK95%: 1,002–1,031; p=0,029). Analisis ROC menunjukkan nilai AUC sebesar 0,645 dengan nilai cut-off 29,3 ng/mL, sensitivitas 79,2%, dan spesifisitas 54,8%. Analisis multivariat menunjukkan bahwa kadar feritin ≥29,3 ng/mL berhubungan dengan peningkatan risiko persalinan kurang bulan (OR=4,513; IK95%: 1,351–15,075; p=0,014), sedangkan PLR ≥134,4 berhubungan dengan peningkatan risiko persalinan kurang bulan sebesar 3,701 kali (OR=3,701; IK95%: 1,186–11,548; p=0,024).
Kesimpulan: Nilai PLR dan kadar feritin berhubungan secara bermakna dengan luaran persalinan. Kadar feritin menunjukkan kekuatan hubungan yang lebih besar dibandingkan PLR terhadap kejadian persalinan kurang bulan. Kedua biomarker berpotensi digunakan sebagai parameter tambahan dalam evaluasi kondisi inflamasi maternal yang berkaitan dengan luaran persalinan.
Kata kunci: PLR, feritin, luaran persalinan, biomarker inflamasi.

Background: Pregnancy outcomes are important indicators of maternal and neonatal health. Preterm birth remains one of the leading causes of neonatal morbidity and mortality worldwide. Maternal inflammatory processes play a crucial role in the initiation of labor and may influence pregnancy outcomes. Platelet-to-Lymphocyte Ratio (PLR) and feritin are readily available inflammatory biomarkers that may reflect maternal inflammatory status associated with adverse pregnancy outcomes. Objective: To determine the association between Platelet-to-Lymphocyte Ratio (PLR) and feritin levels with pregnancy outcomes at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods: This was an analytical observational study with a cross-sectional design. A total of 66 pregnant women who met the inclusion and exclusion criteria were enrolled. Data were obtained from medical records and laboratory examinations. Statistical analyses included univariate analysis, bivariate analysis using logistic regression, Receiver Operating Characteristic (ROC) curve analysis to determine optimal cut-off values, and multivariate logistic regression analysis. The strength of association was expressed as Odds Ratios (ORs) with 95% Confidence Intervals (CIs). Results: Platelet-to-Lymphocyte Ratio was significantly associated with pregnancy outcomes (OR=1.013; 95% CI: 1.002–1.025; p=0.025). ROC analysis demonstrated an Area Under the Curve (AUC) of 0.632, with an optimal cut-off value of 134.4, sensitivity of 54.2%, and specificity of 76.2%. Feritin levels were also significantly associated with pregnancy outcomes (OR=1.016; 95% CI: 1.002–1.031; p=0.029). ROC analysis showed an AUC of 0.645, with an optimal cut-off value of 29.3 ng/mL, sensitivity of 79.2%, and specificity of 54.8%. Multivariate analysis revealed that feritin levels ≥29.3 ng/mL were independently associated with an increased risk of preterm birth (OR=4.513; 95% CI: 1.351– 15.075; p=0.014), while PLR ≥134.4 was associated with a 3.701-fold increased risk of preterm birth (OR=3.701; 95% CI: 1.186–11.548; p=0.024). Conclusion: PLR and feritin levels were significantly associated with pregnancy outcomes. Feritin demonstrated a stronger association with preterm birth compared with PLR. Both biomarkers may serve as additional parameters in assessing maternal inflammatory status related to pregnancy outcomes. Keywords: Platelet-to-Lymphocyte Ratio, PLR, feritin, pregnancy outcomes, inflammation biomarker.