Pengaruh Riwayat Kesehatan Reproduksi terhadap Kejadian Mioma Uteri pada Perempuan di Perkotaan Indonesia
Abstract
Uterine myoma is a reproductive health problem that causes serious morbidity and can affect the quality of life of suff erers. Many factors cause uterine myoma. This study aims to analyze the factors related to reproductive health history that can influence the occurrence of uterine myoma in women in urban Indonesia. This study is a non-intervention analysis which is a further analysis of the 2016 PTM Research results. The 2016 PTM research design is cross-sectional. The population is all women aged 25-64 years in urban Indonesia. Data collection was carried out by interview. In this paper, the data analyzed were respondent characteristics, reproductive health history and the incidence of uterine myomas. Data were analyzed univariate, bivariate, and multivariate. The results showed that the age of menarche and parity did not aff ect the incidence of uterine myoma (p= 0.861 and p= 0.424). Meanwhile, giving birth to a child for the fi rst time under the age of 30 reduced the risk by 48% (95% CI: 0.439-0.607). Having children 1-2 has a risk of 1.3 times greater than those who have more than 2 children (95% CI: 1.126-1.463). Use of contraceptives decreases risk by 30% (95% CI: 0.613-0808). The use of hormonal drugs for infertility treatment increases the risk 3.2 times greater (95% CI: 2.562-4.013). Women who did not use hormone replacement therapy were reduced by around 74% (95% CI: 0.114-0.608). The incidence of uterine myoma is influenced by the age of fi rst birth, number of children, use of contraceptives, use of hormonal drugs for infertility treatment, and hormone replacement therapy drugs. Health promotion is needed so that risk factors that can be prevented/modifi ed can be minimized to reduce the chance of developing uterine myoma.
Abstrak
Mioma uteri merupakan masalah kesehatan reproduksi yang menyebabkan morbiditas yang cukup serius serta dapat mempengaruhi kualitas hidup penderitanya. Banyak faktor yang menjadi penyebab mioma uteri. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang terkait riwayat kesehatan reproduksi yang dapat mempengaruhi terjadinya mioma uteri pada perempuan di perkotaan Indonesia. Penelitian ini adalah analisis non-intervensi yang merupakan analisis lanjut dari data hasil riset PTM 2016. Desain riset PTM 2016 adalah potong lintang dengan populasi seluruh perempuan usia 25–64 tahun di perkotaan Indonesia. Pengumpulan data dilakukan dengan wawancara. Dalam tulisan ini, data yang dianalisis adalah karakteristik responden, riwayat kesehatan reproduksi serta kejadian mioma uteri. Data dianalisis secara univariat, bivariat, dan multivariat. Hasil menunjukkan umur menarche dan paritas tidak berpengaruh terhadap kejadian mioma uteri (p= 0,861 dan p= 0,424). Sementara itu, melahirkan anak pertama kali di bawah umur 30 tahun menurunkan risiko sebesar 48% (95%CI: 0,439–0,607). Memiliki anak 1–2 memiliki risiko 1,3 kali lebih besar dibandingkan dengan yang memiliki anak lebih dari 2 (95%CI: 1,126–1,463). Penggunaan alat kontrasepsi menurunkan risiko sebesar 30% (95%CI: 0,613–0,808). Penggunaan obat-obatan hormonal pengobatan infertilitas meningkatkan risiko 3,2 kali lebih besar (95%CI: 2,562–4,013). Perempuan yang tidak menggunakan obat-obatan terapi sulih hormon risikonya berkurang sekitar 74% (95%CI: 0,114–0,608). Kejadian mioma uteri dipengaruhi oleh umur pertama kali melahirkan, jumlah anak, penggunaan alat kontrasepsi, penggunaan obat-obatan hormonal pengobatan infertilitas, dan obat-obatan terapi sulih hormon. Diperlukan promosi kesehatan sehingga faktor risiko yang dapat dicegah/dimodifi kasi dapat diminimalkan untuk mengurangi peluang terkena mioma uteri.
References
Aleksandrovych, V., Bereza, T., Sajewicz, M., Walocha, J.A., Gil, K., 2015. Uterine Fibroid: Common Features Of Widespread Tumor. Folia Med. Cracov. LV (1), 61–75.
Badan Pusat Statistik, 2014. Persentase Penduduk Daerah Perkotaan menurut Provinsi, 2010-2035 [WWW Document]. URL https://www.bps.go.id/ statictable/2014/02/18/1276/persentase-pendudukdaerah-perkotaan-menurut-provinsi-2010-2035.html (accessed 6.13.20).
Borah, B.J., Nicholson, W.K., Bradley, L., Stewart, E.A., 2013. The Impact of Uterine Leiomyomas: A National Survey of Aff ected Women. Am J Obstet Gynecol 209 (4), 1–28. https://doi.org/10.1016/j.ajog.2013.07.017
Chiaffarino, F., Cipriani, S., Ricci, E., La Vecchia, C., Chiantera, V., Bulfoni, A., Parazzini, F., 2017. Alcohol Consumption And Risk Of Uterine Myoma: A Systematic Review And Meta Analysis. Plos One 12 (11), 1–11. https://doi.org/10.1371/journal. pone.0188355
Ciavattini, A., Di Giuseppe, J., Stortoni, P., Montik, N., Giannubilo, S.R., Litta, P., Islam, Md.S., Tranquilli, A.L., Reis, F.M., Ciarmela, P., 2013. Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction. Obstet. Gynecol. Int. 1–11. http://dx.doi.org/10.1155/2013/173184
Delli Carpini, G., Verdecchia, V., Papiccio, M., Grelloni, C., Ciavattini, A., 2019. Comparison of uterine fi broids’ growth pattern during pregnancy according to fetal sex: an observational study. Biol. Sex Diff er. 10, 53. https://doi.org/10.1186/s13293-019-0266-2
Donnez, J., Dolmans, M.-M., 2016. Uterine fibroid management: from the present to the future. Hum. Reprod. Update 22, 665–686. https://doi.org/10.1093/ humupd/dmw023
El Balat, A., DeWilde, R.L., Iryna, S., Tahmasbi-Rad, M., Bogdanyova, S., Fathi, A., Becker, S., 2018. Modern Myoma Treatment in the Last 20 Years: A Review of the Literature. BioMed Res. Int. 1–6. https://doi. org/10.1155/2018/4593875
Fahrunniza, N., Astutik, H., Praptono, M.G.H., 2015. Kejadian Mioma Uteri Pada Akseptor Hormonal. J. Inf. Kesehat. Indones. 1 (1), 69–75.
Ghosh, S., Naftalin, J., Imrie, R., Hoo, W.-L., 2018. Natural History of Uterine Fibroids: A Radiological Perspective. Curr. Obstet. Gynecol. Rep. 7, 117–121. https://doi. org/10.1007/s13669-018-0243-5
Gurusamy, K.S., Vaughan, J., Faserr, I.S., Best, L.M.J., Richard, T., 2016. Medical Therapies for Uterine Fibroids – A Systematic Review and Network Meta Analysis of Randomised Controlled Trials KurinchiS. 1, Jessica1, IanS.Fraser2,3, LawrenceM.J.Best1, TobyRichards1*. Plos One 11 (2), 1–20. https://doi. org/DOI:10.1371/journal.pone.0149631.
Heertum, K.V., Barmat, L., 2014. Uterine Fibroids Associated with Infertility. Women Health 10 (6), 645–653. https:// doi.org/10.2217/WHE.14.27.
Khan, A.T., Shehmar, M., Gupta, J.K., 2014. Uterine fi broids: current perspectives. Int. J. Womens Health 6, 95– 114. https://doi.org/10.2147/IJWH.S51083.
Knudsen, N.I., Wernecke, K.-D., Siedentopf, F., David, M., 2017. Fears and Concerns of Patients with Uterine Fibroids – a Survey of 807 Women. Geburtshilfe Frauenheilkd. 77 (9), 976–983. https:// doi.org/10.1055/s-0043-118132.
Lewis, T.D., Malik, M., Britten, J., San Pablo, A.M., Catherino, W.H., 2018. A Comprehensive Review of the Pharmacologic Management of Uterine Leiomyoma. BioMed Res. Int. 2018. https://doi. org/10.1155/2018/2414609.
McWilliams, M.M., Chennathukuzhi, V.M., 2017. Recent Advances in Uterine Fibroid Etiology. Semin. Reprod. Med. 35, 181. https://doi.org/10.1055/s0037-1599090.
Oktarina, A., Abadi, A., Bachsin, R., 2014. Faktor-faktor yang Memengaruhi Infertilitas pada Wanita di Klinik Fertilitas Endokrinologi Reproduksi. Maj. Kedokt. Sriwij. 46 (4), 295–300.
Pritts, E.A., Vanness, D.J., Berek, J.S., Parker, W., Feinberg, R., Feinberg, J., Olive, D.L., 2015. The Prevalence Of Occult Leiomyosarcoma At Surgery For Presumed Uterine Fibroids: A Meta-Analysis. Gynecol Surg 12, 165–177. http://dx.doi.org/10.1007/s10397-0150894-4.
Rudiyanti, N., Imron, R., 2016. Hubungan Usia Menarche Dan Parittas Dengan Mioma Uteri. J. Keperawatan 12 (2), 233–239.
Sarais, V., Cermisoni, G.C., Schimberni, M., Alteri, A., Papaleo, E., Somigliana, E., Vigano’, P., 2017. Human Chorionic Gonadotrophin as a Possible Mediator of Leiomyoma Growth during Pregnancy: Molecular Mechanisms. Int. J. Mol. Sci. 18. https:// doi.org/10.3390/ijms18092014.
Sommer, E.M., Balkwill, A., Reeves, G., Green, J., Beral, D.V., Coffey, K., 2015. Effects of obesity and hormone therapy on surgically-confi rmed fi broids in postmenopausal women. Eur. J. Epidemiol. 30, 493– 499. https://doi.org/10.1007/s10654-015-0016-7.
Sparic, R., Mirkovic, L., Malvasi, A., Tinelli, A., 2016. Epidemiology of Uterine Myomas: A Review. Int. J. Fertil. Steril. 9 (4), 424–435.
Stewart, E.A., Cookson, C.L., Gandolfo, R.A., SchulzeRath, R., 2017. Epidemiology Of Uterine Fibroids: A Systematic Review. BJOG Int. J. Obstet. Gynaecol. 124 (10), 1501–1512. https://doi.org/10.1111/14710528.14640.
Stewart, E.A., Nicholson, W.K., Bradley, L., Borah, B.J., 2013. The Burden of Uterine Fibroids for AfricanAmerican Women:Results of a National Survey. J. Womens Health 22 (10), 807–816. https://doi. org/10.1089/jwh.2013.4334.
Surya, E., Muzakkar, M., 2017. Mioma Servikal. Cermin Dunia Kedokt. 118–120. Wise, L.A., Laughlin-Tommaso, S.K., 2016. Epidemiology of Uterine Fibroids – From Menarche to Menopause. Clin Obstet Gynecol 59 (1), 2–24. https://doi.org/10.1097/ GRF.0000000000000164.
Wise, L.A., Palmer, J.R., Rosenberg, L., 2015. Depressive Symptoms and Risk of Uterine Leiomyomata. Am. J. Obstet Gynecol 212 (5), 1–19. https://doi. org/10.1016/j.ajog.2014.12.012.
Zimmermann, A., Bernuit, D., Gerlinger, C., Schaefers, M., Geppert, K., 2012. Prevalence, Symptoms And Management Of Uterine Fibroids: An International Internet-Based Survey Of 21,746 Women. BioMed Cent. 12 (6), 1–11. https://doi.org/10.1186/14726874-12-6.
