Studies had shown that iron-cycling was disturbed by inflammatory process through the role of hepcidin. Pregnancy is characterized by shifts of interleukin. Our objective was to determine if 25(OH) vitamin D (colecalciferol) status was associated with ferritin, anemia, and its changes during pregnancy. Method. A cohort study was done in 4 cities in West Java, Indonesia, beginning in July 2016. Subjects were followed up until third trimester. Examinations included were maternal ferritin, colecalciferol, and haemoglobin level. Result. 191 (95.5%) subjects had low colecalciferol, and 151 (75.5%) among them were at deficient state. Anemia is found in 15 (7.5%) subjects, much lower than previous report. Proportion of anemia increased by trimester among women with colecalciferol deficiency. Ferritin status and prepregnancy body mass index in the first trimester were correlated with anemia (r = 0.147, p = 0.038 and r = −0.56, p = 0.03). Anemia in the second trimester was strongly correlated with anemia in the third trimester (r = 0.676, p < 0.01). Conclusion. Our study showed that the state of colecalciferol was not associated with either ferritin state or anemia, but proportion of anemia tends to increase by trimester in the colecalciferol deficient subjects.

Introduction The role of vitamin D in placental functions and fetal growth had been addressed in many reports with conflicting results. However, such report is limited for Indonesian population. The aim of this study was to explore the association between maternal vitamin D level in the first trimester and fetal biometry in the later stage of pregnancy with adjusted OR for other determinants like hemoglobin and ferritin level. Methods From July 2016 a prospective cohort study of pregnant women had begun in four cities in West Java, Indonesia. Data on maternal vitamin D, ferritin, hemoglobin level, maternal demography and fetal biometry were analyzed with linear regression. Results Among 203 recruited women, 195 (96.06%) had hypovitaminosis D. One hundred fifty two (75%) were in deficient state and 43 women (21%) were in insufficient state. Women with insufficient vitamin D had the highest proportion of anemia, while women with normal vitamin D level had the highest proportion of low ferritin level. Maternal serum vitamin D showed significant associations with biparietal diameter (β = 0.141, p = 0.042) and abdominal circumference (β = 0.819, p = 0.001) after adjustment with maternal age, pre-pregnancy body mass index, parity, serum ferritin level, and hemoglobin level. Conclusion Our study suggested that sufficient maternal vitamin D level was an important factor to improve fetal growth and development.

Probiotic bacteria will improve of immune deviation in infants born by cesarean delivery. A new effector T Cell subset that produces IL-17 has been identified. IL-23 promotes the expansion of antigen primed Th17 cells. The aim of this study is to find out the difference of IL-23 in breastfed infants born by cesarean delivery given probiotic formula and non probiotic Formula. Randomized open label clinical trial was performed on 96 healthy breastfed infants, birthweight ≥ 2500 g, born by cesarean delivery in Hasan Sadikin General Hospital Bandung. Fourty eight infants were breastfed combined with probiotic formula and 48 infants as control group. Daily notes were taken on duration of breastfeeding, the amount of milk formula given and any diseases up to fourth weeks. Plasma Il-23, determined by enzyme immunoassay technique at the fourth weeks of life. The duration of daily breastfeeding was not significantly different in both groups (p>0,05). None of the infants got ill during follow-up. The mean of IL-23 in group breasfeeding with probiotic and non probiotic formula were 1.59 (0,23) and 1.50 (0.29). It was significantly different (p< 0,05). Conclusion of this study: Il-23 was significantly different between infants receiving breastmilk with probiotic formula and non probiotic formula.

Background: Neonatal hyperbilirubinemia or neonatal jaundice is a common disorder and considered as one of the main problems in neonatal period worldwide with high incidence, especially in Asia and Southeast Asia region. This study was conducted to determine the characteristics of neonatal hyperbilirubinemia including the prevalence and frequency of neonatal hyperbilirubinemia causes at Dr. Hasan Sadikin General Hospital in 2012. Methods: This descriptive study was conducted at Dr. Hasan Sadikin General Hospital using the crosssectional method. Four hundred and twenty five cases of neonatal hyperbilirubinemia in hospitalized and outpatients, from 1 January to 31 December 2012 were included in this descriptive study. Results: The prevalence of neonatal hyperbilirubinemia was about 4.08%. Causes were identified in 95 cases and the most common cause of neonatal hyperbilirubinemia during this period of time was physiological causes (23.2%). Other causes included neonatal hepatitis (14.7%), other hemolytic causes (13.7%), infection (12.6%), ABO incompatibility (11.6%) and breastfeeding (11.6%). Conclusions: Neonatal hyperbilirubinemia cases are common and remain as one of the neonatal problems in Dr. Hasan Sadikin General Hospital, thus prevention and proper management of neonatal hyperbilirubinemia should be implemented.

Background The assesment of severity of illness with scoringsystem has been used to predict neonatal mortality in neonatalintensive care unit (NICU). Score for Neonatal Acute PhysiologyPerinatal Extension II (SNAPPE II) is the best scoring systemalthough most of the studies were commonly conducted indeveloped countries.Objective To evaluate SNAPPE II as the predictor of neonatalmortality in NICU Hasan Sadikin General Hospital (HSGH)Ban dung.Methods This was a longitudinal observational study. All neonateshospitalized in NICU HSGH during the period of August toNovember 2008 were investigated according to SNAPPE IIrequirements. We excluded subjects admitted more than 48hours of age, who were discharged or moved to intermediatenewborn care ward less than 24 hours after admission. Predictionof mortality and determination of SNAPPE II cut-off point wereanalyzed using logistic regression. Discrimination was analyzedusing receiver operating characteristic (ROC) and calibration wasanalyzed using Hosmer-Lemeshow goodness-of-fit.Results Forty subjects fulfilled the inclusion criteria. There was agood relation between SNAPPE II and mortality prediction (P =0.007). The cut-off point for predicting mortality was 51. SNAPPEII showed good discrimination with AUC 0.933 (95% CI 0.843to 1.0) and good calibration 1.69 (P = 0.97).Conclusion SNAPPE II can be used to predict neonatal mortalityin NICU similar to that found in developed countries.

Sepsis is a life-threatening disease with a high number of mortality in premature infants. Premature infants have immature immune systems, with less pool neutrophils and imperfect ability to destroy pathogen. Neutrophil function is supported by lymphocyte's ability to form antibody or specific cell-surface receptors for particular antigens. This underlies the use of neutrophil-to-lymphocyte ratio (NLR) as an inflammation marker to detect and assess the severity of sepsis. C-reactive protein (CRP) is known as an acute phase reactant. Neutrophil-tolymphocyte ratio is an easier, fast, and inexpensive method when compared to CRP. The aim of this study was to evaluate the correlation between NLR and CRP in detecting early-onset sepsis (EOS) in premature infants. A cross-sectional study was conducted on 53 premature infants born and hospitalized in a hospital in Indonesia who were recruited during the period of April to October 2018. Blood was sampled from the umbilical cord at birth for laboratory examination. The NLR was determined as the ratio of neutrophil to lymphocyte count. The Tollner scoring system was used to identify sepsis. Mann Whitney-U test and Spearman Correlation test were computed for the statistical analysis. neutrophil-to-lymphocyte ratio which results showed a strong positive correlation with CRP (r=0.702, 0=0.001) in premature infants with EOS. Leukocyte count was lower in infants with EOS than those without EOS group (median; IQR, x10 3 : 8.9 (6.3-13.8) vs 12.5 (10.1-16.1); p=0.016). Neutrophil-to-lymphocyte ratio and CRP tended to be lower in EOS group when compared to that of the non-EOS group. In conclusion, NLR has a strong positive correlation with CRP in premature infants with EOS. Korelasi Positif Kuat antara Neutrophil-to-lymphocyte dan C-reactive Protein pada Sepsis Awitan DiniAbstrak Sepsis pada bayi prematur adalah keadaan mengancam jiwa dengan mortalitas tinggi. Bayi prematur memiliki sistem imun imatur, sedikit persediaan neutrofil serta fungsi belum sempurna untuk melawan patogen. Fungsi neutrofil didukung limfosit membuat antibodi serta reseptor permukaan spesifik untuk antigen tertentu. Neutrophil-to-lymphocyte ratio (NLR) diajukan untuk petanda inflamasi, mendeteksi dan menentukan derajat sepsis, sedangkan C-reactive protein (CRP) telah diketahui sebagai protein fase akut. Neutrophil-to-lymphocyte ratio adalah pemeriksaan yang lebih mudah, cepat, murah dibanding dengan CRP. Penelitian potong lintang ini bertujuan mengevaluasi korelasi NLR dengan CRP untuk mendeteksi sepsis awitan dini pada 53 bayi prematur, yang lahir dan dirawat di rumah sakit kami, selama April-Oktober 2018. Sampel darah dari tali pusat pada saat lahir. Neutrophil-to-lymphocyte ratio adalah rasio jumlah neutrofil terhadap limfosit. Skoring Tollner digunakan untuk mengidentifikasi sepsis. Analisis statistik menggunakan Uji Mann-Whitney dan korelasi Spearman. Korelasi positif antara NLR dengan CRP di antara bayi prematur dengan sepsis awitan dini adalah r=0,702, p=0,001. Bayi dengan sepsis awitan dini memiliki ju...

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