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1/JANUARI/2011
ABSTRACT
Background. Maternal age is the main known risk factor of Down syndrome. Recently some researchers
have suggested that there may be certain environmental factors that increase the risk of the
condition. This study aimed to estimate the association of Down syndrome and maternal age while
controlling for maternal education, family income and environmental factors.
Methods. This study was analytic-observational using case control approach. It was conducted at a
special school for children with disability in Surakarta. A sample of 20 mothers of children with Down
Syndrome and 40 mothers of normal children, was selected by fixed-disease sampling. The relationship
between maternal age and the risk of Down syndrome while controlling for maternal education,
family income, and environmental factor, was analyzed using multiple logistic logistic regression.
Odds ratio was used to measure the association of variables.
Results. Mean maternal age (year) at birth of Down syndrome children (37.82) was higher than that of
normal children (28.60), and it was statistically significant. After controlling for maternal education,
family income and living environmental factor, mothers aged 35 years or older had 12 times as many
risk of Down syndrome as those aged less than 35 years, and it was statistically significant (OR= 12.10;
95%CI 2.96 to 49.22). Evidence from this study did not support the relationship between maternal
education, family income, and the risk of Down syndrome. Living in an unhealthy environment increases
the risk of Down syndrome 2.5 times as many than living in a healthy environment, although this
relationship was not statistically significant with the available sample size of 60 subjects (OR= 2.34;
95%CI 0.44 to 15.28).
Conclusion. There is a very strong relationship between maternal age at birth and the risk of delivering
children with Down syndrome, even after controlling for some potential confounding factors.
Environmental factor seems to play a role in the incidence of this condition, but further studies are
needed with larger sample size.
Key words: Down syndrome, maternal age, maternal education, family income, environmental factor
PENDAHULUAN
Sindroma Down merupakan suatu cacat pada anak
yang paling sering terjadi di dunia, disebabkan karena
kelainan kromosom. Diperkirakan insidensinya 1.01.2 per 1000 kelahiran hidup (Soetjiningsih, 1995).
Kothare et al. (2002) melaporkan angka kejadian
sindroma Down sekitar 1 dari 650-1000 kelahiran
hidup. Kurang lebih 4.000 anak dilahirkan dengan
sindroma Down setiap tahunnya di Amerika, atau
sekitar 1 dari 800-1000 kelahiran hidup (Idris, 2006;
Nicolaidis, 1998). Sindroma Down merupakan
masalah kesehatan masyarakat yang penting. Di In-
96
Tabel 2 menunjukkan, tingkat pendidikan ibu paling banyak adalah SD dan SMA, masing-masing 18
orang (30%).
Tabel 2. Karakteristik sampel menurut pendidikan ibu
Tingkat Pendidikan
Tidak Sekolah
SD
SMP
SMA
D3/PT
Total
98
n
2
18
10
18
12
60
%
3.30
30.00
16.70
30.00
20.00
100.00
n
16
44
60
%
26.70
73.30
100.00
n
40
20
Mean
28.60
37.82
SD
6.71
5.94
t
5.22
p
< 0.001
CI 95%
Batas Batas
Bawah Atas
OR
1.0 0
12.10
<0.001
2.96
49.22
1.0 0
1.0 1
0.972
0.24
4.9 5
1.0 0
1.0 2
0.965
0.22
5.9 0
1.0 0
2.3 4
0.381
0.44
15.28
100
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Lembaga Penyelidikan Ekonomi dan Masyarakat
Fakultas Ekonomi Universitas Indonesia (LPEM
101