THE ASSOCIATION BETWEEN MATERNAL AGE AND GRAVIDITY AND THE

EVENT OF GRAVIDARUM EMESIS IN KUPANG, EAST NUSA TENGGARA

Dina Melanieka Sintikhe Henukh, Siti Nur Asyah.Jamillah Ahmad

Study Program of Midwifery, Universitas Citra Bangsa

ABSTRACT

Background: Emesis gravidarum or better known as morning sickness is a symptom of nausea

which is usually accompanied by vomiting which generally occurs in early pregnancy, usually in
the first trimester. This condition is generally experienced by more than half of pregnant women
due to hormonal changes. This study aimed to analyze the association between maternal age and
gravidity and the event of gravidarum emesis in Kupang, East Nusa Tenggara.
Subjects and Method: This was a cross-sectional study conducted at the Tenau Auxiliary
Community Health Center, Kupang City, East Nusa Tenggara, from February to June 2019. Total
of 60 pregnant women were enrolled in this study. The independent variables were maternal age
and gravidity. The dependent variable was emesis gravidarum. The data were collected using a
questionnaire and analyzed using the Chi-Square.
Results: Total of 68.3% of pregnant women were experienced emesis. 92.7% aged 20-35 years
and 7.3% aged <20 years. 84.2% of pregnant women did not experience emesis aged 20-35 years
and aged> 35 years were 15.8%. Most of the pregnant women who experienced emesis were
primigravida (51.2%) and multigravidas (48.8%). 84.2% of mothers did not experience
multigravida emesis and did not experience primigravida emesis (15.8%), and they were statis-
tically significant.
Conclusion: Maternal age and gravidity are positively related to the incidence of emesis gravi-
darum among pregnant women.

Keywords: age, gravidity, emesis gravidarum

Correspondence:
Dina Melanieka Sintikhe Henukh. Study Program of Midwifery, Universitas Citra Bangsa, Kupang,
East Nusa Tenggara. Jl. Bhakti Warga 34, East Nusa Tenggara. Email: [email protected].
Mobile +6285238629495

BACKGROUND usually accompanied by vomiting, generally

Pregnancy is a process natural and normal. occurs in early pregnancy, usually in the first
However, during pregnancy, the mother ex- trimester. This condition is generally experi-
periences many changes both physically and enced by more than half of pregnant women
psychologically. These changes will usually due to increased levels of the hormone estro-
cause various complaints and discomfort du- gen. These symptoms usually appear in the
ring pregnancy. These complaints and dis- morning with a frequency that will decrease
comforts can point to problems that may ac- every day, often with increasing gestational
company pregnancy and lead to complicati- age (Irmawati, 2016). Factors that influence
ons if not given proper care. One of the dis- emesis gravidarum apart from being caused
comforts that some pregnant women often by hormonal changes are habits, psychologi-
experience is emesis gravidarum. cal, diet, history of emesis and parity (Pujiati,
Emesis gravidarum or better known as 2018).
morning sickness, it is a symptom of nausea Nausea and vomiting among pregnancy

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usually start at 9 to 10 weeks of pregnancy, complications than women who are pregnant
worsens at 11 to 13 weeks and ends at 12 to 14 under or above the reproductive age (Marmi,
weeks. Only in 1-10% of pregnancies do sym- 2014). According to Rochjati (2003), age <20
ptoms continue past the 20th to 22nd week. years and age> 35 years are one of the high-
In 0.3-2% of pregnancies, there is hypereme- risk pregnancy factors.
sis gravidarum, which causes the mother to Gravidity is the total number of preg-
be managed in a hospital setting (Gunawan, nancies that have been experienced, regard-
2011). less of gestational age. Gravida is a woman
Most of the emesis gravidarum can be who is pregnant, primigravida is a woman
treated with outpatient treatment, as well as who is pregnant for the first time, secundi-
sedation and anti-vomiting. But a small pro- gravida is a woman who is pregnant for the
portion of pregnant women are unable to second time, multigravida is a woman who is
cope with ongoing nausea and vomiting, pregnant for more than the second time
which interferes with daily life and leads to (Oxorn, 2010).
lack of fluids and disturbed electrolyte balan-
ce. Excessive vomiting causes body fluids to SUBJECTS AND METHOD
decrease so that the blood becomes thick (he- 1. Study Design
moconcentration) which can slow blood cir- This was a cross sectional study conducted at
culation which means that the consumption the Tenau Auxiliary Community Health Cen-
of O2 and food to the tissues is reduced. Lack ter, Kupang City, East Nusa Tenggara, from
of food and O2 to the tissues will cause tissue February to June 2019.
damage which can increase the weight of the 2. Population and Sample
fetus and pregnant women. Although vomit- The population in this study were all preg-
ing in the form of hyperemesis gravidarum is nant women at the Tenau Auxiliary Commu-
not common, its handling requires serious at- nity Health Center, Kupang City. The samp-
tention (Manuaba, 1998). ling technique used was accidental sampling
Nausea and vomiting occur in 80-60% with a sample size of 60 pregnant women.
of pregnant women, 1 in 1000 pregnancies, 3. Study Variables
these symptoms become more severe (Wikn- The independent variables in this study were
josastro, 2007). Based on data from the the age and gravidity of the mother. The de-
Tenau Helper Health Center, the number of pendent variable in this study was emesis
pregnant women during February-June, out gravidarum
of 153 pregnant women, there were 82 who 4. Study Instruments
experienced emesis gravidarum, and 2 cases This study using questionnaire as the study
became hyperemesis gravidarum (KIA Pustu instrument.
Tenau Report, 2019). 5. Data Analysis Data
Based on the description above, the analysis used is univariate analysis and
authors intend to conduct Study that aims to: bivariate analysis using chi- squares with the
1) Analyze the relationship between maternal help of IBM SPSS Statistics 20
age and the incidence of emesis gravidarum
2) To analyze the relationship between gravi- RESULTS.
dity and the incidence of emesis gravidarum.
1. Characteristics of Study Subjects
A person's age can affect their pregnan-
Characteristics of respondents can be seen
cy. If a woman is pregnant during the repro-
from the frequency distribution of respon-
ductive period, it is less likely to experience
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dents based on the incidence of emesis, age and gravidity.

Table 1. Study subjects’ characteristics

Variable n %
Age
<20 years 3 5.0
20-35 years 54 90.0
> 35 years 3 5.0
Gravidity
Primigravida 24 40.0
Multigravida 36 60.0
Incidence
No emesis 19 31.7
Emesis 41 68.3

Table 1 shows that most of the respondents nant women who experienced emesis. Most
aged 20-35 years were 54 people (90.0%), of the mothers who experienced emesis were
most of the respondents were multigravidas mothers aged 20-35 years 92.7% (38 people)
who had been pregnant more than 1 time, as and those aged <20 years as much as 7.3% (3
many as 36 people (60.0%), and most of the people) and none of them aged> 35 years
respondents at the Tenau Auxiliary Commu- experienced emesis gravidarum. emesis as
nity Health Center experienced emesis du- many as 19 people. Most of the pregnant wo-
ring their pregnancy, namely 41 people men who did not experience emesis were at
(68.3%). the vulnerable age of 20-35 years, 84.2% (16
2. Bivariate Analysis people) and aged> 35 years were 15.8% (3
Table 2 shows the results of the bivariate people). The results of statistical tests show
analysis of the relationship between indepen- that there is a significant relationship bet-
dent and dependent variables. The results of ween the age of pregnant women and the
the analysis showed that there were 41 preg- incidence of emesis seen from p= 0.019.

Table 2. Bivariate Analysis Relationship between Age and Incidence of Emesis Gravidarum
Emesis Gravidarum P
No Emesis Emesis
Age <20 years 0 3 0.019
20-35 years 16 38
> 35 years 3 0

Table 3. Bivariate Analysis Gravidity Relations and Events Emesis Gravidarum

Emesis Gravidarum P
No Emesis Emesis
Gravidity primigravidae 3 21 0009
multigravida 16 20

Table 2 shows the results of the bivariate variables and the dependent variable. The
analysis of the relationship of independent results of the analysis showed that there were
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41 pregnant women who experienced emesis, functions so that it affects a person's health
most of these pregnant women were primi- status. Women aged <20 years of develop-
gravida’s, namely 51.2% (21 people) and mul- ment of the development of reproductive
tigravidas were 48.8% (20 people). There organs and functions physiological have not
were 19 mothers who did not experience yet reached the optimal and psychological
emesis, most of these pregnant women were emotions mature enough, it will increase the
multigravidas as many as 84.2% (16 people) occurrence of interruption of pregnancy. A
and primigravida mothers were 15.8% (3 person's age can affect their pregnancy. If a
people). The results of statistical tests show woman is pregnant during the reproductive
that there is a significant relationship bet- period, it is less likely to experience compli-
ween maternal age and the incidence of cations than women who are pregnant under
emesis seen from the p = 0.009. or above the reproductive age (Marmi, 2014).
2. Relationship between Gravidity and
DISCUSSION. Emesis Gravidarum
1. Relationship between maternal age Based on the results in table 3, after statis-
and the incidence of gravidarum tical tests were carried out on the results of
emesis the study, it was found that there was a
Out of the 60 respondents, 41 pregnant wo- relationship between maternal gravidity and
men experienced emesis, all pregnant women the incidence of emesis gravidarum. Of the
aged < 20 years experienced emesis, while 60 respondents, 41 pregnant women expe-
for mothers aged 20-35 years, 38 women ex- rienced emesis, more primigravida women
perienced emesis and no mother experienced experienced emesis than multigravida mo-
emesis at the age> 35 years. The difference in thers, this is based on the results of gravidity
the number of respondents in each variable and the incidence of emesis gravidarum is
category is a deficiency in this study but 0.009 which is smaller than the significant
based on the results, maternal age and the in- value 0.05 which indicates a significant rela-
cidence of emesis gravidarum is 0.019 which tionship between gravidity and the incidence
is smaller than the significant value 0.05 of emesis gravidarum.
which indicates a significant relationship bet- The results of this study are the same as
ween maternal age and the incidence of Study conducted by Atika (2016) which asse-
emesis gravidarum. ssed the relationship between parity and
hyperemesis gravidarum in inpatients at
This is also in accordance with Study hospital in Palembang.
conducted by Rudiyanti (2019) which was Gravidity is the total number of preg-
conducted in 2018 which stated that 70% of nancies that have been experienced, regard-
ages are at risk and there is a relationship less of gestational age. Gravida is a woman
between age and emesis gravidarum. who is pregnant, a primigravida is a woman
This study is not in line with Study con- who is pregnant for the first time, a multigra-
ducted by Suryaningrum (2019) which states vida is a woman who is pregnant for more
that there is no relationship between mater- than the second time (Oxorn, 2010).
nal age and the incidence of emesis gravida- In primiparous pregnancy, her emo-
rum in pregnant women in the first trimester. tions are not yet optimal, tend to be unstable,
According to Ekasari (2019) age is an mentally immature so that prone to shocks
important part of reproductive status. Age is resulting in a lack of attention to meeting the
related to the increase and decrease in bodily needs of nutrients during pregnancy. This is
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