Maternal characteristics and obstetrical complications impact neonatal outcomes in Indonesia: a prospective study

Abstract

Background: We investigated associations between maternal characteristics, access to care, and obstetrical complications including near miss status on admission or during hospitalization on perinatal outcomes among Indonesian singletons. Methods: We prospectively collected data on inborn singletons at two hospitals in East Java. Data included socio-demographics, reproductive, obstetric and neonatal variables. Reduced multivariable models were constructed. Outcomes of interest included low and very low birthweight (LBW/VLBW), asphyxia and death. Conclusions: Mothers in labor should be encouraged to seek care early and taught to identify early danger signs. Adequate PNC significantly reduced perinatal deaths. Improved hospital management of malpresentation may significantly reduce perinatal morbidity and mortality. The importance of hospital-based prospective studies helps evaluate specific areas of need in training of obstetrical care providers.

Neonatal near miss determinants at a maternity hospital for high-risk pregnancy in Northeastern Brazil: a prospective study

“…This finding is in clear contrast with those of previous reports on age extremes and perinatal outcomes [3, 15]. The data on the risk associated with pregnancy at an age older than 35 years are conflicting due to the presence of other variables, such as parity and pre-existing diseases, which impair assessment of the risk associated with maternal age alone [16].…”

“…In one study published in 2017, the survival of newborn infants born to mothers without severe complications was better than that of infants born to mothers with eclampsia, intrapartum hemorrhage or other complications requiring ICU admission [15]. In the multivariate analysis performed in the present study, maternal ICU admission did not remain associated with NNM.…”

“…First, age younger 20 years did not exhibit an association with NNM, although adolescent pregnancy is usually associated with poorer maternal and perinatal outcomes including prematurity, low birth weight and occurrence of 5-min Apgar scores of less than 7, than pregnancy in adult women [3, 13–15]. Other mechanisms that are not biological might mediate the relationships between adolescence and adverse obstetric/perinatal outcomes, which previous studies failed to detect.…”

Expanding Maternal and Neonatal Survival in Indonesia: A program overview

“…Universal health coverage for maternal and newborn health services (entitled Jampersal ) was being rolled out across the country to reduce financial barriers to accessing maternal newborn health (MNH) services. Nevertheless, the following challenges persisted: High case fatality rates : Preventable maternal and newborn deaths were occurring in hospitals and substandard quality of BEmONC and CEmONC was common and well documented Confusion within the referral process: Referrals were typically made on an ad hoc basis.…”

“…Weaknesses in the district and provincial referral system were identified as key contributors to preventable maternal and newborn mortality . Lack of established relationships and clear communication mechanisms among health workers across the district led to inefficient coordination and communication between private midwifery clinics, puskesmas , and hospitals.…”