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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Pregnancy and Childbirth 1/2017

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

Zeitschrift:
BMC Pregnancy and Childbirth > Ausgabe 1/2017
Autoren:
Trisari Anggondowati, Ayman A. E. El-Mohandes, S. Nurul Qomariyah, Michele Kiely, Judith J. Ryon, Reginald F. Gipson, Benjamin Zinner, Anhari Achadi, Linda L. Wright
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12884-017-1280-1) contains supplementary material, which is available to authorized users.

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.

Results

Referral from a care facility was associated with a reduced risk of LBW and VLBW [AOR = 0.28, 95% CI = 0.11–0.69, AOR = 0.18, 95% CI = 0.04–0.75, respectively], stillbirth [AOR = 0.41, 95% CI = 0.18–0.95], and neonatal death [AOR = 0.2, 95% CI = 0.05–0.81]. Mothers age <20 years increased the risk of VLBW [AOR = 6.39, 95% CI = 1.82–22.35] and neonatal death [AOR = 4.10, 95% CI = 1.29–13.02]. Malpresentation on admission increased the risk of asphyxia [AOR = 4.65, 95% CI = 2.23–9.70], stillbirth [AOR = 3.96, 95% CI = 1.41–11.15], and perinatal death [AOR = 3.89 95% CI = 1.42–10.64], as did poor prenatal care (PNC) [AOR = 11.67, 95%CI = 2.71–16.62]. Near-miss on admission increased the risk of neonatal [AOR = 11.67, 95% CI = 2.08–65.65] and perinatal death [AOR = 13.08 95% CI = 3.77–45.37].

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.
Zusatzmaterial
Additional file 1: QMP5. English version of maternal interview, including demographic data, care/referral data, social and medical support, problems, obstetric history, prenatal care, delivery history, and brief medical history (chronic and infectious disease(s)). (PDF 170 kb)
12884_2017_1280_MOESM1_ESM.pdf
Literatur
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