Kelahiran prematur merupakan penyebab kematian neonatal ketiga terbanyak di Indonesia. Kelahiran prematur dapat meningkatkan morbiditas dan mortalitas neonatal/bayi sehingga dapat berdampak pada indikator kesehatan Indonesia. Penelitian ini bertujuan untuk mengidentifikasi determinan kelahiran prematur di wilayah perkotaan dan perdesaan Indonesia. Data berasal dari Survei Kesehatan Indonesia 2023 dengan menggunakan desain studi potong lintang. Sampel penelitian ini adalah perempuan umur 10-54 tahun yang pernah kawin, mempunyai pengalaman reproduksi dalam kurun waktu lima tahun terakhir untuk anak terakhir dengan total sampel 32.288 responden. Penelitian ini menggunakan uji Chi Square dan regresi logistik ganda dalam analisisnya. Hasil penelitian ini menunjukkan bahwa determinan kelahiran prematur di wilayah perkotaan dan pedesaan yaitu,  kunjungan ANC, kehamilan kembar, hipertensi, dan perdarahan antepartum. Usia, ibu, ketuban pecah dini, dan metode persalinan hanya berhubungan di wilayah perkotaan, sedangkan plasenta previa hanya berhubungan di wilayah perdesaan. Kehamilan kembar menjadi variabel yang berhubungan paling dominan dengan kelahiran prematur di wilayah perkotaan dan perdesaan Indonesia

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Preterm birth is the third leading cause of neonatal mortality in Indonesia. It significantly contributes to neonatal morbidity and mortality, thereby affecting the overall health indicators of the country. This study aims to identify the determinants of preterm birth in urban and rural areas of Indonesia. The data were obtained from the 2023 Indonesian Health Survey using a cross-sectional study design. The study sample consisted of 32,288 ever-married women aged 10–54 years who had given birth in the last five years. Data were analyzed using chi-square tests and multivariable logistic regression. The results showed that antenatal care (ANC) visits, multiple pregnancies, hypertension, and antepartum hemorrhage were significant determinants of preterm birth in both urban and rural areas. Maternal age, premature rupture of membranes, and mode of delivery were only associated with preterm birth in urban areas, while placenta previa was only significant in rural areas. Multiple pregnancies were the most dominant factor associated with preterm birth in both settings.

Latar belakang: Upaya pemenuhan standar Antenatal Care menjadi bagian penting dalam mendukung penurunan Angka Kematian Ibu (AKI) melalui RPJMN 2025 – 2029 serta menjadi salah satu intervensi untuk mencegah stunting pada Strategi Nasional Percepatan Pencegahan dan Penurunan Stunting 2025–2029. Namun, pemenuhan standar ANC di Indonesia masih belum optimal dan menunjukkan ketimpangan antarwilayah sehingga diperlukan analisis determinan berdasarkan regionalisasi wilayah. Tujuan: Penelitian ini bertujuan untuk mengetahui determinan ketidaklengkapan pemenuhan standar ANC berdasarkan regionalisasi wilayah di Indonesia, yaitu Kawasan Barat Indonesia (KBI) dan Kawasan Timur Indonesia (KTI). Metode: Penelitian menggunakan desain crosssectional dengan data sekunder SKI 2023. Analisis dilakukan secara univariat, bivariat, dan multivariabel menggunakan regresi logistik dengan complex sample analysis. Hasil: Hasil penelitian menunjukkan proporsi ketidaklengkapan pemenuhan standar ANC sebesar 87,5% di KBI dan 85,7% di KTI. Pada KBI, faktor yang berhubungan signifikan meliputi tingkat pendidikan ibu, status pekerjaan ibu, paritas, status ekonomi, tempat pemeriksaan ANC, dan status keinginan kehamilan. Faktor paling dominan di KBI adalah status ekonomi terbawah, dengan aOR sebesar 2,41 dibandingkan kelompok ekonomi teratas. Pada KTI, faktor yang berhubungan signifikan meliputi wilayah tempat tinggal, usia ibu, status pekerjaan ibu, gravida, status ekonomi, tempat pemeriksaan ANC, tingkat kemudahan akses ke klinik/praktik mandiri, dan status keinginan kehamilan. Tingkat pendidikan ibu tetap dipertahankan dalam model akhir KTI sebagai variabel confounder. Faktor paling dominan di KTI adalah status keinginan kehamilan, dengan ibu yang memiliki kehamilan tidak diinginkan memiliki aOR sebesar 2,62 dibandingkan ibu dengan kehamilan diinginkan. Kesimpulan: Ketidaklengkapan pemenuhan standar ANC masih tinggi di KBI maupun KTI, dengan pola determinan yang berbeda antarwilayah. Penguatan program ANC perlu diarahkan pada kelengkapan kualitas pelayanan, pemerataan akses, serta perhatian khusus pada ibu dengan status ekonomi rendah dan kehamilan tidak diinginkan.

Background: Efforts to fulfill Antenatal Care (ANC) standards are an important component in supporting the reduction of maternal mortality through the 2025–2029 National Medium-Term Development Plan (RPJMN), as well as one of the interventions to prevent stunting under the 2025–2029 National Strategy for the Acceleration of Stunting Prevention and Reduction. However, the fulfillment of ANC standards in Indonesia remains suboptimal and shows disparities across regions, highlighting the need to analyze its determinants based on regionalization. Objective: This study aimed to identify the determinants of incomplete fulfillment of ANC standards based on regionalization in Indonesia, namely Western Indonesia Region (KBI) and Eastern Indonesia Region (KTI). Methods: This study used a cross-sectional design with secondary data from the 2023 Indonesian Health Survey (SKI). The analyses were conducted using univariate, bivariate, and multivariable analyses with logistic regression through complex sample analysis. Results: The results showed that the proportion of incomplete fulfillment of ANC standards was 87.5% in KBI and 85.7% in KTI. In KBI, the factors significantly associated with incomplete fulfillment of ANC standards were maternal education level, maternal employment status, parity, economic status, place of ANC examination, and pregnancy intention status. The most dominant factor in KBI was the lowest economic status, with an aOR of 2.41 compared with the highest economic group. In KTI, the factors significantly associated with incomplete fulfillment of ANC standards were area of residence, maternal age, maternal employment status, gravidity, economic status, place of ANC examination, accessibility to clinics/private practices, and pregnancy intention status. Maternal education level was retained in the final KTI model as a confounding variable. The most dominant factor in KTI was pregnancy intention status, with women who had unintended pregnancies having an aOR of 2.62 compared with those with intended pregnancies. Conclusion: Incomplete fulfillment of ANC standards remains high in both KBI and KTI, with different determinant patterns across regions. ANC program strengthening should be directed toward improving the completeness of service quality, equitable access, and special attention to mothers with low economic status and unintended pregnancies.