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Komplikasi kehamilan adalah masalah kesehatan yang sering terjadi selama hamil dan berdampak pada mortalitas dan morbiditas ibu dan bayi baru lahir. Peneliti tidak menemukan studi di Indonesia yang membahas komplikasi kehamilan secara umum pada kelompok usia <20 tahun dan ≥35 tahun. Penelitian ini bertujuan untuk menganalisis hubungan antara usia ibu saat hamil dengan kejadian komplikasi kehamilan di Indonesia menggunakan data IFLS V 2014/2015. Sampel yang di analisis pada penelitian ini berjumlah 1.325 setelah memenuhi kriteria inklusi dan eksklusi. Analisis multivariat menggunakan uji multiple cox regression digunakan untuk mengetahui pengaruh usia ibu yang berisiko dalam menyebabkan komplikasi kehamilan pada populasi ibu yang pernah melahirkan pada tahun 2013-2015. Pada penelitian ini dilakukan analisis pada sub populasi untuk jenis komplikasi tertentu. Hasil studi menunjukkan prevalensi komplikasi kehamilan sebesar 24%. Tidak terdapat hubungan yang signifikan secara statistik. Hasil akhir analisis multivariat, komplikasi kehamilan secara umum pada usia ibu saat hamil <20 tahun (aPR 0,98, 95% CI 0,60–1,57), sedangkan usia ibu saat hamil ≥35 tahun memiliki risiko 1,16 kali mengalami komplikasi kehamilan dibandingkan kelompok usia ibu saat hamil 20-34 tahun setelah dikontrol kovariat (aPR 1,16, 95% CI 0,85–1,57). Terdapat peningkatan risiko pada sub populasi komplikasi kehamilan dan sub populasi komplikasi perdarahan antepartum baik pada usia ibu saat hamil <20 tahun atau ≥35 tahun.
Pregnancy complications are common health issues during pregnancy and impact maternal and neonatal mortality and morbidity. Author did not find studies in Indonesia that analyze pregnancy complications in general, particularly for maternal age of <20 years and ≥35 years. This study aims to analyze the relationship between maternal age and the occurrence of pregnancy complications in Indonesia using IFLS V data. The samples analyzed in this study was 1,325 after fulfilling the inclusion and exclusion criteria. Multivariate analysis with multiple cox regression was used to determine the effect of maternal age at risk in causing pregnancy complications in a population of mothers who gave birth in 2013-2015. This study also analyzed subpopulations was performed for specific types of complications. The results showed that prevalence of pregnancy complications was 24%. There was no statistically significant relationship. The final results of the multivariate analysis showed that pregnancy complications in general occurred in maternal age <20 years (aPR 0.98, 95% CI 0.60–1.57), while maternal age ≥35 years had a 1.16 times higher risk of experiencing pregnancy complications compared to maternal age 20-34 years after controlling covariates (aPR 1.16, 95% CI 0.85–1.57). There is an increased risk in the subpopulation of pregnancy complications and antepartum hemorrhage among maternal age <20 years or ≥35 years during pregnancy.
ABSTRAK
BBLR merupakan indikator multidimensi yang penting untuk mengukur masalah kesehatan di masyarakat. Di Indonesia, prevalensi BBLR mengalami penurunan yang lambat padahal BBLR memberi beban ekonomi yang tinggi bagi negara. Komplikasi kehamilan dianggap sebagai determinan penting terjadinya BBLR di negara berkembang. Penelitian ini bertujuan untuk mengetahui pengaruh komplikasi kehamilan terhadap kejadian BBLR pada anak terakhir yang lahir hidup di Indonesia tahun 2007 setelah dikontrol seluruh confounding. Penelitian ini menggunakan desain cross sectional seperti desain sumber data SDKI 2007. Populasi sumber penelitian ini diambil dari 33 provinsi yang diambil dengan metode stratified two stage cluster sampling, sehingga peneliti melakukan analisis Complex sampling. Study participants dalam penelitian ini sebanyak 9.339 responden (11.839 responden sebelum dilakukan pembobotan).
Hasil analisis
diketahui prevalensi BBLR sebesar 5,3%, prevalensi komplikasi kehamilan 11,5% (1,3% mules sebelum 9 bulan, 2,2% perdarahan, 0,6% demam tinggi, 0,1% kejang dan pingsan, 5,8% komplikasi lainnya, dan 1,2% mengalami lebih dari 1 komplikasi kehamilan), dan prevalensi BBLR pada ibu yang mengalami komplikasi kehamilan sebesar 11,5%. Analisis multivariat Logistic regression didapatkan adanya peningkatan PR komplikasi kehamilan terhadap BBLR sebesar 3,184 (CI 95% 1,058 - 4,112) setelah dikontrol variabel confounder umur ibu saat melahirkan, jarak kelahiran, status paritas, riwayat BBLR, pendidikan ibu, tempat tinggal, lahir kembar dan jumlah kunjungan ANC serta mempertimbangkan interaksi antara komplikasi kehamilan dengan status paritas. Jenis komplikasi kehamilan yang paling mempengaruhi terjadinya BBLR adalah demam yang tinggi (POR 6,098 CI 95% 0,4206 ? 7,3606), mules sebelum 9 bulan (POR 5,113 CI 95% 0,22984 ? 6,05784).
ABSTRACT
Low birth weight is an important indicator to measure multidimensional health problems in the community. In Indonesia, the prevalence of low birth weight decreased slowly while LBW become a high economic burden for the country. Complications of pregnancy considered as an important determinant of the LBW in developing countries. This study aimed to determine the effect of pregnancy complications to LBW in Indonesia on 2007 after controlling all confounders. This study use cross-sectional design as the data source IDHS 2007. The source population of this study were taken from 33 provinces which drawn with a two-stage stratified cluster sampling, so the researchers conducted an analysis Complex sampling to prevent bias. Study participants in this study were 9.339 respondents (11.839 respondents prior to weighting).
Results of analysis
show LBW prevalence was 5.6%, 11.5% prevalence of pregnancy complications (1.3% abdominal contraction before 9 months, 2.2% bleeding, 0.6% of high fever, 0.1% seizures and fainting, 5,8% other complications, and 1.2% had more than one pregnancy complication), and 11.5% LBW in women with pregnancy complications. Pregnancy complications were associated with low birth weight. Multivariate logistic regression analysis showed that pregnancy complications women were 34 times more likely to delivered LBW (POR 2,507, 95% CI 1,982-3,173). LBW also associated with maternal age, birth interval, previous abortion, maternal education, wealth index, twins and antenatal visit. Types of pregnancy complications that mostly affecting the LBW are high fever (POR 6,098 CI 95% 0,4206 ? 7,3606), abdominal contraction before 9 months (POR 5,113 CI 95% 0,22984 ? 6,05784).
Labor complications are a primary cause of maternal mortality in Indonesia and are influenced by various factors. Maternal age is a known risk factor, yet the specific factors for each age group require distinct analysis to inform targeted interventions. This study aims to determine the overview and risk factors for labor complications based on maternal age groups in Indonesia. This study utilized a cross-sectional design, analyzing secondary data from the 2023 Indonesian Health Survey (SKI). The sample consisted of 70,681 mothers who met the inclusion criteria. Data were analyzed using descriptive statistics and the Chi-Square test. The study found differences in the proportion of childbirth complications in Indonesia across young (15.1%), ideal (16.9%), and older (19.2%) age groups, as well as differences in factors associated with complications in each age group. The most dominant types of childbirth complications in young and ideal age groups were prolonged labor and premature rupture of membranes, while breech presentation was more common in older age groups. Factors consistently associated with childbirth complications across all three maternal age groups were education level, area of residence, parity, pregnancy planning, history of pregnancy complications, birth attendant, place of delivery, and source of delivery financing. Factors specific to the ideal and older age groups were partner's education level, birth spacing, and history of Antenatal Care (ANC) visits. Factors that were only significantly associated with specific age groups included husband or family support, which only affected the ideal age group, and maternal employment status, which only affected the older age group. Early detection and differentiated risk management tailored to each age group are necessary. targeting specific risk factors, both clinical (e.g., prolonged labor in young age, hypertension in older age) and sociodemographic.
ABSTRAK Derajat kesehatan suatu Negara dilihat dari beberapa indikator kesehatan salah satunya adalah Angka Kematian Ibu (AKI). Sebagian besar penyebab utama kematian ibu di Indonesia (60-80%) adalah akibat komplikasi persalinan (perdarahan, diikuti oleh eklampsia, infeksi, komplikasi aborsi dan persalinan lama). Salah satu target Millennium Development Goals (MDGs) adalah meningkatkan kesehatan ibu yaitu dengan mengurangi angka kematian ibu sampai tiga perempatnya antara tahun 1990 sampai 2015 Sekitar 80% penduduk Indonesia tinggal di daerah perdesaan yang pelayanan kebidanan masih banyak bersifat tradisional dan lebih dari 75% persalinan masih di tolong oleh dukun bayi. Penelitian ini bertujuan untuk mengetahui hubungan pelayanan antenatal dengan komplikasi persalinan wilayah perdesaan di Indonesia. Desain penelitian yang digunakan adalah cross sectional. Responden merupakan ibu yang pernah hamil dan melahirkan bayi berdasarkan data Survey Demografi dan Kesehatan Indonesia (SDKI) tahun 2007. Prevalensi kejadian komplikasi persalinan wilayah perdesaan di Indonesia adalah sebesar 43,5% dan prevalensi kualitas antenatal yang tidak sesuai kriteria adalah 67,5%. Analisis bivariat menunjukkan tidak ada hubungan kualitas pelayanan antenatal dengan komplikasi persalinan dengan PR=0,991 (pvalue<0,05). Analisis multivariat yang digunakan adalah cox regression. Hasil akhir hubungan kualitas pelayanan antenatal dengan komplikasi persalinan setelah dikontrol variabel paritas, komplikasi kehamilan dan penolong persalinan didapat prevalence ratio (PR) sebesar 0,933 (CI 95% : 0,868-1,003). Kondisi akses, infrastruktur jalan dan transportasi yang tidak memadai serta biaya yang tidak murah menyebabkan perlunya penempatan tenaga kesehatan di desa khususnya bidan di setiap desa dalam upaya mencegah komplikasi persalinan di perdesaan dengan memberikan asuhan antenatal seoptimal mungkin.
ABSTRACT One of several health indicator in every country is Maternal Mortality Rate (MMR). The most several factors of maternal mortality in Indonesia about 60- 80% because of delivery complications (excesive vaginal bleeding followed by eclampsia, infection, abortus complication and prolonged labour). One of Millennium Development Goals (MDGs) target is increase the mother?s health with decrease maternal mortality rate for almost three quarters from years 1990 until 2015. About 80% Indonesia citizen live in rural area with traditional maternal care and almost 75% delivery still help with traditional attendance. The purpose of this study to know the relationship between quality of antenatal care with delivery complication in rural area of Indonesia using Indonesia Demographic and Health Survey year 2007 data. Design study is cross sectional. Respondents of this study are mothers that have been pregnant and delivery. Prevalence of delivery complication in this study are 43,5% and bad quality of antenatal care prevalence are 67,5%. Bivariate analysis proven there is no relationship between quality of antenatal care and delivery complications with Prevalence Ratio (PR) = 0,991 (pvalue<0,05). Multivariate analysis using cox regression model analysis. The final result relationship between between quality of antenatal care and delivery complications after controlled by parity, pregnancy complications and delivery attendance show that prevalence ratio (PR) is 0,933 (CI 95% : 0,868-1,003). It is need policy to located minimal one midwife for one village to decrease the incidence of delivery complications with utilization of optimal antenatal care because of the poor access, infrastructure, transportation and expensive payment to reach health facility in rural area.