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Kata kunci: kehamilan tidak diinginkan, kematian neonatal, faktor risiko, perdesaan, perkotaan
This study discusses the effect of unwanted pregnancies towards neonatal mortality. The purpose of this study is to determine how unwanted pregnancy affecting the risk of neonatal mortality and the dominant risk factors for neonatal death among women at risk of childbirth considering their residence, rural and urban areas. The study design of this research is a cross sectional with multivariable logistic regression analysis using IDHS 2017. The number of research subject used in this study were 1618 live births in urban areas and 1645 live births in rural areas among women at risk of childbirth population. The results showed that unwanted pregnancy was not statistically associated to neonatal mortality both in urban and rural area. The results of the bivariate analysis showed that the variable which statistically associated to neonatal mortality both in urban and rural area is low birth weight (lbw) (purban=0,001; prural=0,002). Even After the unwanted pregnancy variables were being controlled by other variables using regression logistic analysis, it remains unrelated and does not increase the risk of neonatal mortality both in urban and rural areas. In urban area, multivariable analysis results show risk factors for neonatal mortality are lbw (OR = 10.14), low education (OR = 2.67), parity 2-3 (OR = 8.4), and parity> 3 (OR = 32). In rural area, the risk factors for neonatal death are lbw (OR = 11), antenatal care 3 births for urban area and lbw for rural area. It can be concluded that unwanted pregnancy is not directly associated to neonatal mortality. However, previous studies have explained there are changes in maternal behavior towards inappropriate pregnancy care. Risk factors for neonatal death vary according to types of residence, urban and rural area.
Keywords: unwanted pregnancy, neonatal mortality, risk factors, rural, urban
Kehamilan tidak diinginkan di Indonesia belum menunjukkan perubahan yang konsisten dari 2002 hingga 2019 (BKKBN, 2019). Dominasi kehamilan tidak diinginkan terjadi pada kelompok usia berisiko tinggi (56% kasus) (BKKBN, 2012, 2017) dan cenderung lebih banyak ditemukan di perkotaan Indonesia. Salah satu faktor yang mempengaruhi terjadinya kehamilan tidak diinginkan yaitu penggunaan kontrasepsi modern. Penelitian ini dilakukan untuk melihat besar hubungan yang terjadi antara penggunaan kontrasepsi modern dengan kejadian kehamilan tidak diinginkan pada wanita kelompok usia berisiko tinggi di wilayah perkotaan dan pedesaan Indonesia. Desain studi pada penelitian ini merupakan cross sectional dengan analisis menggunakan chi square dan regresi logistik. Data yang digunakan merupakan data SDKI 2017. Hasil analisis menunjukkan bahwa wanita usia risiko tinggi di wilayah perkotaan Indonesia yang tidak menggunakan kontrasepsi memiliki risiko yang lebih rendah untuk mengalami kehamilan tidak diinginkan (OR: 0.76; 95% CI: 0.588-0.977). Sedangkan wanita usia risiko tinggi di wilayah pedesaan Indonesia yang tidak menggunakan kontrasepsi memiliki risiko yang lebih tinggi untuk mengalami kehamilan tidak diinginkan (OR: 1.66 95% CI: 1.035-2.648).
Unintended pregnancies in Indonesia have not shown consistent changes from 2002 to 2019 (BKKBN, 2019). In addition, unintended pregnancies mostly occur in the high-risk age group (56% of cases) (BKKBN, 2012, 2017). One of the factor that can influence incident of unintended pregnancy is the use of modern contraception. In Indonesia unintended pregnancies tend to be more common in urban areas. This research was conducted to see the relationship between modern contraception use and the incidence of unintended pregnancies in women in high-risk age groups in urban and rural areas of Indonesia. The study design in this research is cross sectional and data will be conducted with chi square and logistic regression. The data used in this research is the 2017 IDHS. The results show that women of high risk age in urban areas of Indonesia who do not use contraception have a lower risk of experiencing unwanted pregnancy (OR: 0.76; 95% CI: 0.588-0.977). Meanwhile, women of high risk age in rural areas of Indonesia who do not use contraception have a higher risk of experiencing unwanted pregnancy (OR: 1.66 95% CI: 1.035-2.648).
