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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.
Pelayanan antenatal (ANC) adalah salah satu program kegiatan Puskesmas yaitu Kesehatan Ibu dan Anak (KIA) yang berupaya memberikan pelayanan yang berkualitas kepada ibu hamil, mendidik serta memotivasi ibu hamil agar dapat merawat dirinya selama hamil, serta berupaya merubah sikap dan perilaku kearah keamanan persalinan. Berdasarkan basil survei yang dilakukan, maka peneliti mencoba melakukan analisis data Survei Demografi dan Kesehatan Indonesia tahun 2002-2003 tentang Hubungan Kualitas Layanan Antenatal dengan Kejadian Komplikasi Persalinan, yang terdiri dari beberapa variabel yaitu variabel babas utama adalah kualitas layanan antenatal, dan variabel kontrol adalah status reproduksi (umur, paritas, jarak kehamilan), status kesehatan (riwayat obstetri), Perilaku sehat (penolong persalinan, penggunaan KB), tempat persalinan, kualitas pelayanan (penyuluhan) dan komplikasi persalinan yang terdiri dari dua kriteria (partus lama dan perdarahan). Penelitian dilakukan dengan desain cross sectional, dengan melakukan analisis data Survei Demografi dan Kesehatan Indonesia tahun 2002-2003. Setelah ditentukan kriteria inklusi dan eksklusi maka diperoleh sampel minimal meliputi 11674 sampel. Analisis data yang digunakan meliputi analisis univariat, bivariat dan multivariat. Hasil penelitian menunjukkan bahwa hubungan kualitas layanan antenatal berinteraksi dengan jarak kelahiran, dimana pada jarak kelahiran ? 2 tahun hubungan kualitas antenatal dengan komplikasi persalinan (OR F 0,94), sedangkan pada jarak kelahiran < 2 tahun hubungan kualitas layanan antenatal dengan komplikasi persalinan (OR = 1,98) atau dari hasil uji interaksi diperoleh (OR = 2,01, 95%CI 1,11-3,97). Hasil penelitian masih dipengaruhi cara pengukuran, sehingga untuk memperoleh hasil yang iebih valid disarankan dilakukan penelitian selanjutnya dengan perigukuran yang lebih baik dan desain yang lebih baik.
Antenatal Service (ANC) is one of the Puskesmas activities, which is Mother and Child Health (KIA) that make effort in giving quality service to pregnant mother, educating and also motivating pregnant mother to take care of herself during pregnancy, and also make effort to change attitude and behavior toward give birth safety. Based on survey conducted, researchers try to do data analysis of Demographic Survey and Health in Indonesia year 2002 - 2003 about Relation of Antenatal Service Quality with Give Birth Complication Cases, which consist of some variables such as main free variable is antenatal service quality, and control variable is reproduction status (age, parity, pregnancy gap), health status (obstetric history), health behavior (give birth assistance, KB use), give birth place, service quality (counseling) and give birth complication that consist of two criteria (delivery length and haemorrahage). Research design was cross sectional, with data analysis of Demographic Survey and Health in Indonesia year 2002 - 2003. After criteria of inclusion and exclusion determined then obtained minimal sample include 11674 samples. Data analysis that used is including univariate, bivariate, and multivariate analysis. Research result shows that relation of antenatal service quality interact with birth gap, where in birth gap? 2 years of antenatal quality relation with give birth complication (OR = 0,94). While in birth gap < 2 years of antenatal service quality with give birth complication (OR = 1.98) or from interaction test result got (OR = 2,01, 95% CI 1,11 - 3,97). Research result still affected by measuring method, so that to obtain valid result suggested that advanced research done with better measuring and better design.
The exclusive breastfeeding coverage trend in Indonesia remains suboptimal. The objective of this study was to examine the relationship between the frequency of standardized antenatal care (ANC) visits and the practices of exclusive breastfeeding among mothers with infants aged 0–23 months. This investigation utilized the 2023 Indonesia Health Survey (SKI) to conduct its analysis. This cross-sectional study employed modified Cox regression to estimate prevalence ratios (PR) and adjusted for covariates. The results indicated that 47.10% of infants aged 0–5 months were exclusively breastfed, and 64.90% of those aged 6–23 months had a history of exclusive breastfeeding, with 2.52% experiencing delayed complementary feeding. A significant association was identified between ANC visits with a p-value of at least 6 and exclusive breastfeeding in the 0–5 months group (PR adj: 3.01; 95% CI: 2.12–4.27). However, no such association was observed in the 6–23 months group. These findings underscore the necessity for the incorporation of sustained breastfeeding education initiatives beginning in pregnancy, along with the integration of MPASI timing into national monitoring indicators.
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.
Hasil bivariat memperlihatkan bahwa ada tren peningkatan kunjungan ANC tidak sesuai dengan rekomendasi WHO pada pendidikan ibu (pvalue=0.0001), status ekonomi (pvalue=0.0001), dan pendidikan suami (pvalue= 0.0001). Hasil multivariabel memperlihatkan prediktor kunjungan ANC tidak sesuai dengan rekomendasi WHO adalah usia ibu saat hamil > 35 tahun, pendidikan ibu rendah, status ekonomi rendah, dan dukungan suami. Oleh karena itu, disarankan kepada tenaga kesehatan untuk melakukan penyuluhan pentingnya kunjungan ANC sesuai dengan rekomendasi WHO terutama pada ibu hamil usia > 35 tahun, pendidikan rendah, dan status ekomomi rendah, serta pemberdayaan suami.
Kata kunci: ANC rekomendasi WHO, SDKI 2012, pola ANC 1-1-2
