A Five-Year Study of Maternal and Neonatal Risk Factors Contributing to Early Neonatal Death at a Tertiary Referral Hospital

Putri Nadya Syahidah; Setyorini Irianti; Windi Nurdiawan

doi:10.24198/obgynia.v8i2.921

A Five-Year Study of Maternal and Neonatal Risk Factors Contributing to Early Neonatal Death at a Tertiary Referral Hospital

Putri Nadya Syahidah, Setyorini Irianti, Windi Nurdiawan

Abstract

Objective: This study aims to explore maternal and neonatal risk factors associated with early neonatal death at a central referral hospital in West Java.
Methods: A cross-sectional study was conducted. Over five years, 310 early newborn mortality samples were collected from 9,240 births. Key characteristics associated with early infant death were identified using univariate and multivariate analysis.
Results: Among the mothers, 63.9% were from outside Bandung and aged 15–46. 64.5% (n=200) of neonates died within two days. Primiparous mothers accounted for 33.2% (103). Common maternal conditions included premature contractions (27.1%), premature rupture of membranes (22.9%), hypertension (14.2%), placenta previa (6.5%), and eclampsia (3.5%). 84.8% of neonates were premature, and 59.4% experienced early death. Bivariate analysis showed significant relationships with parity, maternal diseases, mode of delivery, and newborn hypoxia. Death after 48 hours was notably associated with mode of delivery (p=0.009; OR 1.54).
Conclusion: END is associated with parity, maternal conditions, delivery mode, and asphyxia. Improved prenatal care and stronger referral systems can reduce mortality rates.

Analisis Faktor Risiko Ibu dan Neonatus terhadap Kematian Neonatal Dini di RS Rujukan Tersier: Studi Lima Tahun

Abstrak
Tujuan: Penelitian bertujuan untuk mengidentifikasi faktor risiko maternal dan neonatal yang terkait dengan kematian neonatal dini pusat rujukan di Jawa Barat.
Metode: Metode penelitian dilakukan dengan studi potong lintang selama lima tahun. 310 sampel kematian neonatal dini diambil dari 9,240 kelahiran. Analisis multivariate dan univariate dilakukan untuk melihat hubungan faktor-faktor penting yang berhubungan dengan kematian neonatal dini
Hasil: Hasil penelitian menunjukan sebanyak 63,9% berasal dari luar Bandung dan berusia antara 15 dan 46 tahun. 64,5% (n=200) bayi meninggal dalam dua hari. 33,2% persalinan prematur (103). Kondisi patologis ibu yang ditemukan kontraksi prematur (27,1%), ketuban pecah dini (22,9%), hipertensi (14,2%), plasenta previa (6,5%) dan eklampsia (3,5%). 84,8% lahir prematur, dan 59,4% meninggal dini. Menurut analisis bivariat, ada hubungan yang signifikan antara cara persalinan, penyakit ibu, hipoksia bayi baru lahir, dan paritas (p=0.009; OR 1.54). Kematian bayi setelah 48 jam memiliki korelasi yang signifikan dengan metode persalinan.
Kesimpulan: KND dikaitkan dengan paritas, penyakit ibu, cara persalinan, dan asphyxia. Memperkuat sistem referral dan meningkatkan perawatan antenatal dapat mengurangi angka kematian.

Kata kunci: faktor risiko maternal; kematian neonatal dini; komplikasi maternal; metode persalinan

Keywords

Keywords: early neonatal death, maternal risk factors, mode of delivery, maternal complications

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References

UNICEF. Neonatal mortality:The neonatal period is the most vulnerable time for a child. Unicef Data. 2023; (January):1–12.

Yan T, Mullany LC, Subedi S, Hazel EA, Khatry SK, Mohan D, et al.

Risk factors for neonatal mortality: An observational cohort study in Sarlahi district of rural southern Nepal. BMJ Open. 2023;13 (9):1–15.

Badan Pusat Statistik. Hasil Long Form Sensus Penduduk 2020.

BpsGoId [Internet]. 2023; (27):1–52. Available from: https://papua.bps.go.id/pressrelease/2018/05/07/336/indeks-pembangunan-manusia-provinsi-papua-tahun-2017.html

WHO. Mortality N. Newborn Mortality [Internet]. 2022; (January):3–7. Available from: https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-c...

Pathirana J, Muñoz FM, Abbing-Karahagopian V, Bhat N, Harris T, Kapoor A, et al. Neonatal death: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2016;34 (49):6027–37.

Lehtonen L, Gimeno A, Parra-Llorca A, Vento M. Early neonatal death: A challenge worldwide. Semin Fetal Neonatal Med. 2017;22 (3):153–60.

Abdullah A, Hort K, Butu Y, Simpson L. Risk factors associated with neonatal deaths: A matched case-control study in Indonesia. Glob Health Action. 2016;9 (1):1–12.

Tekelab T, Chojenta C, Smith R, Loxton D. The impact of antenatal care on neonatal mortality in subh-Saharan Africa: A Systematic review and meta-analysis. Natl Libr Med ; Plos One. 2019;14 (9)

Raghuraman N, March MI, Hacker MR, Modest AM, Wenger J, Narcisse R, et al. Adverse maternal and fetal outcomes and deaths related to preeclampsia and eclampsia in Haiti. Pregnancy Hypertens. 2014;4 (4):279–86.

Noorhalimah. Faktor-Faktor yang Berhubungan Dengan Kematian Neonatal di Kabupaten Taipin (Tinjauan Terhadap Persalinan dan Karakteristik Ibu). J Publ Kesehat Masy Indones. 2015;2 (2):64–71.

Lestari TRP. Pencapaian Status Kesehatan Ibu dan Bayi sebagai Salah Satu Perwujudan Keberhasilan Program Kesehatan Ibu dan Anak. J Kaji. 2020;25 (1):75–89.

Kim YN, Choi DW, Kim DS, Park EC, Kwon JY. Maternal age and risk of early neonatal mortality: A national cohort study. Sci Rep. 2021;11 (1):1–9.

Mohammed S, Bonsing I, Yakubu I, Wondong WP. Maternal obstetric and socio-demographic determinants of low birth weight: A retrospective cross-sectional study in Ghana. Reprod Health. 2019;16 (1):1–8.

Arevalo Cordova TD, Agudo Gonzabay BM, García Maldonado JA, Medina Quizhpe CH, León León NL. Maternal Risk Factors Associated With Neonatal Outcome in Primiparous, Machala, Ecuador. Cureus. 2023;15 (1):1–7.

Kumari R, Margaret B, Shetty S. Risk factors for neonatal death in India: A retrospective case control study. J Neonatal Nurs. 2024; (January): 1-6.

Aggarwal K, Gupta R, Sharma S, Sehgal R, Roy M. Mortality in newborns referred to tertiary hospital: An introspection. J Fam Med Prim Care. 2015;4 (3):435.

Rahmawati D. Pengaruh Asfiksia Terhadap Kejadian Kematian Neonatal Di Provinsi Jawa Timur. 2022;13:464–71.

Khan S, Kilpatrick R, Benjamin DK, Kolnik SE, Greenberg RG.

Morbidity and mortality of twins and triplets compared to singleton infants delivered between 26–34 weeks gestation in the United States. J Perinatol. 2023; (21 November):231–8.

DOI: http://dx.doi.org/10.24198/obgynia.v8i2.921