The authors investigated associations between maternal characteristics, access to care, and obstetrical complications including near-miss status on admission or during hospitalization on perinatal outcomes among Indonesian singletons. Data was collected prospectively on inborn singletons at two hospitals in East Java. Outcomes of interest included low- and very-low birthweight (LBW/VLBW), asphyxia and death.
Referral from a care facility was associated with reduced risk of LBW and VLBW, stillbirth, and neonatal death. Mothers aged less than 20 years increased the risk of VLBW and neonatal death. Mal-presentation on admission increased the risk of asphyxia, still birth, and perinatal death, as did poor prenatal care. Near-miss admission increased the risk of neonatal and perinatal death.
The authors concluded that mothers in labor should be encouraged to seek care early and be taught to identify early danger signs. Adequate prenatal care (PNC) significantly reduced perinatal deaths. Improved hospital management of mal-presentation may significantly reduce perinatal morbidity and mortality. The importance of hospital-based prospective studies helps evaluate specific areas of need in training of obstetrical care providers.
Authors: Trisari Anggondowati, Ayman El-Mohandes, S. Nurul Qomariyah, Michele Kiely, Judith Ryon, Reginald Gipson, Benjamin Zinner, Anhari Achadi and Linda Wright, 2017.