Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia

Asri Adisasmita, Carl Vernon Smith, Ayman A E El-Mohandes, Poppy Elvira Deviany, Judith J. Ryon, Michele Kiely, Quail Rogers-Bloch, Reginald F. Gipson

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective AOR 5.41, 95 % CI 2.64–11.08; prospective AOR 10.45, 95 % CI 5.59–19.52) and severe preeclampsia/eclampsia (retrospective AOR 1.94, 95 % CI 1.05–3.57; prospective AOR 3.26, 95 % CI 1.79–5.94). Associations with near-miss/death were seen for antepartum hemorrhage in retrospective data (AOR 9.34, 95 % CI 4.34–20.13), and prospectively for poverty (AOR 2.17, 95 % CI 1.33–3.54) and delivering outside the hospital (AOR 2.04, 95 % CI 1.08–3.82). Postpartum hemorrhage and severe preeclampsia/eclampsia are leading causes of near-miss/death in Indonesia. Poverty and delivery outside the hospital are significant risk factors. Prompt recognition of complications, timely referrals, standardized care protocols, prompt hospital triage, and structured provider education may reduce obstetric mortality and morbidity. Retrospective data were reliable, but prospective data provided valuable information about barriers to care and referral patterns.

Original languageEnglish (US)
Pages (from-to)1624-1633
Number of pages10
JournalMaternal and Child Health Journal
Volume19
Issue number7
DOIs
StatePublished - Jul 22 2015

Fingerprint

Indonesia
Mothers
Obstetrics
Postpartum Hemorrhage
Eclampsia
Referral and Consultation
Poverty
Pre-Eclampsia
Multivariate Analysis
Economics
District Hospitals
Triage
Logistic Models
Demography
Outcome Assessment (Health Care)
Hemorrhage
Morbidity
Delivery of Health Care
Education
Mortality

Keywords

  • Indonesia
  • Maternal near-miss
  • Pregnancy
  • Risk factors

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

Cite this

Adisasmita, A., Smith, C. V., El-Mohandes, A. A. E., Deviany, P. E., Ryon, J. J., Kiely, M., ... Gipson, R. F. (2015). Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia. Maternal and Child Health Journal, 19(7), 1624-1633. https://doi.org/10.1007/s10995-015-1673-6

Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia. / Adisasmita, Asri; Smith, Carl Vernon; El-Mohandes, Ayman A E; Deviany, Poppy Elvira; Ryon, Judith J.; Kiely, Michele; Rogers-Bloch, Quail; Gipson, Reginald F.

In: Maternal and Child Health Journal, Vol. 19, No. 7, 22.07.2015, p. 1624-1633.

Research output: Contribution to journalArticle

Adisasmita, A, Smith, CV, El-Mohandes, AAE, Deviany, PE, Ryon, JJ, Kiely, M, Rogers-Bloch, Q & Gipson, RF 2015, 'Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia', Maternal and Child Health Journal, vol. 19, no. 7, pp. 1624-1633. https://doi.org/10.1007/s10995-015-1673-6
Adisasmita, Asri ; Smith, Carl Vernon ; El-Mohandes, Ayman A E ; Deviany, Poppy Elvira ; Ryon, Judith J. ; Kiely, Michele ; Rogers-Bloch, Quail ; Gipson, Reginald F. / Maternal Characteristics and Clinical Diagnoses Influence Obstetrical Outcomes in Indonesia. In: Maternal and Child Health Journal. 2015 ; Vol. 19, No. 7. pp. 1624-1633.
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