Increasing Health Promotion

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Maternal Factors and Health Services: Perinatal Death Analysis in Pidie Regency in 2008

Introduction

Perinatal death is a significant public health concern worldwide, including in Indonesia. According to the Indonesian Demographic Survey (SDKI) data in 2002-2003, the perinatal mortality rate reached 24 per 1000 live births, with around 77% of which were caused by neonatal deaths. In Pidie Regency, perinatal mortality rates experienced a significant increase from 0.94% in 2007 to 1.33% in 2008. This study aimed to analyze the relationship between maternal factors and health services with perinatal death events in Pidie Regency in 2008.

Methodology

This study employed an observational analytic study with control case design. The research population included all mothers who gave birth and their babies suffered perinatal deaths in Pidie Regency during the period January to December 2008. The 60 research samples were selected using purposive sampling. Data analysis was carried out using the Chi-Square test.

Results

The results showed a significant relationship between several factors and the incidence of perinatal death, namely:

Mother's Age

Older mothers have a higher risk of perinatal death (p = 0.011, OR = 2,765). This finding suggests that older mothers may be more vulnerable to perinatal death due to various factors, including decreased fertility, increased risk of chronic diseases, and reduced physical resilience.

Parity

Mother with high parity (many giving birth) has a higher risk of perinatal death (p = 0.028, OR = 2,270). This result indicates that women with multiple pregnancies may be at a higher risk of perinatal death due to factors such as increased uterine distension, decreased uterine elasticity, and reduced fetal growth.

Distance between Births

Short distance between births increases the risk of perinatal death (p = 0.003, OR = 3,763). This finding suggests that women who have a short interval between births may be at a higher risk of perinatal death due to factors such as increased uterine distension, decreased uterine elasticity, and reduced fetal growth.

Maternal Disease History

Mother with a history of disease has a higher risk of perinatal death (p = 0,000, OR = 6,417). This result indicates that women with a history of disease may be at a higher risk of perinatal death due to factors such as decreased physical resilience, increased risk of chronic diseases, and reduced ability to cope with pregnancy-related stress.

History of Labor

Mother with a history of problematic delivery has a higher risk of perinatal death (p = 0,000, OR = 9,100). This finding suggests that women with a history of problematic delivery may be at a higher risk of perinatal death due to factors such as decreased physical resilience, increased risk of chronic diseases, and reduced ability to cope with pregnancy-related stress.

Antenatal Care Visit

Low Antenatal Care Frequency Correlated with an increased risk of perinatal death (P = 0,000, OR = 27,008). This result indicates that women who receive inadequate antenatal care may be at a higher risk of perinatal death due to factors such as decreased access to healthcare services, reduced ability to detect and manage pregnancy-related complications, and increased risk of chronic diseases.

Discussion

The results of this study highlight the importance of maternal factors and health services in determining the incidence of perinatal death. The findings suggest that older mothers, women with high parity, short distance between births, maternal disease history, history of labor, and low antenatal care frequency are all associated with an increased risk of perinatal death.

Recommendations

Based on these findings, this study recommends the Pidie District Health Office to make the following efforts:

Increasing Health Promotion

Intensive health promotion to the public about the importance of antenatal care visits. This promotion can be done through counseling in various places such as puskesmas, polindes, posyandu, place of officers, and so forth.

Improvement of Health Services

Improving the quality and accessibility of maternal and child health services, especially in the field of antenatal care.

Development of Intervention Strategies

Developing targeted intervention strategies to overcome risk factors for perinatal death, such as education for pregnant women, disease screening programs, as well as efforts to improve the quality of health services.

Conclusion

The importance of efforts to prevent and handle perinatal deaths cannot be ignored. By understanding the factors that influence the incidence of perinatal death, it is expected to be able to be carried out on time interventions to reduce perinatal mortality and improve the health of mothers and children in Pidie Regency.
Frequently Asked Questions (FAQs) about Maternal Factors and Health Services: Perinatal Death Analysis in Pidie Regency in 2008

Q: What is perinatal death?

A: Perinatal death is death that occurs during 28 weeks of pregnancy until the baby is 7 days old.

Q: What is the perinatal mortality rate in Pidie Regency?

A: According to the Indonesian Demographic Survey (SDKI) data in 2002-2003, the perinatal mortality rate reached 24 per 1000 live births, with around 77% of which were caused by neonatal deaths. In Pidie Regency, perinatal mortality rates experienced a significant increase from 0.94% in 2007 to 1.33% in 2008.

Q: What are the risk factors for perinatal death?

A: The study found that several factors are associated with an increased risk of perinatal death, including:

Older mothers
Women with high parity (many giving birth)
Short distance between births
Maternal disease history
History of labor
Low antenatal care frequency

Q: What is the role of antenatal care in preventing perinatal death?

A: The study found that low antenatal care frequency is associated with an increased risk of perinatal death. Antenatal care is essential for detecting and managing pregnancy-related complications, and reducing the risk of perinatal death.

Q: What are the recommendations for preventing perinatal death in Pidie Regency?

A: Based on the findings of this study, the Pidie District Health Office is recommended to:

Increase health promotion to the public about the importance of antenatal care visits
Improve the quality and accessibility of maternal and child health services, especially in the field of antenatal care
Develop targeted intervention strategies to overcome risk factors for perinatal death, such as education for pregnant women, disease screening programs, and efforts to improve the quality of health services

Q: What are the implications of this study for public health policy?

A: This study highlights the importance of addressing the risk factors for perinatal death, particularly in areas with high perinatal mortality rates. Public health policy should prioritize improving access to antenatal care, reducing the risk of maternal disease, and promoting healthy behaviors among pregnant women.

Q: What are the limitations of this study?

A: This study has several limitations, including:

The study was conducted in a single regency, which may limit the generalizability of the findings
The study relied on secondary data, which may be subject to errors or biases
The study did not control for other potential confounding variables

Q: What are the future directions for research on perinatal death?

A: Future research should aim to:

Investigate the specific risk factors for perinatal death in different populations
Develop and evaluate targeted intervention strategies to prevent perinatal death
Examine the impact of public health policy on reducing perinatal mortality rates

Q: What are the implications of this study for healthcare providers?

A: Healthcare providers should be aware of the risk factors for perinatal death and take steps to prevent and manage these risks. This includes:

Providing high-quality antenatal care to all pregnant women
Identifying and managing maternal disease and other risk factors for perinatal death
Educating pregnant women about healthy behaviors and the importance of antenatal care

Q: What are the implications of this study for pregnant women?

A: Pregnant women should be aware of the risk factors for perinatal death and take steps to prevent and manage these risks. This includes:

Receiving regular antenatal care
Managing maternal disease and other risk factors for perinatal death
Engaging in healthy behaviors, such as a balanced diet and regular exercise.