The Influence of Gestational Age and Birth Weight on Neonatal Mortality

Wedi Iskandar, Yeni Andayani, Lia Marlia, Burhan Burhan, Aris Primadi

Abstract


Prematurity and low birth weight are some of the causes of neonatal death and significant health problem. This study aimed to determine the influence of gestational age and birth weight on neonatal mortality at the Al Islam Hospital Bandung in 2015–2019. It was a case-control retrospective observational analysis using medical records of the Al Islam Bandung Hospital from January 1, 2015, to December 31, 2019. The inclusion criteria for infants were born alive. Exclusion criteria had severe congenital abnormalities and gestational age <26 weeks. The chi-square test evaluated the univariate comparison test of risk factors between 2 groups. Multiple logistic regression to assess neonatal mortality's predictive factors and the percentage contribution of the influence was calculated (Nagelkerke’s R2 analysis). The number of infants enrolled in 2015–2019 was 6,791 neonates, and who died was 56 neonates (0.82%). In premature infants and low birth weight there was a very significant relationship with neonatal mortality, respectively p=0.000 (p<0.05) OR=30.397 (CI=16.506–55.976), and p=0.000 (p<0.05) OR=41.206 (CI=18.611–91.233). In the multiple logistic regression test, p=0.000 (p<0.05), with a Nagelkerke’s R2 value of 0.344 or 34.4%. This presence that gestational age and birth weight significantly affects neonatal mortality, either partially or simultaneously. The percentage contribution of the influence of gestational age and birth weight to neonatal mortality was 34.4%.

 

PENGARUH USIA GESTASI DAN BERAT BADAN LAHIR TERHADAP KEMATIAN NEONATUS

Prematuritas dan berat badan lahir rendah merupakan beberapa penyebab kematian neonatus dan masalah kesehatan yang signifikan. Penelitian ini bertujuan mengetahui pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus di RS Al Islam Bandung tahun 2015–2019. Penelitian ini merupakan penelitian observasional retrospektif kasus kontrol menggunakan data rekam medis RS Al Islam Bandung periode 1 Januari 2015 hingga 31 Desember 2019. Kriteria inklusi bayi lahir hidup. Kriteria eksklusi bayi dengan kelainan kongenital berat dan usia gestasi <26 minggu. Uji chi-square mengevaluasi perbandingan univariat faktor risiko antara 2 grup. Regresi logistik multipel untuk mengevaluasi faktor prediktif kematian neonatus dan persentase kontribusi pengaruh dihitung (Analisis R2 Nagelkerke). Jumlah bayi yang dirawat tahun 2015–2019 sebanyak 6.791 dan yang meninggal sebanyak 56 (0,82%). Pada bayi lahir prematur dan berat badan lahir rendah terdapat hubungan sangat bermakna terhadap kematian neonatus, berturut-turut p=0,000 (p<0,05) OR=30,397 (CI=16,506–55,976) dan p=0,000 (p<0,05) OR=41,206 (CI=18,611–91,233). Pada uji regresi logistik multipel, p=0,000 (p<0,05) dengan nilai R2 Nagelkerke sebesar 0,344 atau 34,4%. Usia gestasi dan berat badan lahir berpengaruh bermakna terhadap kematian neonatus, baik secara parsial maupun simultan. Persentase sumbangan pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus sebesar 34,4%.


Keywords


Berat badan lahir rendah; kematian neonatus; low birth weight; neonatal mortality; prematur; premature

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References


World Health Organization. Global death child causes. Geneva: World Health Organization; 2020.

Every Preemie—SCALE. Indonesia: profile of preterm and low birth weight prevention and care [Internet]. Washington, DC: Every Preemie—SCALE; 2019 May [cited 2019 September 3]. Available from: https://www.everypreemie.org/wp-content/uploads/2019/07/Indonesia_7.5.19.pdf.

United Nations Children’s Fund. Maternal and newborn health disparities: Indonesia [Internet]. New York: United Nations Children’s Fund; 2018 September [cited 2019 September 10]. Available from: https://data.unicef.org/wp-content/uploads/country_profiles/Indonesia/Maternal%20and%20newborn%20health%20country%20profiles/country%20profile_IDN.pdf.

Alisjahbana B, Rivami DS, Octavia L, Susilawati N, Pangaribuan M, Alisjahbana A, et al. Intrauterine growth retardation (IUGR) as determinant and environment as modulator of infant mortality and morbidity: the Tanjungsari Cohort Study in Indonesia. Asia Pac J Clin Nutr. 2019;28(Suppl 1):S17–31.

del Río R, Thió M, Bosio M, Figueras J, Iriondo M. Prediction of mortality in premature neonates. An updated systematic review. An Pediatr (Barc). 2020;93(1):24–33.

World Health Organization. WHO recommendations on intervention to improve preterm birth outcomes. Geneva: World Health Organization; 2015.

United Nations Childrens’s Fund. Levels and trends in child mortality 2014 [Internet]. New York: United Nations Childrens’s Fund; 2014 September [2019 October 1]. Available from: https://data.unicef.org/wp-content/uploads/2015/12/unicef-2013-child-mortality-report-LR-10_31_14_195.pdf.

Sari TW, Syarif S. Hubungan prematuritas dengan kematian neonatal di Indonesia tahun 2010 (analisis data Riskesdas 2010). J Epidemiologi Kesehat Indones. 2016;1(1):9–14.

Smith VC. The high-risk newborn: anticipation, evaluation, management, and outcome. In: Eichenwald EC, Hansen AR, Martin CR, Stark AN, editors. Cloherty and Stark’s manual of neonatal care. 8th edition. Philadelphia: Wolters Kluwer; 2017. p. 76–93.

Gomella TL, Eyal FG, Bany-Mohammed F, editors. Gomella’s neonatology: management, procedures, on-call problems, diseases, and drugs. 8th edition. New York: McGraw-Hill Education; 2020.

Cupen K, Barran A, Singh V, Dialsingh I. Risk factors associated with preterm neonatal mortality: a case study using data from Mt. Hope Women’s Hospital in Trinidad and Tobago. Children (Basel). 2017;4(12):108.

Pepler PT, Uys DW, Nel DG. Predicting mortality and length-of-stay for neonatal admissions to private hospital neonatal intensive care units: a Southern African retrospective study. Afr Health Sci. 2012;12(2):166–73.

Suparmi, Chiera B, Pradoko J. Low Birth weight and risk of neonatal mortality in Indonesia. Health Sci J Indones. 2016;7(2):113–7.

Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia. Penyajian pokok-pokok hasil riset kesehatan dasar 2013 [Internet]. Jakarta: Balitbangkes Kementerian Kesehatan Republik Indonesia; 2013 [cited 2019 November 5]. Available from: https://pusdatin.kemkes.go.id/article/view/MCN-20141230001/info-terkini-riskesdas-2013.html.

Astria Y, Suwita CS, Suwita BM, Widjaya FF, Rohsiswatmo R. Low birth weight profiles at H. Boejasin Hospital, South Borneo, Indonesia in 2010–2012. Paediatr Indones. 2016;56(3):155–61.

Hidayah D, Hafidh Y. Risk factors for neonatal mortality at Moewardi Hospital, Surakarta. Paediatr Indones. 2014;54(4):219–22.

Tarigan IU, Afifah T, Simbolon D. Faktor-faktor yang berhubungan dengan pelayanan bayi di Indonesia: pendekatan analisis multilevel. J Kesehat Reprod. 2017;8(1):103–18.

Peraturan Menteri Kesehatan Republik Indonesia Nomor 25 Tahun 2014 tentang Upaya Kesehatan Anak. 2014.

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

Haksari EL. Low birthweight and preterm infants in Indonesia. NeoReviews. 2019;20(10):e548–60.

Cooper P. Strategies to reduce perinatal mortality. Lancet Glob Health. 2016;4(1):e6–7.

Zainal H, Dahlui M, Soelar SA, Su TT. Cost of preterm birth during initial hospitalization: a care provider’s perspective. PLoS One. 2019;14(6):e0211997.

Cömert S, Ağzıkuru T, Akin Y, Telatar B, Tan PD, Ergen SG, et al. The cost analysis of preterm infants from a NICU of a state hospital in Istambul. Iran J Pediatr. 2012;22(2):185–90.

Pelangi B, Anindhita F, Susanti L. Penelitian kebijakan: efektivitas jaminan kesehatan nasional untuk menurunkan angka kematian ibu: pengalaman bidan dan perempuan di Jakarta Timur dan Kota Bandung. Jakarta: Women Research Institute: 2015.




DOI: https://doi.org/10.29313/gmhc.v8i3.6718

pISSN 2301-9123 | eISSN 2460-5441


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