Pengaruh Perawatan Kehamilan dan Persalinan dengan Kejadian Kematian Neonatal

Abstract

Abstract

Background: Maternal care interventions (ANC) can reduce perinatal mortality by up to 75%. Neonatal mortality is closely related to the first 100 days of life starting from conception, the intra-uterine period, or in the womb for 230 days. Neonatal mortality can also be caused by various factors based on the cause, namely: Direct causes related to complications during the newborn and indirect causes related to the mother are hypertension, anemia in pregnancy, quality of care during pregnancy and/or delivery, and maternal mortality. Maternal mortality has some characteristics, such as Condition 4 is categorized as too much (namely too young; too old; too close range; and too much), while Condition 3 is categorized as delay, (being late to recognize the danger signs of childbirth; being late in making decisions; being late in handling by health workers in health facilities). Neonatal mortality refers to death in the 1st 28 days of life. Neonatal deaths are divided into two types, such as early neonatal mortality refers to death before 7 days or 0-6 days, and late neonatal mortality to death on days 7-28. The highest rate of neonatal deaths is perinatal mortality, where intrauterine fetal death occurs from 28 weeks of gestation to the 1st 7 days of life.

Objective: This study was to determine the risk of neonatal death associated with prenatal care and delivery, as well as other factors.

Research Methods: This type of observational research with a quantitative approach is a case-control research design. In this study, the case was neonatal mortality and the exposure was pregnancy care and delivery care. Calculation of the case-control sample size without matching by considering previous studies with a minimal sample studied for 1:1 control cases. Thus, the total number of samples is 86 people. By taking non-probability sampling, it is determined by quota sample.

Results and Discussion: There is a relationship between Neonatal mortality with a P-value of 0.3150, which means being late in recognizing danger signs has a risk of 3.150 times The Asymptotic Significance (2-sided) value shows a P-value = 0.011 which means that <0.05 then the OR value declared significant or meaningful. While 95% CI showed a value of 1.306-7.600. There is a relationship between age and Neonatal mortality with the Odds value of Haenszel's Mantel Ratio indicated by the Estimate value, which is 3,496, which means that age in the risk category <25 years and >35 years has a risk of 3.496 times that of the age with no risk category 25-35 years. The Asymptotic Significance (2-sided) value shows a P-value = 0.006 which means that <0.05, the OR value is declared significant or significant. While the 95% CI showed a value of 1.438-8.498. There is a relationship between danger signs and Neonatal Mortality, the Odds value of the Haenszel Coat Ratio is indicated by the Estimate value, which is 3.150, which means that the variable late recognizes danger signs has a risk of 3.150 times that of not recognizing danger signs late. The Asymptotic Significance (2-sided) value shows a P-value = 0.011, which means that <0.05, the OR value is declared significant or significant. While 95% CI showed a value of 1.306-7.600.

Conclusion: Pregnancy care and other factors, such as age and danger signs, have a risk of neonatal death compared to delivery care. Pregnant women of reproductive age have a higher risk than the group of live neonates. In the stillbirth group, pregnant women who were late in recognizing danger signs were higher than in the live neonates group.

 Keywords: Neonatal Death; Pregnancy and Delivery Care; RSUD dr. Haulussy Ambon.