High preterm birth at Cipto Mangunkusumo Hospital as a national referral hospital in Indonesia
Background: Preterm birth is the leading direct that causes neonatal death. Indonesia was listed as one of the countries with the greatest number of preterm birth in 2010. This study aims to identify the prevalence and the potential risk factors of preterm birth among women underwent delivery in Cipto Mangunkusumo Hospital, an Indonesian national reference hospital.
Methods: This retrospective cohort study involved 2,612 women who delivered between January and December 2013. Any clinical data which related to the potential risk factors and outcomes were recorded. The data were managed using chi-square for bivariate analysis and t-test or Mann-Whitney for numerical data followed by multiple logistic regression for multivariate analysis in SPSS version 20.0.
Results: Preterm birth affected 1,020 of 2,616 pregnancies (38.5%). Non-booked patients increased nearly twice risk for preterm delivery (OR 1.89, 95% CI 1.37-2.61). While women with singleton pregnancy (OR 0.17, 95% CI 0.12-0.25), head presentation (OR 0.75, 95% CI 0.63-0.89), and regular ANC (OR 0.67, 95% CI 0.54-0.84) had lower risk for preterm birth. Apgar score, birthweight, and mode of delivery were significantly different between the pre-term group and the full-term group.
Conclusion: Prevalence of preterm birth in Cipto Mangunkusumo Hospital was approximately 2.5 times higher compared to the national number. Several factors reducing preterm birth rate include singleton pregnancy, head presentation, and regular ANC.
Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C, GAPPS Review Group. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth. 2010;10 Suppl 1:S1. https://doi.org/10.1186/1471-2393-10-S1-S1
Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75-84. https://doi.org/10.1016/S0140-6736(08)60074-4
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-72. https://doi.org/10.1016/S0140-6736(12)60820-4
Warren JE, Silver RM. Genetics of the Cervix in Relation to Preterm Birth. Semin Perinatol. 2009;33(5):308-11. https://doi.org/10.1053/j.semperi.2009.06.003
Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Pract Res Clin Obstet Gynaecol. 2007;21(5):773-89. https://doi.org/10.1016/j.bpobgyn.2007.03.001
Lo CC, Hsu JJ, Hsieh CC, Hsieh TT, Hung T-H. Risk Factors for Spontaneous Preterm Delivery Before 34 Weeks of Gestation Among Taiwanese Women. Taiwan J Obstet Gynecol. 2007;46(4):389-94. https://doi.org/10.1016/S1028-4559(08)60008-X
Hofer N, Kothari R, Morris N, MÃ¼ller W, Resch B. The fetal inflammatory response syndrome is a risk factor for morbidity in preterm neonates. Am J Obstet Gynecol. 2013 Dec;209(6):542.e1-542.e11. https://doi.org/10.1016/j.ajog.2013.08.030
Olgun NS, Reznik SE. The matrix metalloproteases and endothelin-1 in infection-associated preterm birth. Obstet Gynecol Int. 2010;2010(11):1-8. http://dx.doi.org/10.1155/2010/657039
Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med. 2004;9(6):429-35. https://doi.org/10.1016/j.siny.2004.04.002
UNICEF [Internet]. Maternal, Newborn & Child Survival. [update 2008 ; cited 2017]. Availabe from : www.unicef.org/eapro/Indonesia_Eng.pdf. p. 1-4.
Zachariassen G, Fenger-Gron J. Preterm dietary study: meal frequency, regurgitation and the surprisingly high use of laxatives among formula-fed infants following discharge. Acta Paediatr. 2014 Mar;103(3):e116-22. DOI: 10.1111/apa.12524
Erez O, Mayer A, Shoham-Vardi I, Dukler D, Mazor M. Primiparity, assisted reproduction, and preterm birth in twin pregnancies: a population based study. Arch Gynecol Obstet. 2007 Oct 31;277(4):311-7. DOI 10.1007/s00404-007-0492-4
Chen CP, Wang KG, Yang YC, See LC. Risk factors for preterm birth in an upper middle class Chinese population. Eur J Obstet Gynecol. 1996 Dec;70(1):53-9. DOI: 10.1016/S0301-2115(96)02555-9
Nguyen N, Savitz DA, Thorp JM. Risk factors for preterm birth in Vietnam. Int J Gynecol Obstet. 2004;86(1):70-8. https://doi.org/10.1016/j.ijgo.2004.04.003
Newburn-Cook CV, Onyskiw JE. Is older maternal age a risk factor for preterm birth and fetal growth restriction? A systematic review. Health Care Women Int. 2005;26(9):852-75. https://doi.org/10.1080/07399330500230912
Di Renzo GC, Giardina I, Rosati A, Clerici G, Torricelli M, Petraglia F, et al. Maternal risk factors for preterm birth: a country-based population analysis. Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):342-6. https://doi.org/10.1016/j.ejogrb.2011.09.024
Bastek JA, Sammel MD, Srinivas SK, McShea MA, Foreman MN, Elovitz MA, et al. Clinical prediction rules for preterm birth in patients presenting with preterm labor. Obstet Gynecol. 2012;119(6):1119-28. https://doi.org/10.1097/AOG.0b013e31825503e5
Nice Clinical Guidelines. Multiple pregnancy: The management of twin and triplet pregnancies in the antenatal period. RCOG; 2011.
Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological changes in hematological parameters during pregnancy. Indian J Hematol Blood Transfus. 2012; 28(3):144-6. https://doi.org/10.1007/s12288-012-0175-6
Marchant T, Willey B, Katz J, Clarke S, Kariuki S, Kuile FT, et al. Neonatal Mortality Risk Associated with Preterm Birth in East Africa, Adjusted by Weight for Gestational Age: Individual Participant Level Meta-Analysis. PLoS Med. 2012;9(8):e1001292. https://doi.org/10.1371/journal.pmed.1001292
Gouyon JB, Vintejoux A, Sagot P, Burguet A, Quantin C, Ferdynus C, et al. Neonatal outcome associated with singleton birth at 34â41 weeks of gestation. Int J Epidemiol. 2010;39(3):769-7. https://doi.org/10.1093/ije/dyq037
McCormick MC, Escobar GJ, Zheng Z, Richardson DK. Place of birth and variations in management of late preterm (“near-term”) infants. Semin Perinatol. 2006;30(1):44–7. https://doi.org/10.1053/j.semperi.2006.01.012
Copyright (c) 2017 Ali Sungkar, Adly N.A. Fattah, Raymond Surya, Budi I. Santoso, Ivica Zalud
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.