Predictors of Poor Neonatal Outcomes among Pregnant Women in Indonesia: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Research Sample
2.2. Operational Definition
2.3. Research Query
2.4. Additional Resource
2.5. Data Collection Procedures
2.6. Data Analysis
3. Results
3.1. Characteristics of Included Studies
3.2. Quality of Studies
3.3. Relation between Antenatal Care and Neonatal Mortality
3.4. Potential for Publication Bias Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No | First Author, Publication Year | Study Year | Study Design | Location | Study Subject | Control | Health-Related Behaviors | Neonatal Outcomes | Effect Size | 95% CI | Other Results | Article Quality a | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Abdullah et al., 2012 [45] | 2009 | Case-control | Makassar, South Sulawesi | 40 | Mothers with early neonatal death history | 120 | Mothers without early neonatal death history | 0–4 ANC visits | Early neonatal death | OR 1.558 | 0.32–7.47 | p value = 0.000; B = 0.748; Sig = 0.650 | 7 |
0–3 ANC visits | Early neonatal mortality | OR 7.3 | N/A | |||||||||||
2 | Abdullah et al., 2016 [52] | 2013 | Matched case-control | East Nusa Tenggara | 152 | Mothers with neonatal death history reported to health service | 308 | Mothers without neonatal deaths history reported to health service | Did not take all recommended iron supplements | Neonatal death | OR 2.27 | 1.13–4.54 | Several infants’ habits also significantly influenced the risk of neonatal death (did not initiate early breastfeeding, did not practice the kangaroo method and had health problems) | 7 |
3 | Alfianti and Darmawati, 2016 [34] | 2016 | Retrospective | Banda Aceh | 35 | Mothers who gave birth to LBW baby | N/A | N/A | Smoking | Low-birth weight | N/A | N/A | Results were descriptively analyzed | 1 |
4 | Anggrahini et al., 2020 [51] | 2016–2017 | Case-control | East Nusa Tenggara | 50 | Mothers who gave birth to LBW baby | 50 | Mothers who gave birth to NBW baby | Obedience to traditional pregnancy care | Low-birth weight | N/A | N/A | Path analysis found that LBW was significantly affected by maternal health status and obedience to the traditional pregnancy rate | 5 |
5 | Astuti, 2020 [35] | 2020 | Case-control | South Bengkulu | 15 | Mothers who gave birth to LBW baby | 15 | Mothers who gave birth to NBW baby | Have complete ANC visits | Low-birth weight | 8 | N/A | The author did not define what complete ANC visits is | 3 |
6 | Diniya et al., 2016 [49] | 2013–2015 | Case-control | Banjar | 41 | Mothers who gave birth to LBW baby | 123 | Mothers who gave birth to NBW baby | Have complete ANC visits | Low-birth weight | OR 3.73 | 1.61–8.66 | ANC visits were the only health behavior discussed in this article | 4 |
7 | Ernawati, 2016 [40] | N/A | Case-control | Pati, Central Java | 32 | Mothers who gave birth to LBW baby | 32 | Mothers who gave birth to NBW baby | Frequency ANC visits | Low-birth weight | N/A | N/A | - | 7 |
Have complete ANC visits | Low-birth weight | OR 4.911 | 1.591–15.157 | |||||||||||
8 | Heldawati et al., 2018 [46] | 2015–2016 | Retrospective cohort | Palu, Central Sulawesi | 34 | Preeclamptic pregnant women | 34 | non-preeclamptic pregnant women | <4 ANC visits | Low-birth weight | p=0.013 | N/A | - | 5 |
9 | Ibrahim et al., 2012 [55] | 2006–2007 | Cohort | Indonesia | 1867 | Pregnant women with 2–3 ANC visits during pregnancy | 11,118 | Pregnant women with four or more ANC visits during pregnancy | 4–6 ANC visits | Neonatal mortality | RR 1.01 | 0.61–1.68 | The frequency of ANC visits in the third trimester is significantly associated with the risk of neonatal death. | 7 |
7–9 ANC visits | Neonatal mortality | RR 0.65 | 0.40–1.08 | |||||||||||
Ten or more ANC visits | Neonatal mortality | RR 0.60 | 0.32–1.13 | |||||||||||
10 | Lestari et al., 2015 [54] | 2013 | case-control | Gianyar, Bali | 58 | Infants with low birth weight | 58 | Infants with average birth weight | Husband’s smoking exposure | Low-birth weight | OR 6.37 | 2.836–14.309 | - | 3 |
Family members smoking exposure | Low-birth weight | OR 6.577 | 2.894–14.948 | |||||||||||
11 | Mahdalena, 2014 [50] | 2012 | Retrospective cohort | South Kalimantan | 45 | Active and passive smoking pregnant women | 22 | Nonsmoking pregnant women | Non-smoking | Low-birth weight | p = 0.78 | N/A | - | 3 |
Passive smoking | Low-birth weight | |||||||||||||
Active smoking | Low birth weight | |||||||||||||
12 | Musrifa et al., 2014 [53] | 2013 | Case-control | East Nusa Tenggara | 29 | Mothers with early neonatal death history | 58 | Mothers without early neonatal death history | Husband’s smoking exposure (passive smoking) | Early neonatal death | OR 2.758 | 0.72–10.50 | - | 6 |
13 | Nur et al., 2016 [47] | 2015 | Case-control | Palu, Central Sulawesi | 58 | Mothers giving birth to LBW infant | 116 | Mother giving birth to normal weight infant | Body weighing | Low birth weight | OR 2.5 | 1.26–5.03 | The pregnancy gap was found to be another risk factor for LBW | 4 |
Blood pressure checking | Low birth weight | OR 2.69 | 1.39–5.18 | |||||||||||
Hemoglobin level examination | Low birth weight | OR 3.15 | 1.45–6.85 | |||||||||||
14 | Nur, 2018 [48] | N/A | Case-control | Palu, Central Sulawesi | 63 | Mothers giving birth to LBW infant | 63 | Mother giving birth to normal weight infant | Passive smoking | Low birth weight | OR 2.21 | 1.07–4.58 | Premature rupture of membranes and light placenta is found to be the other risk factors of LBW | 3 |
15 | Oktaria et al., 2021 [41] | 2015–2017 | Community-based cohort | Yogyakarta | 422 | Pregnant women and their infants from birth until 12 months | N/A | N/A | Mother sun exposure for the entire pregnancy (weekday) | 8 | ||||
Q2 v Q1 | pneumonia onset in the first postnatal year | HR 0.72 | 0.41–1.26 | |||||||||||
Q3 v Q1 | pneumonia onset in the first postnatal year | HR 0.85 | 0.49–1.49 | |||||||||||
Q4 v Q1 | pneumonia onset in the first postnatal year | HR 0.25 | 0.25–0.90 | |||||||||||
Mother sun exposure for the entire pregnancy (weekend) | ||||||||||||||
Q2 v Q1 | pneumonia onset in the first postnatal year | HR 0.68 | 0.38–1.22 | |||||||||||
Q3 v Q1 | pneumonia onset in the first postnatal year | HR 0.91 | 0.53–1.55 | |||||||||||
Q4 v Q1 | pneumonia onset in the first postnatal year | HR 0.46 | 0.24–0.87 | |||||||||||
Smoke exposure | ||||||||||||||
Father smokes every day | pneumonia onset in the first postnatal year | HR 1.57 | 1.02–2.41 | |||||||||||
16 | Paunno et al., 2015 [55] | 2007–2008 | Case-control | Ambon, Maluku | 69 | Mothers with stillbirth history | 69 | Mothers without stillbirth history | Passive smoking | Stillbirth | OR 3.36 | 1.22–10.17 | The other risk factors of stillbirth were ANC quality and anemia status. | 6 |
17 | Rahim, 2020 [44] | 2017–2018 | Case-control | Kuningan, West Java | 27 | Mothers giving birth to LBW infant | 27 | Mother giving birth to normal weight infant | 0–3 ANC visits | Low birth weight | OR 2.17 | 0.36–13.01 | The small number of subjects could be the cause of the insignificant results | 8 |
18 | Rini et al., 2018 [36] | 2012–2015 | Case-control | Lampung | 22 | Mothers giving birth to LBW infant | 22 | Mother giving birth to normal weight infant | Passive smoking | Low birth weight | OR 2 | 0.62–6.42 | Passive smoking is the only health behavior analyzed | 4 |
19 | Riyanti et al., 2018 [37] | 2015–2016 | Case-control | Bener Meriah, Aceh | 38 | Mother giving birth to LBW infant | 38 | Mother giving birth to normal weight infant | Active Smoking | Low birth weight | OR 1.45 | 0.43–1.02 | Maternal age, number of children, and anemia are also found to be the risk factors for LBW | 5 |
Four or more ANC visits | Low birth weight | OR 0.28 | 0.08–1.02 | |||||||||||
20 | Savitri et al., 2018 [42] | 2012–2014 | Cohort | Jakarta | 1099 | Pregnant women Ramadhan exposure | 252 | Pregnant women without Ramadhan exposure | Fasted at any trimester | birth weight | β −63.7 | −230.5 to 103 | 8 | |
Fasted in the first trimester | birth weight | β −23.4 | −246.8 to 200.1 | |||||||||||
Fasted in the second trimester | birth weight | β −35.3 | −224.2 to 153.7 | |||||||||||
Fasted in the third trimester | birth weight | β −121.8 | −318 to 74.4 | |||||||||||
21 | Soesanti et al., 2020 [43] | 2012–2017 | Cohort | Jakarta | 133 | Pregnant women who use household pesticide | 151 | Pregnant women who did not use household pesticide | Use of household pesticide | birth weight | β −121.4 | −227.6 to −15.2 | 7 | |
Use of household pesticide | birth length | β −4.0 | −9.3 to 1.4 | |||||||||||
Use of household pesticide | Head circumference | β −6.4 | −12.1 to −0.7 | |||||||||||
22 | Sutan et al., 2014 [38] | 2010–2012 | Unmatched case-control retrospective | Aceh | 250 | Mothers with LBW babies who died during the neonatal period | 250 | Mothers with LBW babies who survived during the neonatal period | 0–3 ANC visits | Neonatal mortality among low birth weight | OR 3.57 | 2.38–5.38 | 7 | |
23 | Syari et al., 2015 [39] | 2015 | Case-control | Padang, West Sumatera | 19 | Mother giving birth to LBW infant | 21 | Mother giving birth to normal weight infant | Energy intake | Low birth weight | OR 76 | 7.7–754 | Macronutrient intake was the only health behavior discussed in the article | 7 |
Protein intake | Low birth weight | OR 8.5 | 1.54–47 | |||||||||||
Fat intake | Low birth weight | OR 7 | 1.7–30.5 | |||||||||||
Carbohydrate intake | Low birth weight | OR 12 | 2.7–53.3 | |||||||||||
24 | Titaley et al., 2010 [24] | 1994, 1997, 2002–2003 | Cohort | Indonesia | 442 | Mothers with recent early death neonate | 40134 | Mothers with singleton live-born infants | Iron/folic acid supplementation | Neonatal mortality | HR 0.53 | 0.36–0.77 | Iron and folic acid supplementation provide the main protective effect combined with no other form of neonatal care or <2 tetanus toxoid injections | 7 |
Risk Factors | Outcomes | p Value a |
---|---|---|
Passive smoking | Low birth weight | 0.656 |
Incomplete ANC | Low birth weight | 0.876 |
Incomplete ANC | Neonatal mortality | 0.717 |
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Helmyati, S.; Wigati, M.; Hariawan, M.H.; Safika, E.L.; Dewi, M.; Yuniar, C.T.; Mahmudiono, T. Predictors of Poor Neonatal Outcomes among Pregnant Women in Indonesia: A Systematic Review and Meta-Analysis. Nutrients 2022, 14, 3740. https://doi.org/10.3390/nu14183740
Helmyati S, Wigati M, Hariawan MH, Safika EL, Dewi M, Yuniar CT, Mahmudiono T. Predictors of Poor Neonatal Outcomes among Pregnant Women in Indonesia: A Systematic Review and Meta-Analysis. Nutrients. 2022; 14(18):3740. https://doi.org/10.3390/nu14183740
Chicago/Turabian StyleHelmyati, Siti, Maria Wigati, Muhammad Hafizh Hariawan, Erri Larene Safika, Mira Dewi, Cindra Tri Yuniar, and Trias Mahmudiono. 2022. "Predictors of Poor Neonatal Outcomes among Pregnant Women in Indonesia: A Systematic Review and Meta-Analysis" Nutrients 14, no. 18: 3740. https://doi.org/10.3390/nu14183740