Determinan Kematian Neonatal Dini di RSUD Dr. Achmad Mochtar Bukittinggi

Abstract

The Indonesia Demographic and Health Survey (SDKI) 2002-2003 reported neonatal death rate in Indonesia of 20 per 1000 live birth. Most of the neonatal death occurred early, that is in the age of infant of 0-7 days. This study aimed at knowing factors influencing early nenonatal detah in Dr Achmad MochtarHospital Bukittinggi in the year 2001-2005. The study used medical records of mother and infant as secondary data source and was designed as a casecontrol study. Cases were infants born alive and died during the early neonatal period (0-7 days), and controls were infants born and stay alive during thatperiod. Number of cases was 93 and control was 392 subjects was calculated on 1:4 ratio to increase the study power. Analysis method used was logistic regression analysis. The results show that early neonatal death was influenced by gestational age, Apgar score 1 minute after birth, Apgar score 5 minuteafter birth and birth weight after controlled by pregnancy or delivery complication, referral, health care class, type of delivery, mother's education, and parity variables. Infants with very low birth weight (<1500 grams) have 59 times greater risk of early neonatal death compared to those of normal birth weight. While those with low birth weight (<2500 grams) have 6 times greater risk compared to normal birth weight infants. To anticipate the occurrence of early neonatal death there is a need to intervene since pregnancy (through ANC) until delivery. There is also a need to foster the collaboration between different levels of health care facilities, delivery assistance by specialist in the hospital level, and to standardize health care process including Neonatal Intensive Care Unit (NICU) implementation