MATERNAL AGE, PARITY, AND ANTENATAL CARE VISITS AS PREDICTORS OF CESAREAN SECTION DELIVERY AT TK II MARTHEN INDEY HOSPITAL, JAYAPURA

Ulfa Rahmadani; Vrensca C M Rupilu; Fika Daulian; Syaharuddin Nur; Faridha Almira; Wilma Florensia; Anneke Yacob; Ristina Rosauli Harianja

Authors

Ulfa Rahmadani Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Vrensca C M Rupilu Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Fika Daulian Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Syaharuddin Nur Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Faridha Almira Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Wilma Florensia Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Anneke Yacob Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia
Ristina Rosauli Harianja Fakultas Kesehatan Masyarakat, Univesitas Cenderawasih, Papua, Indonesia

Keywords:

Cesarean Section, Antenatal Care, Maternal Age, Parity

Abstract

Background: Cesarean section (CS) rates have been increasing in Indonesia, including in Papua, raising concerns about maternal and neonatal outcomes. Antenatal care (ANC) is a key intervention to monitor pregnancy and prevent complications.

Objective: This study aimed to determine the association between maternal age, parity, and ANC Visits with cesarean section delivery at TK II Marthen Indey Hospital, Jayapura.

Methods: An analytical observational study with a cross-sectional design was conducted in 2017. The study population consisted of all delivering mothers, with a sample of 149 respondents selected based on specific inclusion and exclusion criteria. Data were obtained from medical records, including variables on maternal age, parity, ANC visits, and medical history. Univariable, bivariate (Chi-square), and multivariable (logistic regression) analyses were performed to identify dominant factors associated with CS.

Results: Of 149 respondents, 57.0% delivered by CS, exceeding the WHO recommended rate (5–15%). Multivariable analysis showed that maternal age <20 or >35 years (aOR=1.6; 95% CI: 1.02–2.85; p=0.042), primiparity (aOR=1.9; 95% CI: 1.08–3.60; p=0.038), and irregular ANC visits (aOR=3.8; 95% CI: 2.00–7.20; p=0.001) were significantly associated with CS. The model showed good fit (Hosmer–Lemeshow p=0.47, Nagelkerke R²=0.32) and discrimination ability (AUC=0.76).

Conclusion: Maternal age, primiparity, and ANC Visits are significant predictors of cesarean section delivery, with irregular ANC being the dominant factor. Interventions promoting regular ANC visits, particularly for high-risk mothers, are recommended to reduce unnecessary CS.

References

M. Mutiara, "Tren persalinan seksio sesarea di Indonesia," Jurnal Kesehatan Indonesia, 2014.

Gulardi dan Basalamah, "Survei persalinan seksio sesarea di 64 rumah sakit Jakarta," 1993.

Sulastri, dkk., "Kualitas pemeriksaan antenatal yang tidak adekuat sebagai faktor risiko persalinan sectio caesarea di 2 RS wilayah Jakarta Timur," Jurnal Online, 2014. [Online]. Available: Diakses 23-Apr-2017.

Kementerian Kesehatan RI, Riset Kesehatan Dasar (RISKESDAS) 2013, Jakarta: Badan Penelitian dan Pengembangan Kesehatan RI, 2013.

Kementerian Kesehatan RI, Profil Kesehatan Papua 2013, Jakarta: Pusat Data dan Informasi Kesehatan, 2013.

World Health Organization, WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: WHO, 2016.

L. Andayasari, dkk., "Proporsi sectio caesarea dan faktor yang berhubungan dengan sectio caesarea," Buletin Penelitian Kesehatan, vol. 43, no. 2, pp. 105–116, Jun. 2015.

Nursalam, Konsep dan Penerapan Metodologi Penelitian Ilmu Keperawatan, Jakarta, 2003.

S. Notoatmodjo, Metodologi Penelitian Kesehatan, Yogyakarta: Rineka Cipta, 2010.

F. S. S. Maisyaroh, dkk., "Karakteristik ibu bersalin dengan sectio caesarea di Rumah Sakit Umum Daerah Dr. Pirngadi Medan," 2012.

I. B. G. Manuaba, I. A. C. Manuaba, I. B. G. F. Manuaba, Ilmu Kebidanan, Penyakit Kandungan dan KB untuk Pendidikan Bidan, Edisi ke-2, Jakarta: EGC, 2010.

B. Murti, Desain dan Ukuran Sampel untuk Penelitian Kuantitatif dan Kualitatif di Bidang Kesehatan, Yogyakarta: Gajah Mada University Press, 2013.

V. Sumelung, dkk., "Faktor-faktor yang berperan meningkatkanya angka kejadian sectio caesarea di Rumah Sakit Umum Daerah Liun Kendage Years olda," E-journal Keperawatan (e-Kp), vol. 2, no. 1, Feb. 2014.

Y. Chen, L. Wu, W. Zhang, L. Zou, G. Li, L. Fan, and C. Li, “Advanced maternal age and adverse perinatal outcomes: A retrospective cohort study in China,” J. Matern. Fetal Neonatal Med., vol. 31, no. 22, pp. 2901–2906, 2018, doi: 10.1080/14767058.2017.1359830.

N. Yuliani, Hubungan Karakteristik Ibu Bersalin dengan Tindakan Sectio Caesarea di RSUD Kota Semarang Years old 2017. Semarang: Universitas Muhammadiyah Semarang, 2017.

S. Vahratian, “Prevalence of prolonged labor among primiparas in the United States: 1995–2000,” Obstetrics & Gynecology, vol. 107, no. 5, pp. 1051–1058, 2006, doi: 10.1097/01.AOG.0000214957.53133.2a

Sulastri, “Hubungan keteraturan pemeriksaan antenatal care dengan kejadian persalinan sectio caesarea,” Jurnal Kesehatan Reproduksi, 2014.

Lestari, “Pengaruh keteraturan antenatal care terhadap luaran persalinan ibu,” Jurnal Bidan Indonesia, 2018.

P. Titaley, C. Hunter, M. Dibley, dan P. Heywood, “Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia,” BMC Pregnancy and Childbirth, vol. 10, no. 43, pp. 1–14, 2010.

Rahayu, “Faktor usia ibu terhadap kejadian persalinan seksio sesarea,” Jurnal Kebidanan, 2016.