Introduction The health of newborns is inextricably linked to that of their mothers. Some
maternal factors can influence neonatal survival, particularly for low birth
weight babies who are more vulnerable to diseases than normal weight
babies. The aim of this study is to assess the impact of maternal factors on
neonatal mortality among low birth weight babies in Aceh Province,
Indonesia.
Methods Study design was unmatched case control. Data collected from 2010 to 2012
in 8 districts in Aceh province, Indonesia. Total sample was 500, divided into
250 LBW who died in neonatal period (case group) and 250 who did not die
in neonatal period (control group). There were 6 maternal variables analysed.
Results Three of six variables analysed were not associated with neonatal mortality
among LBW (P > 0.05); these were: maternal death, parity and education
level. The age of the mother had a significant association with neonatal
mortality among LBW (P < 0.05), but was not a determinant factor. The
maternal illness and birth interval were determinant factors of neonatal
mortality among LBW(P < 0.05); maternal illness (Adj OR= 2.6; 95 % CI:
1.68 - 4.0) and birth interval (Adj OR= 1.8; 95 % CI: 1.20 - 2.91).
Conclusions Maternal illness and birth interval were determinant factors of neonatal
mortality among LBW. Appropriate care throughout stages of pregnancy and
increasing women’s knowledge on high risk pregnancy are the key factors to
the decrease of the neonatal mortality related to the maternal factors.
BACKGROUND: Cultural practice have often overlooked when providing maternal and child health care services. Low birth weight is the second cause of neonatal mortality in the world but it is a major factor in a developing country such as Indonesia. The purpose of this study is to predict the neonatal mortality among low birth weight babies in Aceh Province Indonesia.
METHODS: Unmatched case control study was conducted using data from year 2010 to 2012 in 8 selected districts of Aceh Province Indonesia. A total of 500 samples were obtained. There were 250 of the samples died in neonatal period (case group) and 250 who were alive (control group). There were 26 variables studied and were grouped into 4 factors: neonatal factor, maternal factor, maternal and child health services and neonatal care practices. The data was analysed using bivariate logistic regression and multivariate logistic regression.
RESULTS: There were 13 out of 26 variables found as determinant factors of neonatal mortality among low birth weight babies in Aceh Province. The predictors found in this study were: boy (aOR1.80, 95% CI: 1.09-2.96), moderate low birth weight (aOR17.84, 95% CI: 6.20-51.35), preterm (aOR1.84, 95% CI: 1.07- 3.17), presence of maternal illnesses (aOR1.87, 95% CI: 1.06-3.30), too short or too long birth interval (aOR1.80, 95% CI: 1.20-2.91), inappropriate antenatal care (aOR2.29, 95% CI: 1.34-3.91), inappropriate neonatal visit (aOR7.04, 95% CI: 3.67-13.49), not practicing kangaroo mother care (aOR15.32, 95% CI: 2.85-82.56), not using warm bottle padding (aOR20.70, 95% CI: 6.32-67.80), not practicing 'didaring' (aOR4.33, 95% CI: 1.83-10.19), late initiation of breastfeeding (aOR2.03, 95% CI: 1.09-3.80), discard colostrums (aOR3.53, 95% CI: 1.93-6.43) and not practicing exclusive breastfeeding (aOR5.58, 95% CI: 2.89-10.77).
CONCLUSIONS: Cultural practices are strongly seen among Acehnese. Inappropriate antenatal care and neonatal care, late initiation of breastfeeding, discarding colostrums and not practicing exclusive breastfeeding were related to cultural practices. Improving knowledge heat preservation to prevent hypothermia using Kangaroo mother care, warm bottle padding and 'didaring' were proven methods to reduce neonatal mortality. Strengthening of health services in screening for high risk cases and anticipate intervention tailored to cultural practices are important to decrease neonatal mortality among low birth weight.