Delivery Complications and Factors Associated with Maternal Death in Central Lampung Regency, Indonesia: A Case-Control Study

Nova Muhani; Aprilia Diantika; Wayan Aryawati; Nurul Aryastuti; Eka Nurhayati

Nova Muhani Public Health Study Program, Faculty of Health Science, Malahayati University, Bandar Lampung, Postal Code 35152
Aprilia Diantika Central Lampung Health Service, Central Lampung, Postal Code 34172
Wayan Aryawati Public Health Study Program, Faculty of Health Science, Malahayati University, Bandar Lampung, Postal Code 35152
Nurul Aryastuti Midwifery Study Program, Faculty of Mathematics and Natural Sciences, University of Bengkulu, Postal Code 34172
Eka Nurhayati Master of Public Health, Faculty of Medicine and Health Sciences, Alma-Ata University, Yogyakarta, Postal Code 55183

Keywords: Complication, Labor, Maternal mortality, Pregnancy

Abstract

Background: Maternal mortality is an important indicator of population health. The maternal mortality rate (MMR) in Indonesia was 189 per 100,000 live births, compared with 192 per 100,000 live births in Lampung. Several efforts have been implemented to reduce maternal mortality by improving access to and the quality of maternal health services. This study aimed to identify risk factors associated with maternal death in Central Lampung Regency.

Method: A case-control design was conducted at hospitals located in Central Lampung Regency, Lampung Province. The cases comprised women who died during pregnancy, childbirth, or the postpartum period, while the controls comprised women who survived childbirth and had live births. A total of 71 cases and 142 controls were included. Data were collected retrospectively from hospital medical records from 2019 to 2021 using a data extraction form. The data were analyzed using logistic regression.

Result: Pregnancy complications (B=1,859; OR=6,414; 95% CI 2,784-14,777), delivery complications (B=2,835; OR=17,026; 95% CI 6,544-44,302), parity (B=1,596; OR=4,931; 95% CI 2,167-11,218), maternal medical history (B=1,401; OR=4,061; 95% CI 1,663-9,916) were significantly associated with maternal death. Among the variables included in the model, delivery complications showed the strongest association with maternal death, with an odds ratio (OR) of 17.0.

Conclusion: Delivery complications showed the strongest association with maternal death in this study. Strengthening healthcare providers’ capacity to recognize and manage pregnancy and childbirth complications, together with comprehensive counseling on safe pregnancy and childbirth practices, may help reduce maternal mortality.