Maternal death associated with preeclampsia in Indonesia

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Public Health

Background:

• Preeclampsia (PE) is a major contributor to maternal mortality globally and in Indonesia.
• Understanding the specific clinical factors associated with PE-related maternal deaths is crucial for targeted interventions.

Purpose of the Study:

• To identify clinical factors associated with maternal mortality in preeclampsia (PE) cases in Indonesia.
• To analyze maternal and perinatal outcomes in relation to PE severity and mortality.
• To inform healthcare policy and interventions for pregnant women in Indonesia.

Main Methods:

• A multicenter retrospective cohort study was conducted across 30 Indonesian hospitals.
• Data from 1,808 pregnancies complicated by PE were analyzed between January 2022 and December 2023.
• Maternal risk factors, complications, and perinatal outcomes were compared between survivors and those who died.

Main Results:

• Pulmonary edema (aOR=3.97) and ICU admission (aOR=5.25) were significantly associated with increased maternal mortality risk.
• HELLP syndrome and acute kidney injury (AKI) showed a tendency towards increased mortality risk (p>0.05).
• Maternal death correlated with adverse perinatal outcomes, including higher intrauterine fetal death and neonatal mortality rates.

Conclusions:

• Preeclampsia poses a significant maternal mortality risk in Indonesia, with pulmonary edema, AKI, and HELLP syndrome as critical factors.
• Prioritizing early screening, identification, and preventative interventions for PE during antenatal care is essential to reduce maternal deaths.
• The findings underscore the need for enhanced healthcare strategies to manage PE effectively in Indonesia.