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Correlation between maternal infections and neonatal health: Evidence from Haji Adam Malik Hospital, Medan
Muara P Lubis1, Melvin N G Barus1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Maternal infections remain a critical but under-addressed determinant of neonatal health in Indonesia, yet hospital-based evidence is limited. This retrospective study reviewed 206 maternal records at Haji Adam Malik Hospital, Medan (2015-2018) to examine the prevalence of HIV, hepatitis B, and syphilis and their associations with neonatal outcomes. HIV prevalence was 6.8% (14/206), substantially higher than national estimates, while hepatitis B was detected in 2.4% (5/206) and no syphilis cases were identified. Overall, one-third of infants (33%) were born with low birth weight and 9.2% had suboptimal Apgar scores. Bivariate analysis showed significant associations between HIV infection and elevated maternal leukocyte counts with adverse neonatal outcomes (p < 0.05). Unexpectedly, none of the hepatitis B-reactive mothers had infants with low birth weight or poor Apgar scores, a finding likely due to the very small sample size and potential confounding. These results highlight the disproportionate burden of HIV in Medan, the methodological challenges of small-case analyses, and the urgent need for reliable antenatal infection screening and strengthened prevention of mother-to-child transmission services to reduce preventable neonatal morbidity.
Maternal infections remain a critical but under-addressed determinant of neonatal health in Indonesia, yet hospital-based evidence is limited. This retrospective study reviewed 206 maternal records at Haji Adam Malik Hospital, Medan (2015-2018) to examine the prevalence of HIV, hepatitis B, and syphilis and their associations with neonatal outcomes. HIV prevalence was 6.8% (14/206), substantially higher than national estimates, while hepatitis B was detected in 2.4% (5/206) and no syphilis cases were identified. Overall, one-third of infants (33%) were born with low birth weight and 9.2% had suboptimal Apgar scores. Bivariate analysis showed significant associations between HIV infection and elevated maternal leukocyte counts with adverse neonatal outcomes (p < 0.05). Unexpectedly, none of the hepatitis B-reactive mothers had infants with low birth weight or poor Apgar scores, a finding likely due to the very small sample size and potential confounding. These results highlight the disproportionate burden of HIV in Medan, the methodological challenges of small-case analyses, and the urgent need for reliable antenatal infection screening and strengthened prevention of mother-to-child transmission services to reduce preventable neonatal morbidity.
Frequently Asked Questions
Based on this study's findings, maternal HIV infection was significantly associated with adverse neonatal outcomes (p < 0.05), including a higher incidence of low birth weight and suboptimal Apgar scores compared to infants born to non-infected mothers.
The researchers identified an HIV prevalence of 6.8% (14 out of 206 maternal records), a value that the study authors noted was substantially higher than the national estimates for Indonesia during the 2015-2018 study period.
The researchers used a retrospective review of 206 records at Haji Adam Malik Hospital to examine the prevalence of HIV, hepatitis B, and syphilis, enabling the identification of significant associations between maternal leukocyte counts and infant health.
The study's authors flagged the very small sample size of hepatitis B-reactive mothers (2.4% or 5/206) as a constraint, which likely explains why none of their infants demonstrated low birth weight or poor Apgar scores.
The study's authors propose that there is an urgent need for reliable antenatal infection screening and strengthened Prevention of Mother-to-Child Transmission (PMTCT) services to reduce preventable neonatal morbidity and address the high regional burden of HIV.
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