Determinants of Adverse Birth Outcomes in Ambon, Indonesia: A Case-Control Study

Background: Globally, adverse birth outcomes were still high, especially in low and middle-income countries like Indonesia. Stillbirth, preterm birth (PTB), low birth weight (LBW), and first-minute birth asphyxia are some of the adverse birth outcomes. The incidence of adverse birth in Ambon is quite high but never been any research about determinants of adverse birth outcomes. Objective: This study aims to examine the determinants of adverse birth outcomes and identify the main modifiable risk factors in Ambon. Method: This retrospective case-control study included all birth outcomes in August and September 2023 in Ambon, Indonesia. A total of 165 birth outcomes (55 cases and 110 controls) with complete information in Puskesmas and Posyandu were included in the analysis. The Chi-square test and regression analyses were applied to evaluate the association between variables. Result: This study showed the impact of pregnant women's age, parity, passive smoking, ANC examination, and ANC counseling on birth outcomes. There are differences in maternal age (p=0.006; 95% CI: 1.22-6.11), parity (p=0.001; 95% CI: 1.52-8.51), passive smokers (p=0.004; 95% CI: 1.37-8.99, ANC examination (p=0.02; 95% CI: 1.08-5.01) and ANC counseling (p=0.002; 95% CI: 1.44-8.67) between case and control groups. Conclusion: Maternal age (≤ 20 and >35 years old), parity (one and ≥ 5), passive smokers, ANC examination not according to standard, and ANC counseling without a husband were associated with a high risk of all adverse birth outcomes.