Wiwien Sugih Utami
Departement of Parasitology, Faculty of Medicine, University of Jember

DOI: https://doi.org/10.19184/ams.v11i3.53772

Abstract

In 2023 and 2024, Jember Regency had the highest maternal mortality rate (MMR) in East Java. Preeclampsia (PE), a form of hypertension during pregnancy, is the second leading cause of MMR after postpartum hemorrhage. This study aimed to analyze the risk factors and quality of antenatal care (ANC) for pregnant women with preeclampsia at the Ajung Community Health Center in Jember Regency. The study employed a retrospective cohort design. The study sample consisted of 55 pregnant women with preeclampsia from the Ajung Community Health Center between 2020 and May 2025. A two-sample independent t-test was used to analyze differences in risk factors among women with preeclampsia statistically. An ordinal regression test determined the relationship between preeclampsia risk factors and ANC quality. The results revealed 49 cases of preeclampsia occurring at or after 34 weeks of gestation and six cases occurring before 34 weeks. A significant difference was found in maternal age as a risk factor for preeclampsia. Most of the ANC quality in the study sample was very poor (62.5%), with maternal age and mean arterial pressure (MAP) being the main influencing factors. Age- related risk factors differed among pregnant women with preeclampsia, and a relationship was found between maternal age, MAP, and ANC quality.

Keyword: Maternal mortality rate, preeclampsia, antenatal care

REFERENCE

1. Abraham, Talitha, & Romani, Andrea M. P. (2022). The Relationship between Obesity and Pre-Eclampsia : Incidental Risks and Identification of Potential Biomarkers for Pre-Eclampsia. MDPI, 11(9), 1–24. https://doi.org/https://doi.org/10.3390/cells11091548

2. Abuosi, Aaron Asibi, Anaba, Emmanuel Anongeba, Daniels, Anita Anima, Asiwome, Anita, Baku, Adzo, & Akazili, James. (2024). Determinants of early antenatal care visits among women of reproductive age in Ghana : evidence from the recent Maternal Health Survey. BMC Pregnancy Childbirth, 24(309), 1–8. https://doi.org/https://doi.org/10.1186/s12884-024-06490-3

3. Anna, W., Zembala-szczerba, Małgorzata, Babczyk, Dorota, Kołodziejczyk-pietruszka, Monika, Lewaczy, Olga, & Huras, Hubert. (2019). Early- and Late-Onset Preeclampsia : A Comprehensive Cohort Study of Laboratory and Clinical Findings according to the New. International Journal of Hypertension, 2019, 1–9. https://doi.org/https://doi.org/10.1155/2019/4108271

4. Braunthal, Stephanie, & Brateanu, Andrei. (2019). Hypertension in pregnancy : Pathophysiology and treatment. SAGE Open Medicine, 7, 1–15. https://doi.org/10.1177/2050312119843700

5. Chang, Kai jung, Seow, Kok min, & Chen, Kuo hu. (2023). Preeclampsia : Recent Advances in Predicting , Preventing, and Managing the Maternal and Fetal Life-Threatening Condition. International Journal of Environmental Research and Public Health, 20(2994), 1–28. https://doi.org/https://doi.org/10.3390/ijerph20042994

6. Cunningham, Gary et al. (2022). Williams Obstetrics. New York: McGraw-Hill Companies.

7. Dimitriadis, Evdokia, Rolnik, Daniel L., Zhou, Wei, Estrada-Gutierrez, Guadalupe, Koga, Kaori, Francisco, Rossana P. V., Whitehead, Clare, Hyett, Jon, da Silva Costa, Fabricio, Nicolaides, Kypros, & Menkhorst, Ellen. (2023). Pre-eclampsia. Nature Reviews Disease Primers, 9(1), 1–22. https://doi.org/10.1038/s41572-023-00417-6

8. Ito, Momoka, Kyozuka, Hyo, Yamaguchi, Tomoko, Sugeno, Misa, Murata, Tsuyoshi, Hiraiwa, Tsuyoshi, Ito, Fumihiro, Suzuki, Daisuke, Fukuda, Toma, Yasuda, Shun, Keiya Fujimori, & Nomura, Yasuhisa. (2023). Association between Gestational Weight Gain and Risk of Hypertensive Disorders of Pregnancy among Women with Obesity: A Multicenter Retrospective Cohort Study in Japan. Nutrients, 15(11), 1–13. https://doi.org/https://doi.org/10.3390/nu15112428

9. Kementerian Kesehatan Republik Indonesia. (2020). Pedoman Pelayanan Antenatal Terpadu. In Qualitative Health Communication (Vol. 1). https://doi.org/10.7146/qhc.v1i2.130396

10. Kementerian Kesehatan Republik Indonesia. (2021). Permenkes No.21 tahun 2021 tentang Penyelenggaraan Pelayanan Kesehatan Masa Sebelum Hamil, Masa Hamil, Persalinan dan Masa Sesudah Melahirkan serta Pelayanan Kontrasepsi dan Kesehatan Seksual. Jakarta: Kementerian Kesehatan Republik Indonesia.

11. Kusuma, Natasha Cita Paradhita, & Hidayat, Fadil. (2023). Karakteristik Preeklamsia berdasarkan Early Onset Preeclampsia (EOPE) dan Late Onset Preeclampsia (LOPE) RSUD DR Slamet Garut Jawa Barat. Jurnal Medika Malahayati, 7(3), 829–834. https://doi.org/https://doi.org/10.33024/jmm.v7i3.10772

12. Mayrink, Jussara, Souza, Renato T., Feitosa, Francisco E., Filho, Edilberto A. Rocha, Leite, Débora F., Vettorazzi, Janete, Calderon, Iracema M., Costa, Maria L., Kenny, Louise, Baker, Philip, & Cecatti, Jose G. (2019). Mean Arterial Blood Pressure: Potential Predictive Tool for Preeclampsia in a Cohort of Healthy Nulliparous Pregnant Women. BMC Pregnancy and Childbirth, 19(1), 1–8. https://doi.org/https://doi.org/10.1186/s12884-019-2580-4

13. Mou, Ananya Dutta, Barman, Zitu, Hasan, Mahmudul, Miah, Rakib, Hafsa, Jaasia Momtahena, Trisha, Aporajita Das, & Ali, Nurshad. (2021). Prevalence of preeclampsia and the associated risk factors among pregnant women in Bangladesh. Scientific Reports, 1–9. https://doi.org/10.1038/s41598-021-00839-w

14. Mouhoumed, Hamda Mohamed, & Mehmet, Nimetcan. (2021). Utilization pattern of antenatal care and determining factors among reproductive-age women in Borama , Somaliland. Journal of Preventive Medicine and Hygiene, 62(2), 439–446. https://doi.org/https://doi.org/10.15167/2421-4248/jpmh2021.62.2.1882

15. Mursyida, Rikhly Faradisy, Bangun, Adriana, Hanifah, Dewi, Sholikah, Siti Mar’atus, Hanifah, Dewi, & Widyastuti, Deny Eka. (2025). Asuhan Komprehensif pada Kehamilan. Jakarta Barat: PT Nuansa Fajar Cemerlang (OPTIMAL).

16. Mussa, Ibsa, Makhubela-nkondo, On, Maruta, Melat B., & Debella, Adera. (2023). Missed Opportunity of Antenatal Care Services Utilization and Associated Factors among Reproductive Age Women in Eastern Hararghe Zone, Eastern Ethiopia : Mixed Methods Study. Journal Pregnancy, 2023, 1–13. https://doi.org/https://doi.org/10.1155/2023/8465463

17. POGI. (2016). PNPK Diagnosis dan Tatalaksana Preeklampsia. Jakarta: POGI. Rahman, Luthfi, Anwar, Ruswana, & Mose, Johanes Cornelius. (2024). Maternal and neonatal outcome among women with early-onset preeclampsia and late-onset preeclampsia. Hypertension in Pregnancy, 43(1), 2405991. https://doi.org/10.1080/10641955.2024.2405991

18. Razzak, Ruhida, & Shivkumar, Poonam V. (2023). Early Prediction of Hypertensive Diseases of Pregnancy by Using Combined Screening Methods in a Rural Population. Cureus, 15(12). https://doi.org/10.7759/cureus.50624

19. Rybak-Krzyszkowska, Magda, Staniczek, Jakub, Kondracka, Adrianna, Bogusławska, Joanna, Kwiatkowski, Sebastian, Góra, Tomasz, Strus, Michał, & Górczewski, Wojciech. (2023). From Biomarkers to the Molecular Mechanism of Preeclampsia—A Comprehensive Literature Review. International Journal of Molecular Sciences, 24(17). https://doi.org/10.3390/ijms241713252

20. Salam, Sabria, & Elawam, Noura. (2023). Risk Factors of Early and Late Onset Preeclampsia. Khalij-Libya Journal of Dental and Medical Research, 7(2), 167–170. https://doi.org/https://doi.org/10.47705/kjdmr.237214

21. Staff, Anne Cathrine. (2019). The two-stage placental model of preeclampsia : An update. Journal Reproduction Immunology, 135, 1–10. https://doi.org/10.1016/j.jri.2019.07.004

22. Sungkar, Ali, & Surya, Raymond. (2020). Antenatal Care for High Risk Pregnancy. Cermin Dunia Kedokteran, 47(8), 631–633. https://doi.org/https://doi.org/10.55175/cdk.v47i8.588

23. Tedyanto, Cecilia Putri, Octavius, Fransiscus, Prasetyadi, Hari, & Dewi, Sianty. (2025). Maternal factors and perinatal outcomes associated with early-onset versus late-onset fetal growth restriction : a meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine, 38(1). https://doi.org/10.1080/14767058.2025.2505774

24. Wu, Yinshuang, Guo, Lu, & Lu, Dan. (2023). The interaction between age and parity on adverse pregnancy and neonatal outcomes. Frontiers in Medicine, 10, 1–13. https://doi.org/https://doi.org/10.3389/fmed.2023.1056064

25. Yasin, Rahima, Azhar, Maha, Allahuddin, Zoha, Das, Jai K., & Bhutta, Zulfiqar A. (2024). Antenatal care strategies to improve perinatal and newborn outcomes. Neonatology, 122(suppl 1), 1–30. https://doi.org/10.1159/000542702

26. Zhu, Jing, Zhang, Jun, Razali, Nurul Syaza, Chern, Bernard, & Tan, Kok Hian. (2021). Mean arterial pressure for predicting preeclampsia in Asian women : a longitudinal cohort study. 1–9. https://doi.org/10.1136/bmjopen-2020-046161