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Supriyadi Hari Respati
Bagian Obgin FK UNS/ RSUD Dr. Moewardi, Jl. Kol. Sutarto 132 Surakarta
Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health Other

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Korioamnionitis Sebagai Faktor Risiko Terjadinya Persalinan Preterm Rahmi, Elita; Respati, Supriyadi Hari; Melinawati, Eriana
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Premature Rupture of Membranes (PROM) is one causes of fetal mortality and morbidity. Suspected chorioamnionitis is a major cause of preterm labor. Methods: This study was observational analytic cross-sectional approach. Sample of 694 study subjects that satisfy with inclusion and exclusion criteria were taken from the medical records of patients who gave birth in RSUD Dr. Moewardi. The data was analyzed using bivariate analysis and processed with Statistical Product and Service Solutions (SPSS) for Windows 20:00. Results: Chorioamnionitis is a risk factor 1.045 times to preterm delivery occur (OR = 1045; CI = 95%, 0737, 1483, p = 0804). Chorioamnionitis caused  death of neonatal mortality 1.554 times compared with norma pregnancy (OR = 1554; CI = 95%, 0790, 3057, p = 0.194). Chorioamnionitis 1.747 times risk factors for occur asphyxia in preterm labor and statistically significant (OR = 1747; CI = 95%, 1114, 2741, p = 0.014). Conclusions: There was no significant relationship between chorioamnionitis with preterm labor and chorioamnionitis with neonatal mortality. There is a significant relationship between chorioamnionitis with asphyxia. Keywords: PROM, Chorioamnionitis, preterm labor
FAKTOR ANGIOGENIK SOLUBLE FMS-LIKE TYROSINE KINASE-1 DAN VASCULAR ENDOTHELIAL GROWTH FACTOR PADA IBU HAMIL 8 – 20 MINGGU DENGAN RISIKO PREEKLAMPSIA Sulistyowati, Sri; Soetrisno, Soetrisno; Respati, Supriyadi Hari; Wiyono, Bambang Eko
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

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Sri Sulistyowati1, Soetrisno2, Supriyadi Hari Respati3, Bambang Eko Wiyono4 ABSTRACTBackground: Preeclampsia is still the main cause for maternal and neonatal mortality or morbidity. Anti-angiogenic Soluble FMS-Like Tyrosine Kinase-1 (sFlt-1) and proangiogenic Endhothelial Vascular Growth Factor (VEGF) factors can be used as an early detection of preeclampsia due to itsrole in the pathogenesis of preeclampsia, so it can be used as one effort to reduce maternal or perinatal morbidity and mortality.Objective: To analyze sFlt-1 and VEGF levels in the serum of normal pregnancy and pregnancy with preeclampsia risk in 8 – 20 weeks gestation.Method: Observational analytic with cross sectional method performed at the Obstetrics and Gynecology, Dr. Moewardi Hospital/ Medical Faculty Sebelas Maret University Surakarta and Prodia laboratory since November – December 2013. Number of samples studied was 30 samples, comprising 15 samples of normal pregnancy and pregnancy with preeclampsia risk with 8 – 20 weeks of gestational age. The sFlt-1 and VEGF serum levels was assessed using ELISA and analyzed using t-test.Result & Discussion: Serum level of sFlt-1 in normal pregnancy is (1252,17±564,65 ng/ml), and in pregnancy with preeclampsia risk is (1741,90±640,97 ng/ml) with p=0,023 serum level of VEGF in normal pregnancy was 96,88±144,29 ng/ml and in pregnancy with preeclampsia risk was 14,24±8,73 ng/ ml with p=0,044.Conclusion: sFlt-1 level is higher and VEGF level is lower in pregnant women with preeclampsia risk than normal pregnancy on 8 – 20 weeks gestational age.Keywords: Pregnancy, Preeclampsia Risk, sFlt-1, VEGF.ABSTRAKLatar belakang: Preeklampsia saat ini masih merupakan masalah pada ibu hamil yang berhubungan dengan mortalitas dan morbiditas maternal dan perinatal. Faktor anti-angiogenik Soluble FMS-Like Tyrosine Kinase-1 (sFLt-1) dan proangiogenik Vascular Endhothelial Growth Factor (VEGF) diduga dapat digunakan sebagai deteksi dini karena perannya dalam patogenesis preeklampsia, sehingga dapat digunakan sebagai upaya untuk mengurangi angka morbiditas dan mortalitas maternal dan perinatal. Tujuan: Untuk menganalisis kadar sFlt-1 dan VEGF pada serum ibu hamil normal dan ibu hamil dengan risiko preeklampsia pada usia kehamilan 8 – 20 minggu.Metode: Penelitian observasional analitik dengan metode Cross Sectional yang dilakukan di bagian Obstetri dan Ginekologi, RSUD Dr. Moewardi/ FK UNS, Surakarta dan Laboratorium Prodia mulai Nopember – Desember 2013. Jumlah sampel terdiri 30 yang terbagi menjadi 15 sampel ibu hamil normal dan dan 15 sampel ibu hamil dengan risiko preeklampsia usia gestasi 8 – 20 minggu. Masing-masing dianalisis kadar sFlt-1 dan VEGF pada serumnya dengan metode ELISA dan dianalisis menggunakan uji t.Hasil & Pembahaasan: Kadar serum sFlt-1 pada kehamilan normal (1252,17±564,65 ng/ml), kehamilan dengan risiko preeklampsia (1741,90±640,97 ng/ml) dengan nilai p=0,023 dan kadar VEGF pada kehamilan normal (96,88±144,29 ng/ml), kehamilan dengan risiko preeklampsia (14,24±8,73 ng/ ml) dengan nilai p=0,044.Kesimpulan: Kadar sFlt-1 lebih tinggi dan kadar VEGF lebih rendah pada kehamilan dengan risiko preeklampsia dibanding kehamilan normal pada usia hamil 8 – 20 minggu.Kata kunci: Kehamilan, Risiko Preeklampsia, sFlt-1, VEGF.1,2,3,4Sri Sulistyowati, Bagian Obgin FK UNS/ RSUD Dr. Moewardi, Jl. Kol. Sutarto 132 Surakarta. Telp. 08122968215, Email: elis_spog@yahoo.co.id
Recombinant vascular endothelial growth factor 121 decreases vascular cell adhesion molecule-1 in murine pre-eclampsia model placenta Sulistyowati, Sri; Sondakh, John Arianto; Yuliantara, Eric Edwin; Respati, Supriyadi Hari; Soetrisno, Soetrisno
Universa Medicina Vol 35, No 3 (2016)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.192-198

Abstract

BackgroundPreeclampsia is one of the major contributors to maternal and fetal morbidity and mortality. Imbalance of soluble Fms-like tyrosine kinase (sFlt-1) as anti-angiogenic factor and vascular endothelial growth factor (VEGF) as pro-angiogenic factor plays a role in the pathogenesis of preeclampsia. Endothelial dysfunction in preeclampsia causes vascular cell adhesion molecule-1 (VCAM-1) to be expressed on its surface. This study aims to evaluate the effect of recombinant VEGF-121 on VCAM-1 expression in the placenta of a murine preeclampsia model. Methods An experimental analytical study conducted from February until March 2016 in the Biomedical Laboratory, Faculty of Veterinary Medicine, Airlangga University. The study sample consisted of 30 pregnant mice, divided into three groups, i.e. 10 normal pregnant mice, 10 mice with preeclampsia model and 10 mice with preeclampsia model and recombinant VEGF-121 therapy. All animals were subjected to immunohistochemical examination of VCAM-1 expression in their placentas. The results were assessed semiquantitatively according to a modified Remmele method. Data analysis was done using one-way ANOVA and Tukey’s multiple comparisons method. ResultsMean VCAM-1 expression in normal (0.97 ± 0.54%) murine placentas, compared with placentas (2.94 ± 0.96%) of murine preeclampsia models (p=0.000), while mean VCAM-1 expression in placentas of murine preeclampsia models with VEGF intervention was 2.14 ± 0.68% (p=0.030).Conclusion Recombinant VEGF-121 can reduce VCAM-1 expression in placentas of murine preeclampsia models. The present study has shown the potential benefits of VEGF therapy, justifying serious consideration of this therapeutic approach for use in women with preeclampsia.
Factors Associated with Early Marriage in Sleman, Yogyakarta Husna, Nurul; Demartoto, Argyo; Respati, Supriyadi Hari
Journal of Health Promotion and Behavior Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Early marriageis a complex social issue with indirect implication on the quality of family. Early marriage can indirectly contribute to increasing maternal mortality rate and infant mortality rate. There were 135 early marriage cases reported in Sleman district in 2013, 150 cases in 2014, and 123 cases in 2015. The purpose of this study was to analyze factors associates with the incident of early marriage in Sleman, Yogyakarta.Subjects and Method: This was an analytic observational study with case control design conducted in Sleman, Yogyakarta, Central Java, in Indonesia, August to November 2016.A total sample of 120 study subjects consisting of 40 early married young couples and 80 in time married young couples, was selected for this study, by purposive sampling. The dependent variable was early marriage. The indipendent variables included family disharmony, emotional insecurity, promiscuity tendency, unintended pregnancy, maternal education, family social economic class, parent perception of early marriage, and local culture regarding early marriage. The data were collected by questionnaire and document review at the office of religious affairs. The data were analyzed by path analysis using STATA 13.Results: There were direct relationships between unintended pregnancy (b= 3.40; CI95%= 1.08–5.71; p=0.004), income (b=-1.58; CI95%=0.58 sd 2.18; p= 0.001), promiscuity tendency (b=1.93; CI95%=-3.11–0.06; p=0.042), parent perception of early marriage (b=2.75; CI95%=0.49-5.02; p=0.017), local culture regarding early marriage (b=5.62; CI95%=2.63–8.62; p<0.001) and the incidence of early marriage. There were indirect relationsh e. ips between family disharmony, emotional security, promiscuity tendency, maternal education, and incident of early marriage.Conclusion: There were direct relationships between unintended pregnancy, social economic class, promiscuity tendency, parent perception of early marriage, local culture regarding early marriage and the incidence of early marriage.Keywords: Early marriage, family disharmony, unintended early married, local culturCorrespondence: Nurul Husna. Masters Program in Public Health, Sebelas Maret University, Surakarta.Journal of Health Promotion and Behavior (2016), 1(2): 87-98https://doi.org/10.26911/thejhpb.2016.01.02.04
Biopsychosocial Determinants of Pregnant Women’s Behaviour in Conducting Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) Tests in Madiun Arwiyantasari, Wida Rahma; Respati, Supriyadi Hari; Pamungkasari, Eti Poncorini
Journal of Health Promotion and Behavior Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Human Immunodeficiency Virus (HIV) is top ranked infectious disease which causes death with high mortality and morbidity rates, and requires diagnosis and long-term therapy (WHO, 2013). In October 2016, Health Office of Madiun City stated that in 2015, there were 2,772 pregnant women, among those only 1,120 conducted HIV-AIDS tests and 4 of them declared HIV positive. These numbers indicated that the participations of pregnant women in conducting HIV-AIDS tests are not optimal. This study aimed to discover biopsychosocial determinants in conducting HIV-AIDS tests on pregnant women in Madiun.Subject and Methods: This was an analytic observational study with case control design. A total of 108 samples of pregnant women in Madiun which consisted of 54 pregnant women who conducted HIV/AIDS tests as cases, and 54 pregnant women who did not conduct HIV/ AIDS tests as controls were collected by using fixed disease sampling  The device to gather the data was a set of questionnaire. Data analysis used Chi Square and path analysis.Results: There were positive influence of family support (b=1.57; 95% CI= 0.52 to 2.63; p=0.004), information exposure (b=1.14; 95% CI= 0.33 to 1.95; p=0.006), perceived seriousness (b=1.21; 95% CI= 0.14 to 2.28; p=0.027), perceived vulnerability b=1.12; 95% CI= 0.12 to 2.13; p=0.028), perceived benefit (b=1.28; 95% CI= 0.23 to 2.31; p=0.017) on pregnant women’s behaviour in conducting HIV/ AIDS tests, and statistically significant. There were negative influence of family income (b=-0.73; 95% CI= -1.51 to 0.05; p=0.067), perceived obstacles (b=-0.92; 95% CI= -1.99 to 0.15; p=0.093) and statistically significant.Conclusion: Family support, information exposure, family income, perceived seriousness, perceived vulnerability, perceived obstacles, and perceived benefit influence pregnant women in conducting HIV/ AIDS tests.Keywords: determinants, bipsychosocial, HIV/ AIDS testCorrespondence: Wida Rahma Arwiyantasari. Muhammadiyah Midwifery Academy Madiun. Email: widarahmaarwiyantasari@ymail.com. Mobile: 085736709597.Journal of Health Promotion and Behavior (2017),  2(2): 112-123https://doi.org/10.26911/thejhpb.2017.02.02.02
The Effect of Peer Support Group on Depression and Quality of Life among People Living with HIV/AIDS in Kediri East Java Rasyiid, Astika; Dharmawan, Ruben; Respati, Supriyadi Hari
Journal of Health Promotion and Behavior Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: People living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome or HIV/AIDs encounter such problems as society stigma and depression that can affect their quality of life in the term of physical, mental, and social health. Social support should be improved from individual, family, Peer Support Group (PSG), and government. PSG serves to help PLWHA feel not lonely, to give opportunity of seeing others, of sharing information about newest treatment and local support service, to reduce isolation, to improve social support, and to reduce stigma in order to achieve better quality of life and to reduce depression. The objective of research was to analyze the effect of KDS on depression and quality of life among PLWHA in Friendship Plus Peer Support Group in Kediri City.Subjects and Method: This study was an analytical observational study with cross sectional design. This was conducted at Friendship Plus Peer Support Group in Kediri, Indonesia in May to July 2016. The sample consisted of 60 subjects taken using simple random sampling. Technique of collecting data used was questionnaire, while analysis was carried out using Pearson’s Product Moment correlational and multiple linear regression tests.Results: The result of research showed that there was a statistically significant effect of Peer Support Group on the reduced depression in PLWHA (b= -0.60; 95% CI= -0.82 to 0.38; p<0.001). Depression was affected by family income of 88.8% (b= -8.68; 95% CI= 0.01; p=0.021) and education (b= -7.86; 95% CI= -14.05 to 1.67; p=0.014). There was a statistically significant effect of Peer Support Group on the improved quality of life among PLWHA (b=0.32; 95% CI= 0.09 to 0.53; p=0.005). Quality of life was affected by family income of 92.3% (b= 1.36; 95% CI= 0.01; p<0.001) and education (b=20.84; 95% CI=  14.75 to 26.93; p<0.001). Conclusion: This research concluded that there was an effect of peer support group on the reduced depression among PLWHA and there was an effect of peer support group the improved quality of life among PLWHA.Keywords: peer support group, depression, quality of life, PLWHACorrespondence: Astika Rasyiid. Diploma III Midwifery of Tulungagung University, East Java.Journal of Health Promotion and Behavior (2016), 1(1): 32-40https://doi.org/10.26911/thejhpb.2016.01.01.05
Effectiveness of Pregnant Woman Class in The Prevention of Pregnancy Anemia in Banyuwangi, East Java Andriani, Yeni; Respati, Supriyadi Hari; Astirin, Okid Parama
Journal of Maternal and Child Health Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: In developing countries 40% of maternal mortality is associated with pregnancy anemia. Pregnancy anemia has negative effect to mothers, before, during, and after delivery. The purpose of this study was determined effectiveness of pregnant woman class in the prevention of pregnancy anemia in Banyuwangi, East Java.Subjects and Method: This was an analytical observational study with retrospective cohort design. This study was conducted at Benculuk health center, Banyuwangi, East Java. A total of 100 subjects were selected for this study by fixed exposure sampling, consisting of 50 pregnant mothers who participated pregnant woman class and 50  who did not participate pregnant woman class. The dependent variable was pregnancy anemia. The independent variables were  participation in the pregnant woman class, maternal education, family income, food myth, and visit to obstetric gynecology specialist. Anemia was measured by spectrophotometer. Other variables were measured by a set of questionnaire. The data were analyze by multiple logistic regression.Results: Participation in pregnant woman class (OR=0.18; CI 95%= 0.03 to 1.21; p=0.078), maternal education ≥ senior high school (OR=0.07; CI 95%= 0.01 to 0.92; p=0.043), and high family income (≥ Rp 1,599,000) (OR=0.18; CI 95%= 0.31 to 1.03; p=0.054) decreased the risk of pregnancy anemia. Myth in food restriction (OR=4.47; CI 95%=0.73 to 27.51; p=0.106) increased the risk of pregnancy anemia. There was no relationship between visit to obstetric and gynecology specialist and the risk of pregnancy anemia (OR=0.93; CI 95%=0.09 to 9.17; p=0.952).Conclusion: Participation in pregnant mother class, maternal education ≥ senior high school, and high family income (≥ Rp 1,599,000) decrease the risk of pregnancy anemia. Myth in food restriction increase the risk of pregnancy anemia. There is no relationship between visit to obstetric and gynecology specialist and the risk of pregnancy anemia.Keywords: pregnant woman class, pregnancy anemiaCorrespondence: Yeni Andriani. Masters Program in Public Health, Sebelas Maret University, Surakarta.Journal of Maternal and Child Health 2016, 1(4): 230-241https://doi.org/10.26911/thejmch.2016.01.04.04
Multilevel Analysis on the Risk Factors of Post Partum Hemorrhage in Bondowoso, Central Java Saadah, Miftahus; Respati, Supriyadi Hari; Aristin, Okid Parama
Journal of Maternal and Child Health Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The primary causes of maternal mortality in Indonesia are hemorrhage (32%), pre-eclampsia/ eclampsia (25%), infection (5%), prolonged labor (5%), abortus (1%), and other causal factors not related to pregnancy and birth delivery (32%). This study aimed to investigate risk factors of post partum hemorrhage in Bondowoso, East Java.Subjects and Method: This was an analytic observational study with case control design. This study was conducted in Bondowoso, East Java, from  May, 15 to June, 15, 2016. A total of 90 study subjects was selected by fixed disease sampling, consisting of 30 women with post-partum bleeding and 60 control women without post-partum bleeding. The dependent variable was post-partum hemorrhage. The independent variables were age, parity, hemoglobin, obstetric history, use of ANC, and type of birth attendant. The data were collected by questionnaire and medical record. The data were analyzed by mix-effect model.Results: Anemia (Hb <11 g%) (b=2.22; 95%CI=1.05 to 3.39; p=0.001) and obstetric history of bleeding (b=1.31; 95%CI= 0.15 to 2.47; p= 0.027) increased the risk logodd of postpartum hemorrhage, and it was statistically significant. ANC ≥ 4 times (b= -1.46; 95%CI=-2.95 to 0.02; p=0.052) decreased the risk logodd of postpartum hemorrhage, and it was marginally significant. Age <20 year or ≥ 35 year (b= 0.12; 95%CI= -1.01 to 1.26; p= 0.827) and parity = 1 or ≥4 (b= 0.18; 95%CI= -0.95 to 1.32; p=0.754) increased the risk logodd of postpartum hemorrhage, but it was not statistically significant. Multilevel analysis was not needed in this model because ICC <1%.Conclusion: Anemia and history of postpartum bleeding are important risk factors of postpartum hemorrhage. Use of ANC ≥4 times decreases the risk of postpartum bleeding.Keywords: Postpartum bleeding, risk factor.Journal of Maternal and Child Health (2016), 1(4): 205-213https://doi.org/10.26911/thejmch.2016.01.04.01
Association Between Pregnant Woman Class and Pregnancy Complication in Tegal District, Central Java Maryani, Siti; Respati, Supriyadi Hari; Astirin, Okid Parama
Journal of Maternal and Child Health Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Maternal mortality amounted to 33 cases in Tegal, Central Java, in 2015. The leading cause of maternal mortality rate in Indonesia was obstetric complication, i.e 46.8%. Pregnancy complication may be affected by maternal age, parity, education, and maternal employment status. Various efforts have been implemented by the government to reduce maternal mortality rate, including pregnant woman class. The objective of the pregnant mother class is to increase maternal knowledge in risk factor detection and to increase their willingness to use antenatal care. This study aimed to estimate the association between pregnant woman class and pregnancy complication, while controlling for confounding factors.Subjects and Method: This was an analytical observational with case control design. This study was conducted at Pagerbarang, Pangkah and Dukuhwaru Health Centers, Tegal, Central Java. A total of 90 study subjects, consisting of 30 laboring women with complication and 60 without complication. The dependent variable was pregnancy complication. The independent variables were maternal age, parity, education, employment status, and participation in pregnant woman class. The data were collected by a set of questionnaire. The data on pregnancy complication was obtained from the obstetric record at the health center. The data were analyzed by multiple logistic regresion.Results: Parity ≥3 (OR = 3.47; CI 95% = 0.95 to 12.69; p=0.060) and maternal education <senior high school (OR= 8.58; CI 95% = 1.7 to 43.33; p= 0.009) increased the risk of pregnancy complication. Maternal age 20 to 35 years (OR= 0.26; CI 95% = 0.08 to 0.81; p=0.020), employed  mother (OR= 0.21; CI 95% = 0.06 to 0.71; p = 0.012), and participation in pregnant woman class (OR =0.35; CI 95% = 0.12 to 1.05; p = 0.061), decreased the risk of pregnancy complication.Conclusion: Participation in pregnant woman class is associated with decreased risk of pregnancy complication. Parity ≥3 and maternal education <senior high school are associated with increased risk of pregnancy complication. Maternal age 20 to 35 years and employed  mother are associated with decreased risk of pregnancy complication. It is suggested that pregnant women plan their pregnancy in order to prevent pregnancy complication.Keywords: pregnant woman class, pregnancy complication.Correspondence: Siti Maryani. Academy of Midwifery Siti Fatimah, Slawi, Central Java. Mobile: 085741950488.Journal of Maternal and Child Health (2016), 1(4): 214-219https://doi.org/10.26911/thejmch.2016.01.04.02
Analysis of Maternal Mortality Determinants in Bondowoso District, East Java Fransiska, Ratna Diana; Respati, Supriyadi Hari; Mudigdo, Ambar
Journal of Maternal and Child Health Vol 2, No 1 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Data from Population Inter-Census Survey (Survei Penduduk Antar Sensus,  SUPAS) 2015 showed that maternal mortality ratio was 305 per 100,000 live-births in Indonesia. Sustainable Development Goals (SDGs) set 70 per 100,000 live-births as the target for maternal mortality ratio to be achived by 2030. This study aimed to analyze the determinants of maternal mortality in Bondowoso district, East Java.Subjects and Method:This was an analytic observational study with cross-sectional design. This study was carried out at 17 Community Health Centers, in Bondowoso, East Java from February to March 2017. A sample of 117 study subjects, consisting of 39 cases of maternal death and  78 control, was selected for this study by fixed disease sampling. The dependent variable was incidence of maternal death. The independent variables were maternal education, maternal employment status, antenatal care  visit, complication, late model, and other pregnancy risk factors. The data were collected from the obstetric and medical record, as well as a set of questionnaire. The data were analyzed by path analysisResults: Determinants of maternal death included late decision making (b=2.37; 95% CI=0.81 to3.93; p=0.003), late transfer to the hospital (b=2.35; 95%CI =-0.21to4.91; to p=0.072), late handling at the hospital (b=2.36; 95%CI=-0.19to 4.91; p=0.069), and  complication (b=2.5; 95%CI=1.41to3.62; p<0.001). Complication was determined by completeness of antenatal visits (b=-1.01; 95%CI=-1.94to-0.09; p=0.032), and existence of pregnancy risk factor (b=1.90; 95%CI=1.01to 2.78; p=<0.001). Pregnancy risk factors was determined by completeness of antenatal visit (b=-1.09; 95%CI =-1.99to-0.19; p=0.018), maternal education (b=-0.47; 95%CI=-0.85to-0.07; p=0.020), and maternal employment status (b=0.14; 95%CI=-0.17to0.45; p=0.369). Antenatal visit was determined by maternal education (b=0.54; 95%CI=0.098to0.99; p=0.017) and maternal employment status (b=0.08; 95%CI=-0.29to0.45; p=0.683).Conclusion: The direct determinants of maternal death include late decision making, late transfer to the hospital, late handling at the hospital, and complication. The indirect determinants of maternal death include completeness of antenatal visits, existence of pregnancy risk factor, maternal education, and maternal employment status.Keywords: determinant, delay, complication, antenatal care, maternal death Correspondence: Ratna Diana Fransiska. Masters Program in Public Health, Sebelas Maret University. Email: ratnadiana00@gmail.com. Mobile: 085778822668Journal of Maternal and Child Health (2017), 2(1): 76-88https://doi.org/10.26911/thejmch.2017.02.01.08
Co-Authors -, Soetrisno - Adhi, Kresno Condro Adiyana, Febrian Andhika Alamsyah, Meuthia Ambar Mudigdo Antonius Budi Giri Bawono, Antonius Budi Giri Argyo Demartoto, Argyo Aris Sudiyanto Aristin, Okid Parama Arwiyantasari, Wida Rahma Astetri, Lini Bachnas, Muhammad Adrianes Bambang Eko Wiyono, Bambang Eko Bhisma Murti Carissa, Dinda Diffah Hanim Ediningtyas, Atifa Nadira Elita Rahmi Eriana Melinawati Eric Edwin Yuliantara Eti Poncorini Pamungkasari Fajriah, Asruria Sani Fitriawan, Ahmad Hermawan Udiyanto Heru Priyanto John Arianto Sondakh, John Arianto Kartikasari, Uswatun Khasanah Karuniawati, Benny Khoeronisa, Siti Kurniawan, Hendro Kusnadi, Noferi Laqif, Abdurahman Mahandaru, Araafi Hariza Miftahus Saadah, Miftahus Mubarokah, Rizka Innayatun Muhammad Adrianes Bachnas MUHAMMAD AGUS SUPRAYUDI Nababan, Ronald Nasrudin, Muhamad Nurinasari, Hafi Nurul Husna Nutria Widya Purna Anggraini Nuur, Aliffudin Okid Parama Astirin Pella Todungbua', Prima Derry Pradana, Muhammad Denny Gagah Prasetya, Hanung Pujojati, Ferri Waluyo Wiwoho Rahmawati, Deni Nur Fauzia Rahmawati, Oktantia Dyah Rasyiid, Astika Ratna Diana Fransiska Ratnasari Dwi Cahyanti, Ratnasari Dwi Ratnasari, Affi Angelia Ridwan, Robert Rizkiani, Inne RUBEN DHARMAWAN Saputra, Ricky Bernadi Sesunan, Arfan Syahfani SITI MARYANI Soetrisno Kasan Wiharjo, Soetrisno Kasan Soetrisno Soetrisno Sri Mulyani Sri Sulistyowati Sulistywati, Sri Uki Retno Budihastuti Ulfah, Maharani Wiraswesty, Ika WISNU PRABOWO Yeni Andriani, Yeni Yuliani, Saffana Oka