Risk factors associated with spontaneous abortion in Dr. Soetomo General Hospital Surabaya: a case-control study

Abstract

The Maternal Mortality Ratio (MMR) in Indonesia is still fairly high. One of the top three causes of maternal death is bleeding. Spontaneous abortion is an early pregnancy problem leading to the occurrence of bleeding and direct maternal death. The causes of spontaneous abortion vary and can be caused by multiple factors. Early identification of risk factors is necessary to reduce mortality and morbidity due to spontaneous abortion and its complications. This study's objective was to identify the risk factors of spontaneous abortion in Dr. Soetomo General Hospital. This study was an observational analytic with a case-control approach. The population was all pregnant women hospitalized at the Obstetrics and Gynaecology Department in Dr. Soetomo General Hospital from January 2017 to December 2018. The samples were 120 in total, included  40 cases and 80 controls taken by consecutive sampling. The data were analyzed using univariate and bivariate analysis with the Chi-square test. The results based on the bivariate analysis showed history of previous abortion (p <0.001), chronic maternal disease (p <0.001), hemoglobin levels (p = 0.020), maternal age (p= 0.026), gravidity (p= 0.036), and  infection (p= 0.037) had significant correlation with spontaneous abortion. In conclusion, risk factors associated with spontaneous abortion in Dr. Soetomo General Hospital were history of previous abortion, chronic maternal disease, anemia, advanced maternal age, multigravidity, and infection. Positive pregnancy outcomes are expected to play a role in reducing MMR in Indonesia. Therefore, high-risk pregnant women are suggested to carry out regular Antenatal care recommendations with intensive supervision.