Muhammad Ilham Aldika Akbar, Khanisyah Erza Gumilar, Adhi Pribadi, Muhammad Alamsyah Aziz, Ernawati Ernawati, Manggala Pasca Wardhana, Agus Sulistyono, Muhammad Adrianes Bachnas, Rima Irwinda, Bambang Rahardjo, Aditiawarman, Agus Rusdhy Hariawan Hamid, Julian Dewantiningrum, Fransiscus Octavianus Hari Prasetyadi, Febriansyah Darus, Ariawan Ditya, Jonathan Kevin Djuanda, Ruth Widhiati Raharjo Putri, Tedy Teguh Satriadi, Alini Hafiz, Roza Sriyanti, Dovy Djanas, A.I. Suratman, Aryani Aziz, Novi Resistantie, Ario Danianto, Yuyun Lisnawati, Purnawan Senoaji, Sri Pudyastuti, Besari Adi Pramono, Dharma Putra P. Banjarnahor, Dhanny Primatara Johari Santoso, Defrin Defrin, Junneke J. Kaeng, Nutria Widya Purna Anggraini, Anak Agung Gede Putra Wiradyana, Anak Agung Ngurah Jaya Kusuma, Nuswil Bernolian, Joserizal Serudji, Cut Meurah Yeni, Maisuri T. Chalid, Yusrawati, John J. E. Wantania, Sarma Lumbanraja, Sri Sulistyowati, Noroyono Wibowo, Johanes C. Mose, Erry Gumilar Dachlan, Gustaaf Dekker, Rozi Aditya Aryananda
Objective: This study aimed to investigate maternal and neonatal outcomes of pregnancies complicated by pre-eclampsia (PE) in Indonesia and analyze regional variations in risk factors and clinical outcomes across the country. Methods: A multicenter retrospective cohort study was conducted in 30 hospitals located across five major islands in Indonesia (Java, Sumatra, Kalimantan, Sulawesi, and Bali-West Nusa Tenggara) between January 2022 and December 2023. Data were collected from medical records, including demographic characteristics, risk factors, and clinical outcomes. Results: A total of 6763 pregnancies complicated by PE were analyzed. The maternal mortality rate was 1.6%, while the stillbirth and neonatal mortality rates were 5.7% and 6.1%, respectively. Severe PE was observed in 69% of cases, and preterm PE occurred in 35.5%. High rates of cesarean deliveries (72.4%) were recorded. Key risk factors included obesity (50.4%), primiparity (27.5%), and chronic hypertension (20.5%). Regional disparities were noted, with Sulawesi reporting the highest maternal (4.7%) and neonatal (7.7%) mortality rates. Complications such as hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome (8.9%), eclampsia (7.4%), and others requiring intensive care unit (ICU) admission (12.6%) were significant contributors to adverse pregnancy outcomes. Conclusion: PE continues to pose substantial risks for maternal and perinatal health in Indonesia, despite reductions in mortality rates. Variations in regional outcomes underscore disparities in healthcare accessibility and infrastructure. These findings emphasize the need for strengthened national strategies, including early screening, improved clinical management, and targeted interventions to reduce morbidity and mortality associated with PE. © 2025 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia; Department of Obstetrics and Gynecology, Universitas Airlangga Hospital, Surabaya, Indonesia; Department of Obstetrics and Gynecology, Hasan Sadikin Central General Hospital, Bandung, Indonesia; Department of Obstetrics and Gynecology, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia; Department of Obstetrics and Gynecology, Dr. Moewardi General Hospital, Solo, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Brawijaya, Malang, Indonesia; Department of Obstetrics and Gynecology, NTB Province General Hospital, Lombok, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Diponegoro, Semarang, Indonesia; Department of Obstetrics and Gynecology, Dr. Ramelan Naval Central Hospital, Surabaya, Indonesia; Department of Obstetrics and Gynecology, Gatot Soebroto Army Central Hospital, Jakarta, Indonesia; Department of Obstetrics and Gynecology, RA Kartini General Hospital, Jepara, Indonesia; Department of Obstetrics and Gynecology, Ulin General Hospital, Banjarmasin, Indonesia; Department of Obstetrics and Gynecology, Dr. Kanujoso Djatiwibowo General Hospital, Balikpapan, Indonesia; Department of Obstetrics and Gynecology, Dr. Kariadi Central General Hospital, Semarang, Indonesia; Department of Obstetrics and Gynecology, Dr. M Djamil General Hospital, Padang, Indonesia; Department of Obstetrics and Gynecology, KRT Setjonegoro General Hospital, Wonosobo, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia; Department of Obstetrics and Gynecology, Bhayangkara Hospital Level 1 Center for Medicine and Health of the Indonesian National Police, Jakarta, Indonesia; Department of Obstetrics and Gynecology, Persahabatan Central General Hospital, Jakarta, Indonesia; Department of Obstetrics and Gynecology, Dr. M Soewandhi General Hospital, Surabaya, Indonesia; Department of Obstetrics and Gynecology, Dr. Slamet General Hospital, Garut, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sam Ratulangi, Manado, Indonesia; Department of Obstetrics and Gynecology, Prof Dr. IGNG Ngoerah General Hospital, Bali, Indonesia; Department of Obstetrics and Gynecology, Dr. M. Hoesin Central General Hospital, Palembang, Indonesia; Department of Obstetrics and Gynecology, Universitas Andalas Hospital, Padang, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Syiah Kuala, Aceh, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Hasannudin, Makasar, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Andalas, Padang, Indonesia; Department of Obstetrics and Gynecology, Adam Malik General Hospital, Medan, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret, Solo, Indonesia; Department of Obstetrics and Gynecology, Faculty of Medicine University of Adelaide, Adelaide, Australia; Department Obstetrics and Gynecology Erasmus University, Medical Center, Rotterdam, Netherlands
