Maternal and infant mortality rates in Indonesia remain relatively high compared to other Southeast Asian countries, with a maternal mortality ratio (MMR) of 189 per 100,000 live births and an infant mortality rate (IMR) of 17 per 1,000 live births.
Although these figures have declined over the past decade, they still fall short of the Sustainable Development Goals (SDGs) targets.
Professor R. Detty Siti Nurdiati Z., MD, of the UGM Faculty of Medicine, Public Health, and Nursing (FK-KMK UGM), explained that the leading causes of maternal mortality in Indonesia have shifted.
While postpartum hemorrhage previously ranked first, followed by pregnancy-induced hypertension and infection, these have now transitioned to non-obstetric complications as the top cause, followed by hypertension and hemorrhage.
“Non-obstetric complications refer to a range of diseases related to metabolic disorders, including heart disease, obesity, and diabetes mellitus,” said Professor Nurdiati in her professorial inauguration speech at the UGM Senate Hall on Thursday (Apr. 10).
Professor Nurdiati says this shift in maternal mortality patterns must be further explored to address existing challenges and improve maternal and infant health.
To ensure comprehensive care, identifying risk factors must begin as early as the preconception phase and continue through pregnancy, childbirth, and postpartum.
Strategies should adopt the assumption that “every pregnancy is at risk,” meaning no pregnancy is entirely free from the potential for complications.
“Efforts should not only focus on current pregnancies but also on improving outcomes for future ones,” she stated.
Her research, which applies epidemiological approaches to analyze patterns, causes, and impacts of public health problems, reveals that delayed diagnosis is a common issue in the field.
Early screening and detection of fetal abnormalities are crucial. With timely awareness of their condition, expectant mothers can make more informed and safer decisions regarding continuing or terminating a pregnancy.
“The earlier the gestational age, the lower the risk of complications from termination, both physically, reproductively, and psychologically,” she explained.
She presented two case studies highlighting the importance of fetomaternal medicine (KFm) in providing continuous and comprehensive care before, during, and after pregnancy.
Subspecialists in KFm manage high-risk pregnancies due to obstetric or medical complications, perform prenatal screenings and diagnostics, treat fetal abnormalities, conduct invasive and non-invasive fetal procedures, manage high-risk deliveries, address genetic issues in pregnancy, and assess impacts on both mother and fetus.
Fetomaternal medicine also enables evidence synthesis, or secondary research, which compiles relevant primary studies to address knowledge gaps or conflicting expert opinions.
This process is critical to identify the best and most recent scientific evidence for clinical decision-making and policy formulation.
Professor Nurdiati emphasized the importance of strengthening primary healthcare facilities, such as community health centers, in identifying high-risk pregnancies.
These centers can provide antenatal care, assist with uncomplicated deliveries, and refer high-risk cases to hospitals.
This approach aligns with the transition from community-based to personalized healthcare services.
Unlike community medicine, which applies uniform strategies for maternal health improvement, personal medicine tailors care to individual conditions, including genetics, environment, lifestyle, and risk factors.
In closing, Professor Nurdiati stressed that improving healthcare services is intended to reduce maternal and infant mortality and enhance the quality of life for both.
A strong healthcare system and adequate resources are essential.
She also emphasized the importance of understanding disease progression and research methodology and leveraging technological advances such as artificial intelligence to enhance maternal and infant health outcomes in Indonesia.
She called on all parties to work together to prioritize maternal and infant health as a vital national asset.
According to her, the role of fetomaternal subspecialists would be ineffective without a robust healthcare system, interprofessional collaboration, both within and beyond the health sector, and public awareness of the importance of comprehensive healthcare.
“This initiative is expected to improve the quality of maternal and infant health services for a brighter future in Indonesia,” she concluded.
The Rector of Universitas Gadjah Mada, Professor Ova Emilia, stated that Professor Nurdiati is one of 528 active professors at UGM and one of 75 active professors out of 102 ever appointed at FK-KMK UGM.
Author: Leony
Editor: Gusti Grehenson
Post-editor: Afifudin Baliya
Photographer: Firsto