Analysis of Lungs Maturity Induction (LMI) in Preterm Labor on Neonatal Asphyxia Status at dr. Sayidiman Regional General Hospital, Magetan
Abstract
Neonatal asphyxia remains a major contributor to neonatal morbidity and mortality, particularly among preterm infants whose lungs are physiologically immature and lack adequate surfactant production. At Dr. Sayidiman Regional General Hospital, Magetan, neonatal mortality due to asphyxia remains considerably high, indicating the need for effective preventive interventions. Lungs Maturity Induction (LMI) is widely recommended for pregnant women at risk of preterm delivery to accelerate fetal lung development; however, evidence regarding its effectiveness in reducing neonatal asphyxia in local clinical settings is still limited. This study aimed to analyze differences in neonatal asphyxia status among preterm births between mothers who received LMI and those who did not. This research employed an analytical survey with a cross-sectional design. Secondary data were obtained from the Delivery Register Book at Dr. Sayidiman Regional General Hospital, Magetan, covering the period from January 2024 to February 2025. The study population comprised 121 preterm deliveries, from which 93 samples were selected using proportional random sampling. Of these, 44 mothers received LMI and 49 did not. Neonatal asphyxia status served as the dependent variable, while LMI administration was the independent variable. Data were analyzed using the Chi-Square test with a significance level of α = 0.05. The results showed that 79.5% of preterm infants whose mothers received LMI did not experience neonatal asphyxia, whereas 75.5% of preterm infants without LMI experienced asphyxia. Statistical analysis demonstrated a significant difference in neonatal asphyxia status between the two groups (χ² = 26.090; p < 0.001). In conclusion, LMI is significantly associated with a lower incidence of neonatal asphyxia in preterm deliveries. The routine administration of LMI to pregnant women at risk of preterm birth is strongly recommended to improve neonatal outcomes and reduce neonatal mortality.
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References
[1] World Health Organization, Preterm Birth, Geneva, Switzerland, 2023.
[2] UNICEF, Levels and Trends in Child Mortality, New York, NY, USA, 2022.
[3] J. Lawn et al., “Global burden of neonatal mortality,” Lancet Glob. Health, vol. 8, no. 1, pp. e37–e46, 2020.
[4] S. Hug et al., “Causes of neonatal death,” BMC Pediatr., vol. 21, no. 1, 2021.
[5] K. Bhutta et al., “Neonatal survival in low-resource settings,” Nat. Med., vol. 27, pp. 107–115, 2021.
[6] A. Jobe and E. Bancalari, “Mechanisms of lung immaturity,” Am. J. Respir. Crit. Care Med., vol. 203, no. 6, pp. 674–686, 2021.
[7] T. Sweet et al., “Surfactant deficiency in preterm infants,” Pediatrics, vol. 148, no. 4, 2021.
[8] H. Liu et al., “Risk factors of neonatal asphyxia,” BMC Pediatr., vol. 22, 2022.
[9] M. Jain et al., “Neonatal asphyxia and neurological outcomes,” J. Perinatol., vol. 42, pp. 120–128, 2022.
[10] S. McGoldrick et al., “Antenatal corticosteroids for fetal lung maturation,” Cochrane Database Syst. Rev., no. 12, 2020.
[11] R. Goldenberg et al., “Biological effects of antenatal steroids,” Lancet, vol. 399, pp. 217–228, 2022.
[12] A. Roberts et al., “Physiological effects of antenatal corticosteroids,” BMJ, vol. 373, 2021.
[13] Y. Zhu et al., “Neonatal respiratory outcomes after antenatal steroids,” Front. Pediatr., vol. 10, 2022.
[14] M. Patel et al., “Antenatal steroid exposure and neonatal survival,” Healthcare, vol. 11, no. 6, 2023.
[15] R. Carlo et al., “Respiratory outcomes in preterm neonates,” N. Engl. J. Med., vol. 384, pp. 163–172, 2021.
[16] American College of Obstetricians and Gynecologists, “Antenatal corticosteroid therapy,” ACOG Committee Opinion, no. 831, 2021.
[17] Royal College of Obstetricians and Gynaecologists, Preterm Labour Guidelines, London, UK, 2022.
[18] S. Travers et al., “Limitations of antenatal steroid studies,” Pediatrics, vol. 149, no. 2, 2022.
[19] A. Kumar et al., “Neonatal outcomes beyond RDS,” Int. J. Gynecol. Obstet., vol. 160, no. 1, pp. 45–52, 2023.
[20] S. Rahman et al., “Antenatal steroids and neonatal asphyxia,” BMC Pregnancy Childbirth, vol. 23, 2023.
[21] P. Ashish et al., “Health system factors affecting neonatal outcomes,” Lancet Reg. Health, vol. 18, 2022.
[22] T. Singh et al., “Variability of antenatal care practices,” Children, vol. 9, no. 5, 2022.
[23] M. Hassan et al., “Hospital-based studies on preterm outcomes,” J. Neonatal Nurs., vol. 29, no. 4, 2023.
[24] D. Sari et al., “Neonatal asphyxia in Indonesian referral hospitals,” Kesmas, vol. 18, no. 2, 2024.
[25] J. Setiawan et al., “Retrospective cross-sectional designs in clinical research,” J. Clin. Epidemiol., vol. 128, pp. 85–92, 2020.
[26] World Health Organization, Preterm Birth, Geneva, Switzerland, 2023.
[27] R. Israel, “Determining sample size for health research,” Int. J. Health Sci., vol. 14, no. 3, pp. 45–52, 2020.
[28] M. Levin and J. Fox, “Observational study designs and limitations,” BMC Med. Res. Methodol., vol. 21, 2021.
[29] American Academy of Pediatrics, Neonatal Resuscitation Guidelines, 8th ed., 2021.
[30] A. Field, Discovering Statistics Using SPSS, 5th ed., London, UK: Sage, 2022.
[31] S. Council for International Organizations of Medical Sciences, International Ethical Guidelines for Health-Related Research, Geneva, 2021.
[32] P. von Elm et al., “The STROBE guidelines for observational studies,” Lancet, vol. 402, pp. 1731–1740, 2023.
[33] J. Lawn et al., “Progress, priorities, and potential beyond survival for women’s and children’s health,” Lancet, vol. 399, pp. 173–184, 2022.
[34] M. Blencowe et al., “Preterm birth–associated neonatal outcomes,” Lancet Glob. Health, vol. 8, no. 1, pp. e37–e46, 2020.
[35] S. Bhutta et al., “Antenatal care and preterm birth prevention,” Nat. Med., vol. 27, pp. 107–115, 2021.
[36] T. Singh et al., “Maternal workload and adverse pregnancy outcomes,” Children, vol. 9, no. 5, 2022.
[37] H. Liu et al., “Risk factors of neonatal asphyxia,” BMC Pediatr., vol. 22, 2022.
[38] M. Jain et al., “Prematurity and neonatal asphyxia,” J. Perinatol., vol. 42, pp. 120–128, 2022.
[39] Y. Zhu et al., “Antenatal corticosteroids and neonatal respiratory outcomes,” Front. Pediatr., vol. 10, 2022.
[40] S. Rahman et al., “Effect of antenatal steroids on neonatal outcomes,” BMC Pregnancy Childbirth, vol. 23, 2023.
Authors
Copyright (c) 2026 Eni Rahayu, Sulikah, S.ST., M.Kes., Budi Joko Santosa, S.KM., M.Kes., Tutiek Herlina, S.KM., MM.Kes
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