The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia

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 Aryanandha

doi:10.1002/ijgo.70587

The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia

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 Aryanandha

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	216-226
Number of pages	11
Journal	International Journal of Gynecology and Obstetrics
Volume	173
Issue number	1
DOIs	https://doi.org/10.1002/ijgo.70587
Publication status	Accepted/In press - 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities

Keywords

hypertension
Indonesia
maternal health
pre-eclampsia
pregnancy outcomes

Access to Document

10.1002/ijgo.70587

Cite this

Aldika Akbar, M. I., Gumilar, K. E., Pribadi, A., Aziz, M. A., Ernawati, E., Wardhana, M. P., Sulistyono, A., Bachnas, M. A., Irwinda, R., Rahardjo, B., Aditiawarman, Hamid, A. R. H., Dewantiningrum, J., Prasetyadi, F. O. H., Darus, F., Ditya, A., Djuanda, J. K., Putri, R. W. R., Satriadi, T. T., ... Aryanandha, R. A. (Accepted/In press). The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia. International Journal of Gynecology and Obstetrics, 173(1), 216-226. https://doi.org/10.1002/ijgo.70587

@article{06e785e84a0742898be98e85bf06bd57,

title = "The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia",

abstract = "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.",

keywords = "hypertension, Indonesia, maternal health, pre-eclampsia, pregnancy outcomes",

author = "\{Aldika Akbar\}, \{Muhammad Ilham\} and Gumilar, \{Khanisyah Erza\} and Adhi Pribadi and Aziz, \{Muhammad Alamsyah\} and Ernawati Ernawati and Wardhana, \{Manggala Pasca\} and Agus Sulistyono and Bachnas, \{Muhammad Adrianes\} and Rima Irwinda and Bambang Rahardjo and Aditiawarman and Hamid, \{Agus Rusdhy Hariawan\} and Julian Dewantiningrum and Prasetyadi, \{Fransiscus Octavianus Hari\} and Febriansyah Darus and Ariawan Ditya and Djuanda, \{Jonathan Kevin\} and Putri, \{Ruth Widhiati Raharjo\} and Satriadi, \{Tedy Teguh\} and Alini Hafiz and Roza Sriyanti and Dovy Djanas and Suratman, \{A. I.\} and Aryani Aziz and Novi Resistantie and Ario Danianto and Yuyun Lisnawati and Purnawan Senoaji and Sri Pudyastuti and Pramono, \{Besari Adi\} and Banjarnahor, \{Dharma Putra P.\} and Santoso, \{Dhanny Primatara Johari\} and Defrin Defrin and Kaeng, \{Junneke J.\} and Anggraini, \{Nutria Widya Purna\} and Wiradyana, \{Anak Agung Gede Putra\} and Kusuma, \{Anak Agung Ngurah Jaya\} and Nuswil Bernolian and Joserizal Serudji and Yeni, \{Cut Meurah\} and Chalid, \{Maisuri T.\} and Yusrawati and Wantania, \{John J.E.\} and Sarma Lumbanraja and Sri Sulistyowati and Noroyono Wibowo and Mose, \{Johanes C.\} and Dachlan, \{Erry Gumilar\} and Gustaaf Dekker and Aryanandha, \{Rozi Aditya\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). International Journal of Gynecology \& Obstetrics published by John Wiley \& Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.",

year = "2025",

doi = "10.1002/ijgo.70587",

language = "English",

volume = "173",

pages = "216--226",

journal = "International Journal of Gynecology and Obstetrics",

issn = "0020-7292",

publisher = "John Wiley and Sons Ltd",

number = "1",

}

Aldika Akbar, MI, Gumilar, KE, Pribadi, A, Aziz, MA, Ernawati, E, Wardhana, MP, Sulistyono, A, Bachnas, MA, Irwinda, R, Rahardjo, B, Aditiawarman, Hamid, ARH, Dewantiningrum, J, Prasetyadi, FOH, Darus, F, Ditya, A, Djuanda, JK, Putri, RWR, Satriadi, TT, Hafiz, A, Sriyanti, R, Djanas, D, Suratman, AI, Aziz, A, Resistantie, N, Danianto, A, Lisnawati, Y, Senoaji, P, Pudyastuti, S, Pramono, BA, Banjarnahor, DPP, Santoso, DPJ, Defrin, D, Kaeng, JJ, Anggraini, NWP, Wiradyana, AAGP, Kusuma, AANJ, Bernolian, N, Serudji, J, Yeni, CM, Chalid, MT, Yusrawati, Wantania, JJE, Lumbanraja, S, Sulistyowati, S, Wibowo, N, Mose, JC, Dachlan, EG, Dekker, G & Aryanandha, RA 2025, 'The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia', International Journal of Gynecology and Obstetrics, vol. 173, no. 1, pp. 216-226. https://doi.org/10.1002/ijgo.70587

TY - JOUR

T1 - The Indonesia pre-eclampsia study (INAPRES)

T2 - Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia

AU - Aldika Akbar, Muhammad Ilham

AU - Gumilar, Khanisyah Erza

AU - Pribadi, Adhi

AU - Aziz, Muhammad Alamsyah

AU - Ernawati, Ernawati

AU - Wardhana, Manggala Pasca

AU - Sulistyono, Agus

AU - Bachnas, Muhammad Adrianes

AU - Irwinda, Rima

AU - Rahardjo, Bambang

AU - Aditiawarman,

AU - Hamid, Agus Rusdhy Hariawan

AU - Dewantiningrum, Julian

AU - Prasetyadi, Fransiscus Octavianus Hari

AU - Darus, Febriansyah

AU - Ditya, Ariawan

AU - Djuanda, Jonathan Kevin

AU - Putri, Ruth Widhiati Raharjo

AU - Satriadi, Tedy Teguh

AU - Hafiz, Alini

AU - Sriyanti, Roza

AU - Djanas, Dovy

AU - Suratman, A. I.

AU - Aziz, Aryani

AU - Resistantie, Novi

AU - Danianto, Ario

AU - Lisnawati, Yuyun

AU - Senoaji, Purnawan

AU - Pudyastuti, Sri

AU - Pramono, Besari Adi

AU - Banjarnahor, Dharma Putra P.

AU - Santoso, Dhanny Primatara Johari

AU - Defrin, Defrin

AU - Kaeng, Junneke J.

AU - Anggraini, Nutria Widya Purna

AU - Wiradyana, Anak Agung Gede Putra

AU - Kusuma, Anak Agung Ngurah Jaya

AU - Bernolian, Nuswil

AU - Serudji, Joserizal

AU - Yeni, Cut Meurah

AU - Chalid, Maisuri T.

AU - Yusrawati,

AU - Wantania, John J.E.

AU - Lumbanraja, Sarma

AU - Sulistyowati, Sri

AU - Wibowo, Noroyono

AU - Mose, Johanes C.

AU - Dachlan, Erry Gumilar

AU - Dekker, Gustaaf

AU - Aryanandha, Rozi Aditya

PY - 2025

Y1 - 2025

N2 - 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.

AB - 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.

KW - hypertension

KW - Indonesia

KW - maternal health

KW - pre-eclampsia

KW - pregnancy outcomes

UR - https://www.scopus.com/pages/publications/105019187263

U2 - 10.1002/ijgo.70587

DO - 10.1002/ijgo.70587

M3 - Article

C2 - 41099475

AN - SCOPUS:105019187263

SN - 0020-7292

VL - 173

SP - 216

EP - 226

JO - International Journal of Gynecology and Obstetrics

JF - International Journal of Gynecology and Obstetrics

IS - 1

ER -

The Indonesia pre-eclampsia study (INAPRES): Pregnancy outcomes in pregnancy with pre-eclampsia in Indonesia

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Keywords

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