3D Display of stillbirth in Indonesian obstetrics part 3: antenatal visits as preventive determinant.

Abstract

Expansion of previous analytical work with MCM data in Indonesia focuses on antenatal visits (AV). AV is introduced as a systematic co-control of the risk of SB with either registration status, maternal morbidity, complication of labor/delivery or birth weight. 20 out of 22 control categories reveal risk profiles dependent on antenatal visits, the two exceptions being placenta abruptio and very low birth weight (less than 1500g). A systematic confrontation of relative risks obtained across antenatal visits with relative risks obtained within the four co-control variables highlights AV as being an important preventive determinant of late fetal death. In a second step, a clinical baseline of "NOCARE" shows a very strong association with education and a weak association with family planning within controlled education categories. A v-shaped pattern across maternal age is also noted. Two hypotheses are derived. Since FP precedes AV, the next analytical focus is on FP (CONUSE). If co-controlled with the five control factors used so far, the QUINTET will lead to a "closed six-variable control system" (SEXTET) of the risk of stillbirth.