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All Journal Jurnal Gizi dan Pangan Microbiology Indonesia Indonesian Journal of Cancer Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Amerta Nutrition Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Andalas obstetrics and gynecology journal World Nutrition Journal Science Midwifery Indonesian Journal of Global Health research Bioscientia Medicina : Journal of Biomedicine and Translational Research Cermin Dunia Kedokteran eJournal Kedokteran Indonesia Archives of Pediatric Gastroenterology, Hepatology, and Nutrition MEDICINUS Cermin Dunia Kedokteran Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Dwiana Ocviyanti
Department Of Obstetrics And Gynecology, Faculty Of Medicine, University Of Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary Other

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Triple-Threat Pregnancy: Navigating PPCM, Preeclampsia, and Thalassemia Major – A Holistic Reproductive Risk Assessment Post-Cesarean Delivery Arya Ady Nugroho; Yudianto Budi Saroyo; Dwiana Ocviyanti
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qdxs3625

Abstract

Background: Pregnancies complicated by multiple severe maternal conditions such as peripartum cardiomyopathy (PPCM), preeclampsia, and β-thalassemia major, pose significant risks to both mother and fetus. This case explores the challenges of managing a high-risk pregnancy, involving these conditions and highlights the importance of a multidisciplinary approach in high-risk pregnancy management.Case presentation: A 33-year-old pregnant woman with β-thalassemia major presented at 32+4 weeks of gestation with acute dyspnea, severe preeclampsia, and signs of PPCM. She was carrying dichorionic diamniotic twins and required emergency cesarean section after stabilization. Echocardiography revealed severe left ventricular systolic dysfunction with an ejection fraction of 35%. The patient underwent immediate postoperative management and received a trans-cesarean intrauterine device (IUD) insertion for long-term contraception. Both neonates were admitted to the neonatal intensive care unit (NICU) for prematurity care.Conclusion: This case underscores the critical need for a holistic, multidisciplinary approach in managing complex highrisk pregnancies, focusing on immediate maternal stabilization, neonatal care, and long-term reproductive planning.
Comparison of WHO global and Asia-Pacific body mass index classifications for screening low birth weight risk among pregnant women in urban Indonesia Mayditania Intan Bunga Pratiwi; Dwiana Ocviyanti; Rima Irwinda; Dian Novita Chandra
World Nutrition Journal Vol. 10 No. 1 (2026): WNJ. Volume 10 Issue 1, Agustus 2026
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V10.i1.0012

Abstract

Background: Low birth weight (LBW) remains a major contributor to neonatal morbidity and mortality. Maternal body mass index (BMI) is widely used to identify pregnancies at risk of adverse birth outcomes; however, the optimal BMI classification for Asian populations remains uncertain. This study compared the WHO Global and WHO Asia-Pacific BMI classifications in identifying pregnant women at risk of delivering LBW infants. Methods: An unmatched case-control study was conducted among 729 pregnant women attending 10 primary healthcare centers in Jakarta, Indonesia. Cases comprised 368 women who delivered LBW infants (2,500 g), while 361 women with normal birth weight infants served as controls. Logistic regression models were developed using both BMI classifications and compared using the area under the receiver operating characteristic curve (AUC), Akaike Information Criterion (AIC), and Nagelkerke R². Screening performance was assessed using sensitivity, specificity, positive predictive value, and negative predictive value. Results: After adjustment for maternal age, preterm delivery, and pregnancy-induced hypertension, both BMI classifications showed comparable predictive performance (WHO Global: AUC=0.646; Asia-Pacific: AUC=0.634). BMI category was not independently associated with LBW in either model. However, using obesity as the screening threshold, the WHO Asia-Pacific classification demonstrated substantially higher sensitivity than the WHO Global classification (49.5% vs. 16.3%), although specificity was lower. Conclusions: Although both BMI classifications showed similar predictive performance, the WHO Asia-Pacific classification identified a substantially greater proportion of women at risk of delivering LBW infants. These findings support the use of population-specific BMI 2 thresholds to strengthen antenatal nutritional screening in Indonesian and other Asian populations.
Co-Authors Adang Bachtiar Adnani, Syahredi Airin Roshita Anies Irawati Anies Irawati Anis Karuniawati Anugrah, Pani Matin Ariescha, Putri Ayu Yessy Arietta Pusponegoro Arya Ady Nugroho Denny Khusen Denny Khusen Dian Novita Chandra Diyah Septiti Wulan Dorothea, Maya Emeraldy Chatra Endang L Achadi Endang L. Achadi, Endang Endang Laksminingsih Achadi Endang Laksminingsih Achadi Erda Ayu Umami Erda Ayu Umami Evi Martha Farhan D Hasan Farhan D Hasan, Farhan D Ferry Darmawan Finny Fitry Yani Harry Prawiro Tantry Harry Prawiro Tantry Hartati Helda Khusun IPG Kayika JM Seno Adjie Joan M. Sari Junita Indarti Junita Indarti Junita Indarti Kms Yusuf Effendi Levina, Jessica Luh Ade Ari Wiradnyani Mayditania Intan Bunga Pratiwi Nur Afrainin Syah Omo Abdul Madjid Omo Abdul Madjid Pratiwi, Mayditania Intan Bunga Qirani, Ida Ayu Devi Rachelya Nurfirdausi Islamah Radiyati Umi Partan Rafika Novianti Rahmah Amran Ramzi Amin, Ramzi Ratu Ayu Dewi Sartika Ratu Ayu Dewi Sartika Raymond Surya Raymond Surya Ribkhi A. Putri Rima Irwinda Rizanda Machmud Rizanda Machmud Robiatul Adawiyah Shanty Olivia Simon Fongana Siti R. F. Harun Susie Susilawati Susilawati, Susie SYADZA RHIZKY PUTRI AKHMAD Syahredi Adnani Tria Astika Endah Permatasari Urip Purwono Urip Purwono Yeva Rosana Yudianto Budi Saroyo Yuli Budiningsih Yusrawati Yusrawati Yuyun Lisnawati Zen Hafy