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All Journal Scientia Psychiatrica Sriwijaya Journal of Obstetrics and Gynecology Sriwijaya Journal of Neurology
Reza Andrianto
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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The Impact of Gestational Diabetes on Long-Term Cognitive Function: A Prospective Cohort Study with Neuroimaging Correlates in Bandung, Indonesia Miranda Aisah; Lestini Wulansari; Vania Delma; Reza Andrianto; Zahra Amir; Dedi Sucipto; Agnes Mariska; Saurie Hernandez
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.91

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a growing public health concern with potential long-term consequences for both mother and child. Emerging evidence suggests that GDM may impact maternal cognitive function, but the underlying mechanisms remain unclear. This prospective cohort study investigates the association between GDM and long-term cognitive function in mothers, exploring potential neuroimaging correlates. Methods: Pregnant women were recruited from antenatal clinics in Bandung, Indonesia, between 2018 and 2020. GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Cognitive function was assessed at 6 months, 1 year, and 3 years postpartum using a comprehensive neuropsychological battery. A subset of participants underwent structural and functional magnetic resonance imaging (MRI) at 3 years postpartum. Results: Women with GDM exhibited lower scores on tests of executive function, processing speed, and memory compared to women without GDM at all follow-up assessments. MRI analysis revealed alterations in brain structure and function inwomen with a history of GDM, including reduced gray matter volume in the prefrontal cortex and hippocampus, and altered functional connectivity within the default mode network. Conclusion: GDM is associated with long-term cognitive impairment in mothers, possibly mediated by structural and functional brain changes. These findings highlight the importance of early identification and management of GDM to mitigate potential long-term cognitive consequences.
Social Determinants of Health and Their Influence on Preterm Birth in Rural Indonesian Communities Miranda Aisah; Tomiola Owkwulu; Winata Putri; Theresia Putri Sinaga; Syaifudin Syaifudin; Reza Andrianto
Sriwijaya Journal of Obstetrics and Gynecology Vol. 1 No. 2 (2023): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i1.22

Abstract

Introduction: Preterm birth (PTB), defined as birth before 37 completed weeks of gestation, is a major contributor to neonatal mortality and morbidity globally, with a disproportionate burden in low-resource settings like rural Indonesia. This study aimed to investigate the influence of social determinants of health (SDOH) on PTB in rural Indonesian communities. Methods: A retrospective cohort study was conducted using data from the Indonesian Maternal and Perinatal Health Survey (IMPHS) 2018-2021. A total of 15,480 women residing in rural areas with singleton pregnancies were included. SDOH variables examined included maternal education, socioeconomic status (SES), access to healthcare, and geographical remoteness. Multivariable logistic regression analysis was performed to assess the association between SDOH and PTB, adjusting for potential confounders. Results: The prevalence of PTB in the study population was 12.3%. Lower maternal education, lower SES, limited access to healthcare, and residing in remote areas were significantly associated with increased odds of PTB. Women with no formal education had 2.1 times higher odds of PTB compared to those with higher education (adjusted odds ratio [aOR] 2.1, 95% CI 1.8-2.5). Similarly, women in the lowest SES quintile had 1.8 times higher odds of PTB compared to the highest quintile (aOR 1.8, 95% CI 1.5-2.2). Conclusion: SDOH significantly influence PTB in rural Indonesian communities. Addressing these social inequities through targeted interventions, such as improving access to education, healthcare, and economic opportunities, is crucial for reducing the burden of PTB and improving maternal and child health outcomes.
Assessing the Effectiveness of Telemedicine for Cervical Cancer Screening in Remote Areas of Indonesia Kristianti, Silvia; Reza Andrianto; Sonya Syarifah; Taryudi Suharyana
Sriwijaya Journal of Obstetrics and Gynecology Vol. 2 No. 1 (2024): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i2.86

Abstract

Introduction: Cervical cancer remains a significant public health issue in Indonesia, particularly in remote areas with limited access to healthcare facilities. Telemedicine offers a potential solution to overcome geographical barriers and improve cervical cancer screening rates. This study aimed to assess the effectiveness of a telemedicine-based cervical cancer screening program in remote areas of Indonesia. Methods: A cross-sectional study was conducted in five remote villages in Indonesia. Women aged 30-49 years were invited to participate in cervical cancer screening using a telemedicine platform. The program involved self-sampling for human papillomavirus (HPV) DNA testing, followed by teleconsultation with healthcare providers for result interpretation and referral for further management if required. The primary outcome was the participation rate in the telemedicine-based screening program. Secondary outcomes included the positivity rate for high-risk HPV, the rate of referral for colposcopy, and participant satisfaction with the program. Results: A total of 500 women were invited to participate in the study, of whom 380 (76%) completed the screening process. The high-risk HPV positivity rate was 12%, and 46 women (12.1%) were referred for colposcopy. Participant satisfaction with the telemedicine program was high, with 92% of women reporting that they were satisfied with the convenience and accessibility of the service. Conclusion: Telemedicine-based cervical cancer screening is a feasible and effective strategy for reaching women in remote areas of Indonesia. The program achieved a high participation rate and enabled timely referral for further management. This approach has the potential to improve cervical cancer screening coverage and reduce mortality rates in underserved populations.
Impact of Maternal Anxiety and Stress During Pregnancy on Fetal Neurodevelopment: A Longitudinal Cohort Study in Jakarta, Indonesia Leonardo Simanjuntak; Tomiola Owkwulu; Tanvir Ahmed; Reza Andrianto; Lestini Wulansari
Scientia Psychiatrica Vol. 6 No. 1 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.182

Abstract

Introduction: Maternal anxiety and stress during pregnancy are increasingly recognized as significant factors influencing fetal neurodevelopment. This study investigated the impact of maternal anxiety and stress levels during pregnancy on various aspects of fetal neurodevelopment in a cohort of pregnant women in Jakarta, Indonesia. Methods: A longitudinal cohort study was conducted at three major hospitals in Jakarta, involving 500 pregnant women in their first trimester. Maternal anxiety and stress levels were assessed using the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS) at three time points: first trimester (10-14 weeks), second trimester (20-24 weeks), and third trimester (30-34 weeks). Fetal neurodevelopment was assessed using fetal movement counting, fetal heart rate variability (using Doppler ultrasound), and later, infant neurodevelopmental assessments at 6 and 12 months postpartum using the Bayley Scales of Infant Development III. Data analysis involved correlation and regression analyses to examine the relationship between maternal anxiety/stress and fetal/infant neurodevelopmental outcomes. Results: The study found a significant positive correlation between maternal anxiety and stress levels across all trimesters. Higher maternal anxiety and stress, particularly in the second and third trimesters, were associated with reduced fetal movement counts (p < 0.05) and altered fetal heart rate variability patterns (p < 0.01). Furthermore, higher maternal anxiety and stress during pregnancy were associated with lower scores on the cognitive and motor scales of the Bayley Scales at both 6 and 12 months (p < 0.001). Specifically, maternal anxiety in the third trimester was the strongest predictor of lower cognitive scores at 12 months. Conclusion: Maternal anxiety and stress during pregnancy, particularly in the second and third trimesters, have a demonstrable impact on fetal neurodevelopment and subsequent infant development. These findings highlight the importance of screening for and managing maternal anxiety and stress during pregnancy to promote optimal fetal and infant neurodevelopment. Interventions targeting stress reduction and anxiety management should be integrated into routine prenatal care.
First Trimester Ultrasound Biomarkers for Predicting Preeclampsia: A Prospective Cohort Study in Surabaya, Indonesia Reisha Notonegoro; Aline Hafidzah; Reza Andrianto; Tanvir Ahmed
Sriwijaya Journal of Obstetrics and Gynecology Vol. 3 No. 1 (2025): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v2i2.180

Abstract

Introduction: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality worldwide, particularly in developing countries like Indonesia. Early identification of high-risk women is crucial for timely intervention. This study aimed to evaluate the predictive performance of first-trimester ultrasound biomarkers, specifically uterine artery pulsatility index (UtA-PI) and mean arterial pressure (MAP), combined with maternal characteristics, for predicting PE in a cohort of pregnant women in Surabaya, Indonesia. Methods: This prospective cohort study enrolled pregnant women attending their first-trimester antenatal care visit at Private Hospital, Surabaya, between January 2022 and December 2023. Inclusion criteria were singleton pregnancies, gestational age between 11 and 13 weeks 6 days, and availability of complete follow-up data until delivery. Maternal characteristics (age, body mass index, parity, smoking history, family history of PE) were recorded. UtA-PI was measured using transabdominal Doppler ultrasound, and MAP was calculated from blood pressure measurements. The primary outcome was the development of PE, defined according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Logistic regression analysis was used to develop a prediction model, and its performance was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC). Results: A total of 850 pregnant women were included in the final analysis. The incidence of PE was 8.2% (n=70). The prediction model incorporating maternal age, BMI, prior history of PE, UtA-PI, and MAP demonstrated good predictive performance for overall PE (AUC = 0.85; 95% CI, 0.81-0.89). For early-onset PE (delivery <34 weeks), the AUC was 0.92 (95% CI, 0.87-0.97), and for late-onset PE (delivery ≥34 weeks), the AUC was 0.78 (95% CI, 0.73-0.83). UtA-PI and MAP were significant independent predictors of PE (p<0.001). A risk score was developed, with a cut-off value showing a sensitivity of 80% and specificity of 75% for overall PE. Conclusion: The combination of maternal characteristics, UtA-PI, and MAP in the first trimester provides a valuable tool for predicting PE in an Indonesian population. This model demonstrates particularly strong performance for predicting early-onset PE, which is associated with greater maternal and fetal morbidity. Early identification of high-risk women allows for targeted surveillance and potential preventative strategies.
Co-Authors Agnes Mariska Aline Hafidzah Dedi Sucipto Kristianti, Silvia Leonardo Simanjuntak Lestini Wulansari Miranda Aisah Reisha Notonegoro Saurie Hernandez Sonya Syarifah Syaifudin Tanvir Ahmed Taryudi Suharyana Theresia Putri Sinaga Tomiola Owkwulu Vania Delma Winata Putri Zahra Amir