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

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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.
Prenatal Exposure to Maternal Stress and Neurodevelopmental Outcomes in Children: A Longitudinal Study with Epigenetic Analysis in Jakarta, Indonesia Fatimah Mursyid; Akmal Hasan; Tomiola Owkwulu; Maximillian Wilson; Yi-Fen Huang; Husin Sastranagara
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.v1i2.81

Abstract

Introduction: Prenatal exposure to maternal stress has been identified as a potential risk factor for adverse neurodevelopmental outcomes in children. This study aimed to investigate the association between prenatal maternal stress and neurodevelopmental outcomes in children in Jakarta, Indonesia, and to explore the potential mediating role of epigenetic modifications. Methods: A longitudinal cohort study was conducted involving 300 pregnant women recruited from antenatal clinics in Jakarta. Maternal stress was assessed during the second trimester of pregnancy using the Perceived Stress Scale (PSS). Neurodevelopmental outcomes in children were evaluated at 12 and 24 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Epigenetic analysis of cord blood DNA methylation was performed using the Illumina Infinium MethylationEPIC BeadChip. Results: Higher maternal stress scores during pregnancy were significantly associated with lower cognitive, language, and motor scores in children at 12 and 24 months of age. Epigenetic analysis revealed differential methylation patterns in genes related to neurodevelopment in children exposed to high prenatal maternal stress. Mediation analysis indicated that DNA methylation partially mediated the association between prenatal maternal stress and neurodevelopmental outcomes. Conclusion: Prenatal exposure to maternal stress is associated with adverse neurodevelopmental outcomes in children, and epigenetic modifications may play a mediating role in this relationship. These findings highlight the importance of addressing maternal stress during pregnancy to promote optimal child neurodevelopment.
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.
Co-Authors Akmal Hasan Fatimah Mursyid Husin Sastranagara Leonardo Simanjuntak Lestini Wulansari Maximillian Wilson Miranda Aisah Reza Andrianto Syaifudin Tanvir Ahmed Theresia Putri Sinaga Winata Putri Yi-Fen Huang