Journal of Epidemiology and Public Health
Vol. 11 No. 1 (2026)

Maternal Death Review Through the Maternal Perinatal Death Notification Surveillance System: An Aggregate Analysis at Universitas Airlangga Hospital, Surabaya, East Java, Indonesia

Muhammad Ardian Cahya Laksana (Obstetrics and Gynecology Social, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Indonesia)
Nurani Zulfa Zakiya (School of Midwifery, Faculty of Medicine, Universitas Airlangga, Indonesia)
Nur Sahila (Master of Public Health Program Student, Faculty of Medicine, Nursing and Health Science, Monash University, Indonesia)
Ayu Dyah Primaningrum (Department of Obstetrics and Gynecology, Universitas Airlangga Hospital, Indonesia)
Asti Alya Rahmahdia (Department of Epidemiology, Population Biostatistics and Health Promotion, Faculty of Public Health, Universitas Airlangga, Indonesia)
Dinda Zhafira (Universitas Airlangga Hospital, Indonesia)



Article Info

Publish Date
16 Jan 2026

Abstract

Background: Maternal mortality remains a major concern in Indonesia, particularly in referral hospitals that manage high-risk pregnancies. This study aimed to examine maternal deaths and assess contributory factors at Universitas Airlangga Hospital in 2024 using the maternal perinatal death notification (MPDN) system. Subjects and Method: A retrospective-descriptive study was conducted, including all maternal deaths recorded from January to December 2024. Quantitative data were analyzed descriptively, and factors contributing to maternal mortality were classified using the Three Delays Model. A mixed method with multidisciplinary hospital staff provided qualitative insights into clinical and institutional gaps. Results: A total of 11 maternal deaths occurred during the study period, resulting in an MMR of 557 per 100,000 live births. Most deaths occurred in women over 35 years (81.8%) and during the third trimester (81.8%). Non-obstetric complications were the leading cause (40%), followed by pregnancy-related infections (20%) and hypertensive disorders (10%). First, delay factors, particularly socio-cultural barriers, were present in 36.4% of cases, while third, delay factors, including delayed diagnosis and treatment, were identified in 45.5%. FGDs highlighted gaps in emergency preparedness, blood availability, and interprofessional communication. Conclusion: These findings highlight the combined role of clinical complexity and systemic delays, emphasizing the need to strengthen referral readiness, rapid multidisciplinary response, and decision-making to reduce preventable maternal deaths.

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Journal Info

Abbrev

jepublichealth

Publisher

Subject

Public Health

Description

Background: Increased blood pressure for a long time can increase the risk of kidney failure, co­ronary heart disease, brain damage, and other di­seases. In 2019, it is estimated that hyper­tens­ion is experienced by 1.13 billion people in the world with most (two thirds) living in low and ...