Revi Gama Hatta Novika

Background: Breastfeeding does not always progress as mothers anticipate during pregnancy, as challenges may emerge during the postnatal period and affect their breastfeeding experiences and decisions. However, few studies have explored the breastfeeding journey as a continuous process, from preparation during pregnancy through postnatal coping and decision making. This study aimed to explore mothers’ experiences throughout their breastfeeding journey, from pregnancy preparation to the postnatal period, including their coping and decision-making. Subjects and Methods: This descriptive qualitative study was conducted at Mamina, Malang, East Java from August-September 2026. Eleven mothers with infants aged 0-3 months who had breast­feeding experience were purposively selected. Recruitment continued until subsequent interviews provided largely repetitive information. Data were collected through face-to-face in-depth semi-structured interviews lasting 45–60 minutes and analyzed using NVivo software and reflexive thematic analysis. Results: Four themes have come out of the interviews conducted; they include (1) Preparation for breastfeeding during pregnancy, (2) Childbirth and childbirth experiences in health care institutions, (3) Transition into breastfeeding at home and problems experienced, and (4) Coping strategies and decision making. While some mothers were not well prepared for breastfeeding, other mothers took initiative to search for information via social media, relatives, and friends. Postpartum, some mothers faced difficulties in practicing what they have been learning on breastfeeding. There was inconsistency in the kind of help that mothers received from the health care practitioners on breastfeeding. Mothers encountered problems related to breastfeeding after going home, including positioning and attachment, nipple soreness or flatness, engorgement, plugged ducts, worry about low milk supply, among other problems. In response, mothers sought for information or help, tried new strategies, got support from the surrounding and adapted the methods of breastfeeding depending on themselves and their babies. Conclusion: Mothers’ breastfeeding experiences changed as they encountered different situations after childbirth. Breastfeeding support therefore needs to continue beyond preparation during pregnancy and address the practical and emotional difficulties mothers may experience at home.

Background: Preeclampsia remains a major cause of maternal and neonatal morbidity and mortality worldwide, while research on biomarkers, screening strategies, and early diagnostic approaches has increased substantially. However, a comprehensive understanding of global research trends and emerging hotspots in preeclampsia screening and early diagnosis remains limited, prompting this study to analyze these trends using bibliometric analysis. Subjects and Method: This was a descriptive bibliometric study conducted using the Scopus database. The target population consisted of publications related to preeclampsia screening and early diagnosis published between 2020 and 2026. Documents were identified using keywords related to preeclampsia, screening, prediction, and early diagnosis. Of 3,105 retrieved records, 882 English-language articles and reviews meeting the eligibility criteria were included in the analysis. The variables analyzed included annual scientific production, citation performance, source journals, authorship characteristics, institutional contributions, country productivity, keyword occurrence, and thematic evolution. Data were analyzed using R programming and VOSviewer. Results: Research on preeclampsia screening and early diagnosis increased substantially during the study period and reached its highest productivity in 2025. BMC Pregnancy and Childbirth was the most productive journal, while the 2021 ISSHP guideline on hypertension in pregnancy was the most globally cited document. The University of Oxford was the leading institutional contributor. Thematic and keyword analyses showed growing attention to biomarkers, placenta, prenatal diagnosis, and predictive models. Five major research clusters were identified, covering maternal risk factors, molecular biomarkers, screening and diagnostic methods, clinical and laboratory parameters, and predictive models. Bioinformatics and messenger RNA emerged as developing research themes. Conclusion: Research on preeclampsia screening has shifted toward biomarker-based prediction and molecular diagnostic approaches, reflecting the growing emphasis on early detection strategies. This bibliometric study provides a comprehensive overview of global research trends, emerging hotspots, and research gaps that may guide future investigations, strengthen biomarker based screening strategies, and foster international collaboration to improve maternal healthcare.

Background: Fear of childbirth (FOC) is an increasingly recognized maternal health issue that affects women's physical, psychological, and overall well-being and is associated with adverse outcomes, including increased obstetric interventions and perinatal mental health problems. This study aimed to analyze global research trends, collaboration patterns, and thematic developments in FOC research over the past decade using a bibliometric approach. Subjects and Method: This was a bibliometric study using the Scopus database. A literature search was performed from database inception January 27, 2026 using the search query: TITLE-ABS-KEY (“fear of childbirth” OR “tokophobia” OR “anxiety childbirth”). The search was english-language, open-access, and final published articles were included. A total of 1,022 publications met the eligibility criteria. Annual scientific production, institutional productivity, author productivity, and publication trends by source and country were descriptively analyzed, while thematic analysis was conducted using VOSviewer. Results: A total of 1.022 publications, demonstrating a consistent increase in scientific product­ion, with the highest output recorded in 2025 (n=184). Iran contributed the largest number of publications (n=137), while the United Kingdom showed the strongest international collaboration network with the highest total link strength (TLS=135), followed by the United States (TLS=112). Citation analysis revealed that the most cited article received 472 citations. Keyword co-occurrence analysis identified four major research themes: social and healthcare system factors, clinical and physiological aspects of childbirth, perinatal mental health, and methodological and psychological measurement approaches. Conclusion: Research on fear of childbirth has expanded substantially, reflecting a multi­dimensional field encompassing psychological, clinical, social, and healthcare perspectives. Key research gaps, particularly regarding family involvement and healthcare system factors, highlight priorities for future research and the development of comprehensive, woman centered maternal healthcare strategies.

Background: Compliance with complete postnatal care (PNC) visits is essential for the early detection of postpartum complications and the prevention of maternal morbidity and mortality. However, the coverage of complete postnatal care visits in several areas of Sragen Regency remains below the national target. This study aimed to examine the individual- and contextual-level determinants of compliance with complete PNC visits in Sragen Regency, Indonesia. Subjects and Method: This analytic observational study employed a cross-sectional design and was conducted in six primary healthcare centers in Sragen Regency, comprising three urban and three rural facilities. A total of 162 postpartum women were selected using purposive sampling. The dependent variable was compliance with complete postnatal care (PNC) visits. Individual-level independent variables included maternal age, educational level, employment status, parity, pregnancy risk status, mode of delivery, and knowledge of postnatal care, while the contextual-level variable was the category of the primary healthcare centers (urban or rural). Data were collected using a structured questionnaire and the Maternal and Child Health (MCH) handbook and were analyzed using multilevel logistic regression in STATA version 17. Results: Compliance with complete PNC visits was significantly higher among women of optimal reproductive age (aOR=6.75; p=0.027), those with higher education (aOR=5.20; p=0.015), unemployed women (aOR=3.06; p=0.026), primiparous women (aOR=4.41; p=0.002), women with high-risk pregnancies (aOR=4.34; p=0.004), women who had operative deliveries (aOR= 6.76; p=0.002), and women with good knowledge of postnatal care (aOR=16.98; p<0.001). There was a contextual effect of the primary healthcare service, with ICC= 9.70%. Conclusion: Compliance with complete postnatal care visits was influenced by both individual characteristics and the contextual characteristics of primary healthcare centers. Strengthening maternal knowledge and implementing context-specific postnatal care strategies are needed to improve the coverage of complete postnatal care visits.

Depression has been recognized as a major public health issue that affects middle-aged people in developing countries. The research explored how diabetes mellitus and stroke history affected depressive symptoms in Indonesian among middle-aged adults. This is a cross-sectional study that used data from the IFLS-5, which included 7,503 participants. Weighted descriptive, bivariate, and multivariable logistic regression analyses were performed. The prevalence of depressive symptoms was 17.72%, while 5.62% reported diabetes and 1.00% reported stroke. In adjusted analysis, diabetes only ((AOR = 0.77; 95% CI: 0.57–1.03; p= 0.082)), stroke only (AOR = 1.32; 95% CI: 0.70–2.52; p= 0.387), and combined diabetes and stroke (AOR = 0.91; 95% CI: 0.18–4.50; p= 0.912) were not significantly associated with depressive symptoms. Female (AOR = 1.20; 95% CI: 1.05–1.39; p= 0.009), unhealthy self-rated health (AOR= 2.48; 95% CI: 2.17–2.84; p= 0.001), and lack of community participation (AOR = 0.86; 95% CI: 0.74–0.99; p= 0.043) were significant. However, BMI had lower odds of depressive symptoms. Marital status, education, residence, smoking status, and physical activity were not significantly associated with depressive symptoms. These findings suggest that psychosocial and perceptual factors play a more prominent role in midlife depressive symptoms than chronic disease status. Integrated public health strategies addressing self-perceived health, social engagement, and gender disparities are necessary.

Background: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with increasing prevalence in both urban and rural areas. Differences in sociodemographic characteristics and health behaviors between urban and rural populations are suspected to influence the clinical profile and demographic characteristics of T2DM patients. This study aims to analyze differences in T2DM patient characteristics in adults in urban and rural areas of Sragen Regency, Indonesia, and identify the most dominant factors differentiating these two groups. Subjects and Method: This was a comparative observational analytical study with a cross-sectional design conducted in six health centers in Sragen Regency representing urban and rural areas. Research subjects were adult patients with T2DM who met inclusion criteria. Variables examined included age, sex, educational level, income, occupation, and physical activity. Data were collected using structured questionnaires and medical records. Bivariate analysis was performed using the Chi-square test, while multivariate analysis used binary logistic regression. Results: Significant differences were found between T2DM patients in urban and rural areas based on age (p=0.035), educational level (p=0.007), income (p=0.011), occupation (p=0.016), and physical activity (p=0.005). No significant difference was found in sex distribution between the two areas (p=0.078). Binary logistic regression analysis showed that physical activity was the most dominant factor differentiating T2DM patient characteristics in urban and rural areas (OR=2.326; p=0.007). Patients with low physical activity had 2.326 times higher odds of residing in urban areas compared to those with moderate or high physical activity. Conclusion: Physical activity is the most dominant factor differentiating T2DM patient characteristics between urban and rural areas. Area-specific T2DM prevention and control stra­tegies should prioritize physical activity improvement with approaches tailored to local community characteristics.

Background: Cyberbullying can trigger postpartum mother to experience anxiety and depression, which impacts their enthusiasm for caring for their babies. This study aimed to know the Impact of Psychoeducation on Postpartum Stress and Knowledge Related to Cyberbullying. Subjects and Method: This was a quasi-experimental study conducted in Surakarta, Central Java, Indonesia. A total of 86 postpartum mothers who experienced cyberbullying were included for study. The dependent variables were knowledge and postpartum stress. The independent variable was psychoeducation. Educational media video given to the respondent once a day for a week. Before and after the intervention, depression was measured using the Edinburgh Postnatal Depression Scale (EPDS). Data was analyzed using the Wilcoxon Test. Results: A total of 86 postpartum mothers had a high school education, were housewives, and married without prior depressive history. Knowledge of cyberbullying increased markedly, with the proportion of respondents in the "high knowledge" category rising from 15.56% to 84.44% (p = 0.02). Anxiety and depression levels showed substantial reduction. The number of mothers in the "normal" category increased from 24.44% to 82.22%, with no respondents remaining in the moderate or severe depression categories post-intervention. Conclusion: Innovative interventions play a positive role in increasing the knowledge level of postpartum mother about cyberbullying and decreasing their anxiety and depression due to cyberbullying.