Latar belakang: Saat ini, kematian neonatal masih menjadi masalah kesehatan masyarakat nasional dan global sehingga diperlukan upaya untuk menurunkannya. Salah satunya melalui pemanfaatan antenatal care (ANC). Dalam ANC terdapat 10 komponen pelayanan kesehatan yang harus diberikan kepada ibu hamil, termasuk imunisasi tetanus toksoid (TT) yang penting untuk mencegah tetanus neonatorum (TN) yang memiliki fatality rate yang tinggi. Di Indonesia, persentase TT2+ pada ibu hamil menurun, sedangkan kasus TN mulai meningkat kembali.Tujuan: Untuk mengetahui hubungan imunisasi TT pada ibu hamil dengan kematian neonatal di Indonesia.Metode: Penelitian ini menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) 2017 dengan desain studi cross sectional. Sampel dari penelitian ini terdiri dari 10.028 wanita usia subur yang melahirkan bayi dalam rentang tahun 2012 – 2017 dengan kondisi bayi lahir hidup dan tunggal. Analisis data dilakukan dengan analisis survei kompleks menggunakan uji chi square dan regresi logistik.Hasil: Prevalensi kematian neonatal di Indonesia mencapai 0,8%. Ada sebanyak 28,6% ibu yang belum pernah mendapatkan, 17,7% ibu yang hanya menerima satu kali, dan 53,7% ibu yang telah mendapatkan ≥2 dosis imunisasi TT selama kehamilannya. Berdasarkan uji statistik, baik sebelum maupun setelah dikontrol dengan variabel confounding, diperoleh bahwa bayi yang dilahirkan dari ibu yang tidak pernah mendapatkan imunisasi TT berpeluang tinggi untuk mengalami kematian neonatal daripada bayi yang ibunya telah mendapatkan imunisasi TT 2 kali atau lebih (AOR 1,89; 95% CI 1,11 – 3,23). Di sisi lain, pada ibu yang hanya satu kali menerima imunisasi TT tidak ditemukan adanya asosiasi dengan kematian neonatal (AOR 0,67; 95% CI 0,29 – 1,54).Kesimpulan: Menambah bukti tentang pentingnya imunisasi TT pada ibu hamil dalam upaya mencegah kematian neonatal.

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Background: Currently, neonatal mortality remains a significant public health issue both nationally and globally. Therefore, efforts are needed to reduce it. One effective strategy is the utilization of antenatal care. ANC encompasses 10 essential health services that should be provided to pregnant women, including the administration of tetanus toxoid (TT) immunization, which is crucial for preventing neonatal tetanus (NT) with a high fatality rate. In Indonesia, the percentage of TT2+ immunization among pregnant women has decreased, while NT cases have risen again.

Objective: To determine the association between TT immunization in pregnant women and neonatal mortality in Indonesia.

Method: This study utilized data from the 2017 Indonesia Demographic and Health Survey (IDHS) with a cross-sectional study design. The sample consisted of 10.028 women of childbearing age who gave birth to live and single babies between 2012 and 2017. Data analysis was performed using complex survey analysis with chi-square tests and logistic regression.

Result: The prevalence of neonatal mortality in Indonesia is 0.8%. Among the mothers, 28.6% had never received TT immunization, 17.7% had received it only once, and 53.7% had received two or more doses of it during their pregnancy. Based on statistical tests, both before and after controlling for confounding variables, it was found that babies born to mothers who had never received TT immunization had a higher likelihood of experiencing neonatal mortality compared to babies whose mothers had received TT immunization twice or more (AOR 1.89; 95% CI 1.11 – 3.23). On the other hand, no association was found between mothers who received only one dose of TT immunization and neonatal mortality (AOR 0.67; 95% CI 0.29 – 1.54).

Conclusion: Add more evidence about the importance of TT immunization in pregnant women to prevent neonatal mortality.