Background Child mortality rates have been reducing in most countries in recent years. However, perinatal mortality (stillbirths and deaths in the first week of life) has remained high and is a significant public health issue, particularly in low-middle-income countries. This study aimed to identify the risk factors and their association with perinatal mortality in Indonesia.

Methods This project involved Demographic Health Survey (DHS) data from Indonesia in 2017 to calculate perinatal mortality and its potential determinants. Multivariable logistic regression was used to examine the association of the potential risk factors with perinatal mortality across the country.

Results This study included 17,171 births in Indonesia in 2017, with a perinatal mortality rate (PMR) of 21.23 per 1,000 births. There was a wide variation in PMRs across the island group, with the highest PMR in Maluku/Papua (34.34 per 1,000) and the lowest in Java (18.59 per 1,000). From the 20 determinants investigated, 15 variables were found to be statistically significant in multivariable analysis: multiple births (OR: 1.74; 95%CI 1.01 – 2.99) compared to singleton, size of child at birth (smaller than average OR: 2.05; 1.52–2.87) compared to very large, working mother (OR: 1.45; 1.14–1.84) than not working, the government hospital (OR: 1.68; 1.23 – 2.30) compared to respondent’s home, age of respondent at first birth (OR: 1.07 per year; 1.01–1.13 and births in the last five years (OR: 1.94 per year; 1.59–2.35). Variables with reduced odds ratio were: female sex (OR: 0.72; 0.57 – 0.91) compared to male, mother’s age at birth (20–29, OR: 0.65; 0.46–0.92; and 30–39, OR: 0.69; 0.48–0.99) compared to <20, complete primary school (OR: 0.68; 0.47 – 0.97) compared to incomplete primary, wealth index group of the middle (OR: 0.63; 0.44 – 0.90), and richest (OR: 0.55 0.37 – 0.81) compared to the poorest group, previous pregnancy interval of 15–26 months (OR: 0.59; 0.38 – 0.93), compared to first pregnancy and age of respondent at first cohabitation (OR: 0.92 per year; 0.87 – 0.98).

Conclusion Perinatal mortality in Indonesia was high, with a wide variation across the island groups. Further study is essential to examine confounders and mediators of the association between perinatal mortality and risk factors.