Gestational weight gain is a risk factor of stunting among children aged 6-23 months in Bangli District, Bali, Indonesia
DOI:
https://doi.org/10.53638/phpma.2019.v7.i1.p04Keywords:
stunting, children aged 6-23 months, anemia, increased body weight of pregnant women, BaliAbstract
Background and purpose: Stunting in children is a chronic nutritional concern that has short-term and long-term health effects. Several studies have shown inconsistent results related to the association between stunting and anemia and increased maternal weight during pregnancy. This study aims to determine anemia during pregnancy, increased body weight and weight gain during pregnancy based on body mass index (BMI) before pregnancy as the risk factors of stunting.
Methods: A case control study was carried out using the baseline data of an intervention study conducted from April to September to prevent stunting in children aged 6-23 months in nine villages in Bangli District, Bali Province. Baseline data collection was conducted from December 2017–February 2018 by interviewing 330 mothers of the children and observation of their ANC records. The number of samples for the case control study was 156 children aged 6-23 months consisting of 78 cases and 78 controls (1:1). Cases were selected by systematic random sampling from 82 children with stunting and controls were selected in the same way from 248 children without stunting. Data analyzed were maternal age at pregnancy, education, employment, number of children, family income, height, hemoglobin level and maternal body weight during pregnancy. Multivariate analysis with logistic regression was conducted to determine the adjusted odds ratio (AOR) of each risk factor.
Results: The increase in maternal weight during pregnancy which is not in accordance with maternal BMI before pregnancy and an increase in maternal weight of <10 or >12.5 kilograms are significantly associated with stunting with AOR=3.53 (95%CI: 1,55-8.07) and AOR=3.31 (95%CI: 1.24-8.85). Hemoglobin <11gr/dL during pregnancy was not found to be significantly associated with stunting (AOR=5.02; 95%CI: 0.80–31.71).
Conclusion: The increase of maternal weight during pregnancy which is not suitable with BMI before pregnancy and an increase in maternal weight of <10 or >12.5 kilograms are risk factors for stunting in children aged 6-23 months. In addition to monitoring the increase of maternal weight during pregnancy, it is important to consider the mother’s BMI before pregnancy in order to reduce the risk of stunting.
References
UNICEF. Levels and trends in child malnutrition. New York; 2015.
UNICEF. Levels and trends in child malnutrition. Washington DC; 2017.
The Ministry of Health of Indonesia. Riset Kesehatan Dasar tahun 2018 [The 2018 Indonesia Basic Health Research]. 2018.
Bali Province Health Office. Laporan hasil pemantauan status gizi dan pemantauan konsumsi gizi (PSG-PKG) Provinsi Bali 2016 [Report on the results of 2016 Bali Province nutritional status and nutrition consumption monitoring survey]. Denpasar; 2016.
WHO. Childhood stunting: Challenges and opportunities. 2013. 6. Nkurunziza S, Meessen B, Van geertruyden J-P, Korachais C. Determinants of stunting and severe stunting among Burundian children aged 6-23 months: evidence from a national cross-sectional household survey, 2014. BMC Pediatrics. 2017;17(176):1–14.
Najahah I, Adhi KT, Pinatih GNI. Faktor risiko balita stunting usia 12-36 bulan di Puskesmas Dasan Agung, Mataram, Provinsi Nusa Tenggara Barat [Risk factors of stunting among children aged 12-36 months at Dasan Agung Public Health Centre, Mataram, West Nusa Tenggara]. Public Health and Preventive Medicine Archive. 2013;1(2):134–41.
Danaei G, Andrews KG, Sudfeld CR, Nther Fink G, Mccoy DC, Peet E, et al. Risk factors for childhood stunting in 137 Developing Countries: A comparative risk assessment analysis at global, regional, and country levels. PLoS Medicine. 2016;13(11):1–18.
Zaif RM, Wijaya M, Hilmanto D. Hubungan antara riwayat status gizi ibu masa kehamilan dengan pertumbuhan anak balita di Kecamatan Soreang Kabupaten Bandung [The association between the history of gestational nutritional status with the growth of children under five years old in Soreang Sub-District, Bandung District]. Jurnal Sistem Kesehatan. 2016;2(3):156–63.
Ruaida N. Hubungan anemia ibu hamil dengan kejadian stunting pada anak usia 6-24 bulan di Kota Yogyakarta (tesis) [The association between gestational anemia and stunting among children aged 6-24 months in Yogyakarta (thesis)]. Universitas Gadjah Mada; 2013.
Warsini KT, Hadi H, Nurdiati DS. Riwayat KEK dan anemia pada ibu hamil tidak berhubungan dengan kejadian stunting pada anak usia 6-23 bulan di Kecamatan Sedayu, Bantul, Yogyakarta [History of malnutrition and anemia in pregnant women are not associated with stunting among children aged 6-23 months in Sedayu Sub-District, Bantul. Yogyakarta]. Jurnal Gizi dan Dietetik Indonesia. 2016;4(1):29–40.
Pandey P, Bajpai P, Jain S, Sharma A. Maternal empowerment holds the key to reducing stunting during first 1000 days of life: Evidence from a case–controlled study. Annals of Tropical Medicine and Public Health. 2017;10(3):667–77.
Prabandari Y, Hanim D, Cilmiaty RA, Dono Indarto D. Hubungan kurang energi kronik dan anemia pada ibu hamil dengan status gizi bayi usia 6-12 bulan di Kabupaten Boyolali [The association of chronic malnutrition and anemia among pregnant women with the nutrition status of infants aged 6-12 months in Boyolali District]. Penelitian Gizi dan Makanan. 2016;39(1):1–8.
Erowati D. Pengaruh faktor ibu dan anak pada periode 1000 hari pertama kehidupan terhadap kejadian stunting pada anak usia 12-24 bulan [The influence of maternal and child factors during the first 1000 days period of life towards stunting among children aged 12-24 months. Universitas Gadjah Mada; 2016.
Torlesse H, Cronin AA, Sebayang SK, Nandy R. Determinants of stunting in Indonesian children: evidence from a cross-sectional survey indicate a prominent role for the water, sanitation and hygiene sector in stunting reduction. BMC Public Health. 2016;16(669):1–11.
Bangli District Health Office. Hasil Pemantauan Status Gizi (PSG) tahun 2017 di Kabupaten Bangli [The results of 2017 nutritional status monitoring survey in Bangli District]. Bangli District; 2017.
World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. World Health Organization; 2011.
Institute of Medicine. Weight gain during pregnancy: re-examining the guidelines. Washingron, D.C.: The National Academies Press; 2009.
Government of Bali Province. Peraturan Gubernur Bali Nomor 65 Tahun 2017 tentang Upah Minimum Kabupaten/Kota [The Bali Province Governor Act No. 65 Year 2017 on the Local District/City Minimum Wages]. 2017.
Ministry of Health of Indonesia. Kehamilan: 1000 hari pertama periode emas janin [Pregnancy: The first 1000 days of infants’ gold period]. Ministry of Health of Indonesia. 2012. Available from: http://gizi.depkes.go.id/wp-content/uploads/2012/11/FA-LEAFLET-KEHAMILAN.pdf
Pusparini, Ernawati F, Briawan H. Indeks massa tubuh rendah pada awal kehamilan dan defisiensi Vitamin A pada trimester kedua sebagai faktor risiko gangguan pertumbuhan linier pada bayi lahir [Low BMI during early pregnancy and Vitamin A deficiency in the second trimester as risk factors of linier growth disorders among infants]. Jurnal Gizi Pangan. 2016;11(3):191–200.
Black RE, Allen LH, Qar Z, Bhutta A, Caulfi LE, De Onis M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.
Neufeld LM, Haas JD, Grajéda R, Martorell R. Changes in maternal weight from the first to second trimester of pregnancy are associated with fetal growth and infant length at birth. The American Journal of Clinical Nutrition. 2004;79(4):646–52.
Ota E, Haruna M, Suzuki M, Anh DD, Tho LH, Tam NTT, et al. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bulletin of the World Health Organization. 2011;89:127–36.
Soltani H, Lipoeto NI, Fair FJ, Kilner K, Yusrawati Y. Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. BMC Women’s Health. 2017;17(102):7–12.
Ruchayati F. Hubungan kadar hemoglobin dan lingkar lengan atas ibu hamil trimester III dengan panjang bayi lahir di Puskesmas Halmahera Kota Semarang [The association of hemoglobin levels and upper arm circle among third trimester pregnant women with the length of infants at Halmahera Public Health Center, Semarang City]. Jurnal Kesehatan Masyarakat. 2012;1(2):578–85.
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