Impact of maternal behavior and history of infectious diseases during pregnancy on the prevalence of stunting among children under five years 10.55131/jphd/2025/230115
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Abstract
The prevalence of stunting in children under 5 years of age is a problem that must be resolved, mothers are people who have an important role in stunting prevention efforts, so prevention efforts are relevant in reducing the prevalence of stunting in Indonesia. A cross sectional design was conducted on 532 participants. Simple random sampling and proportional sampling techniques were used for sampling. Structured questionnaires were used to collect data through interviews and anthropometric measurements. Multiple logistic regression analysis and statistical significance expressed at 95% CI were used. Mothers who had a low knowledge score (OR=4.8, 95% CI=3.1-7.3), low attitude score (OR=2.0, 95% CI=1.3-3.1), low action score (OR=1.8, 95% CI=1.1-2.7), and a history of infectious diseases during pregnancy (OR=2.2, 95% CI=1.4-3.5) were the main causal factors of stunting. Maternal behaviour is a significant determinant of stunting in children under 5 years old. If a mother has low scores in knowledge attitude score, score, along with a history of infectious diseases during pregnancy, the chance of stunting is 85.7%. Therefore, strategies and programmes that focus on mothers are the right choice, and increasing maternal knowledge is necessary to improve maternal attitudes and actions.
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References
Vaivada T, Akseer N, Akseer S, Somaskandan A, Stefopulos M, Bhutta ZA. Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. Am J Clin Nutr. 2020;112(Suppl 2):777S-791S. doi: 10.1093/ajcn/nqaa159
Gebreayohanes M, Dessie A. Prevalence of stunting and its associated factors among children 6–59 months of age in pastoralist community, Northeast Ethiopia: A community-based cross-sectional study. PLoS One. 2022;17(2):e0256722. doi: 10.1371/ journal.pone.0256722
Deshpande A, Ramachandran R. Early childhood stunting and later life outcomes: A longitudinal analysis. Econ Hum Biol. 2022;44:101099. doi: 10.1016/j.ehb.2021.101099
Chowdhury TR, Chakrabarty S, Rakib M, Afrin S, Saltmarsh S, Winn S. Factors associated with stunting and wasting in children under 2 years in Bangladesh. Heliyon. 2020;6(9): e04849. doi: 10.1016/j.heliyon.2020. e04849
Akseer N, Tasic H, Onah MN, Wigle J, Rajakumar R, Sanchez-Hernandez D, et al. Economic costs of childhood stunting to the private sector in low-and middle-income countries. EClinical Medicine. 2022;45:101320. doi: 10.1016/j.eclinm.2022.101320
Suratri MAL, Putro G, Rachmat B, Nurhayati, Ristrini, Pracoyo NE, et al. Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia. Int J Environ Res Public Health. 2023;20(2):1640. doi: 10.3390/ ijerph20021640
Ministry of Health of the Republic of Indonesia. Indonesia Health Profile 2022. Ministry of Health of the Republic of Indonesia [Internet]. [Cited 2024 Jan 7]. Available from: https://p2p.kemkes.go.id/profil-kesehatan-2022.
Health Office of Bandung City. Health Profile of Bandung City in 2022. Health Office of Bandung City [Internet]. [Cited 2024 Jan 12]. Available from: https://dinkes.bandung.go.id/download/profil-kesehatan-2022.
Atamou L, Rahmadiyah DC, Hassan H, Setiawan A. Analysis of the Determinants of Stunting among Children Aged below Five Years in Stunting Locus Villages in Indonesia. Healthcare. 2023;11(6):810. doi: 10.3390/healthcare11060810
Mbuya MN, Humphrey JH. Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries. Matern Child Nutr. 2016;12 Suppl 1(Suppl 1):106-20. doi: 10.1111/mcn. 12220
Halli SS, Biradar RA, Prasad JB. Low Birth Weight, the Differentiating Risk Factor for Stunting among Preschool Children in India. Int J Environ Res Public Health. 2022;19(7):3751. doi: 10.3390/ijerph19073751
Logarajan RD, Nor NM, Ibrahim S, Said R. Social determinants of stunting in Malay children aged <5 years in Malaysia. Nutrition. 2023;111:112030. doi: 10.1016/j.nut.2023.112030
Liu J, Sun J, Huang J, Huo J. Prevalence of Malnutrition and Associated Factors of Stunting among 6–23-Month-Old Infants in Central Rural China in 2019. Int J Environ Res Public Health. 2021;18(15):8165. doi: 10.3390/ ijerph18158165
Vale D, Andrade MEDC, Dantas NM, Bezerra RA, Lyra CO, Oliveira AGRDC. Social Determinants of Obesity and Stunting among Brazilian Adolescents: A Multilevel Analysis. Nutrients. 2022;14(11):2334. doi: 10.3390/nu14112334
Ministry of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia Number 2 of 2020 concerning Child Anthropometric Standards. Jakarta: Ministry of Health of the Republic of Indonesia [Internet]. [Cited 2024 Sep 8]. Available from: http://hukor. kemkes.go.id/uploads/produk_hukum/PMK_No__2_Th_2020_ttg_Standar_Antropometri_Anak.pdf.
Organization WH. WHO Child Growth Standards Growth Velocity Based on Weight, Length and Head Circumference. Methods and Development Geneva: World Health Organization. 2009 [Internet]. [Cited 2024 Sep 8]. Available from: https://www.who.int/publications/i/item/9789241547635.
Simarmata VPA, Patriawati KA. A Descriptive Study on Stunting in Toddlers & Contributing Factors in Cibungur Village, Sumedang District, Indonesia. Journal of Complementary and Alternative Medical Research. 2024;25(7):58–72.
Picauly I, P Manongga S, Adar D, CH Liufeto F. Stunting Determinant Analysis in the East Mainland Province of East Nusa Tenggara for the Period of 2017-2021. Journal of Maternal and Child Health. 2022;7(6):711–9.
Fadare O, Amare M, Mavrotas G, Akerele D, Ogunniyi A. Mother’s nutrition-related knowledge and child nutrition outcomes: Empirical evidence from Nigeria. PLoS One. 2019;14(2): e0212775. doi: 10.1371/journal.pone. 0212775
Mediani HS, Hendrawati S, Pahria T, Mediawati AS, Suryani M. Factors Affecting the Knowledge and Motivation of Health Cadres in Stunting Prevention Among Children in Indonesia. J Multidiscip Healthc. 2022 May;Volume 15:1069–1082. doi: 10.2147/JMDH.S356736
Hagos S, Hailemariam D, WoldeHanna T, Lindtjørn B. Spatial heterogeneity and risk factors for stunting among children under age five in Ethiopia: A Bayesian geo-statistical model. PLoS One. 2017;12(2):e0170785. doi: 10.1371/journal.pone.0170785
Saleh A, Syahrul S, Hadju V, Andriani I, Restika I. Role of Maternal in Preventing Stunting: a Systematic Review. Gac Sanit. 2021;35:S576–82. doi: 10.1016/j.gaceta.2021.10.087
Yabancı N, Kısaç İ, Karakuş SŞ. The Effects of Mother’s Nutritional Knowledge on Attitudes and Behaviors of Children about Nutrition. Procedia Soc Behav Sci. 2014;116:4477–4481.
Rachmawati PD, Triharini M, Suciningtyas PD. The contribution of family functions, knowledge and attitudes in children under five with stunting. Enferm Clin. 2021;31:S296–300.
Kurnia ID, Krisnana I, Rahmadhani TD. Perceived barriers of nutritional feeding related to severe stunting. Enferm Clin. 2021;31:S33–S36. doi: 10.1016/j.enfcli.2020.10.013
Yuarnistira, Nursalam N, Rachmawati PD, Efendi F, Pradanie R, Hidayati L. Factors Influencing the Feeding Pattern of Under-Five Children in Coastal Areas. IOP Conf Ser Earth Environ Sci. 2019;246:012008. doi: 10.1088/1755-1315/246/1/012008
Finnane JM, Jansen E, Mallan KM, Daniels LA. Mealtime Structure and Responsive Feeding Practices Are Associated With Less Food Fussiness and More Food Enjoyment in Children. J Nutr Educ Behav. 2017;49(1):11-18.e1. doi: 10.1016/j.jneb.2016.08.007
Mugode RH, Puoane T, Michelo C, Steyn NP. “Feeding a child slowly:” a responsive feeding behavior component likely to reduce stunting: Population-based observations from rural Zambia. J Hunger Environ Nutr. 2018;13(4): 455–469.
Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health. 2014 Nov 13;34(4):250–265. doi: 10.1179/2046905514Y.0000000158
Santosa A, Novanda Arif E, Abdul Ghoni D. Effect of maternal and child factors on stunting: partial least squares structural equation modeling. Clin Exp Pediatr. 2022;65(2):90–97. doi: 10.3345/cep.2021.00094
Farias PM, Marcelino G, Santana LF, de Almeida EB, Guimarães RCA, Pott A, et al. Minerals in Pregnancy and Their Impact on Child Growth and Development. Molecules. 2020;25(23): 5630. doi: 10.3390/molecules25235630
Weckman AM, Ngai M, Wright J, McDonald CR, Kain KC. The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes. Front Microbiol. 2019;10:1924. doi: 10.3389/fmicb. 2019.01924
Kumar M, Saadaoui M, Al Khodor S. Infections and Pregnancy: Effects on Maternal and Child Health. Front Cell Infect Microbiol. 2022;12:873253. doi: 10.3389/fcimb.2022.873253
Mate A, Reyes-Goya C, Santana-Garrido Á, Sobrevia L, Vázquez CM. Impact of maternal nutrition in viral infections during pregnancy. Biochim Biophys Acta Mol Basis Dis. 2021; 1867(11):166231. doi: 10.1016/ j.bbadis.2021.166231
Amir M, Brown JA, Rager SL, Sanidad KZ, Ananthanarayanan A, Zeng MY. Maternal Microbiome and Infections in Pregnancy. Microorganisms. 2020; 8(12):1996. doi: 10.3390/micro organisms8121996