The Effect of Maternal and Child Factors on Stunting in Children Under Five Years in Rural Indonesia
Indonesia has the fifth largest prevalence of stunting in the world. The results of the 2013 Basic Health Research showed that the prevalence of stunting in toddlers in Indonesia was 37.2%. In Cianjur District, the prevalence of stunting in 2017 reached 35.7%. The purpose of this study was to analyze the effect of maternal and child factors on stunting in children under five years in Cikancana, Cianjur District, in rural Indonesia. The study used an analytical design with a case-control approach. 42 mothers were included who had children under five years with stunting and 42 mothers who had healthy children. Data analysis was through the Chi-square test and multiple logistic regression. The results showed that, of the maternal factors, gestational weight gain and anemia during pregnancy were significantly related to stunting (both p < 0.001), while maternal height (p = 0.068) and maternal nutritional status during pregnancy (p = 0.801) were not significantly related to stunting. None of the child factors were significantly related to stunting, namely birth weight (p = 1.000), birth length (p = 0.156), early breastfeeding initiation (p = 1.000), exclusive breastfeeding (p = 0.175), complete basic immunization (p = 0.713), or history of infectious diseases (p = 1.000). Multiple logistic regression showed that anemia during pregnancy was the most influential factor for stunting in children under five years (OR 18.41; 95% CI 3.43-98.75; p < 0.001). Pregnant women need to be prepared by taking iron supplementation tablets during pregnancy so that anemia can be prevented.
Keywords: stunting, maternal factors, child factors
 Prawirohartono E, Nurdiati D, Hakimi M. Prognostic factors at birth for stunting at 24 months of age in rural Indonesia. Paediatrica Indonesiana. 2016;56:48–56.
 Ni’mah K, Nadhiroh SR. Factors associated with the incidence of stunting in infants. Media Gizi Indonesia. 2016;10:13–19.
 Elba F, Marheni D, Dhamayanti M, et al. Factors affecting the incidence of stunting in toddlers age 24-36 months in Batujajar district, West Bandung, Indonesia. Jurnal Pendidik dan Pelayanan Kebidanan Indonesia. 2015;2:9–16.
 Prabandari Y, Hanim D, Ar RC, et al. Hubungan kurang energi kronik dan anemia pada ibu hamil dengan status gizi bayi usia 6-12 bulan di kabupaten boyolali (correlation chronic energy deficiency and anemia during pregnancy with nutritional status of infant 6–12 months in Boyolali regency). Nutrition and Food Research. 2016;39:1–8.
 Danaei G, Andrews KG, Sudfeld CR, 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;13:1002164.
 Trihono T, Atmarita A, Tjandrarini DH, et al. Short (stunting) in Indonesia, problems and solutions. Lembaga Penerbit Badan Litbangkes; 2015.
 Dinas Kesehatan Kabupaten Cianjur. Holistic intervention of integrative stunting countermeasures.
 Beal T, Tumilowicz A, Sutrisna A, et al. A review of child stunting determinants in Indonesia. Maternal and Child Nutrition. 2018;14:12617.
 Neufeld LM, Haas JD, Grajéda R, et al. 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;79:646–652.
 Sawaya AL, Roberts S. Stunting and future risk of obesity: Principal physiological mechanisms. Cadernos de saúde pública. 2003;19:S21–S28.
 Silveira KBR, Alves JFR, Ferreira HS, et al. Association between malnutrition in children living in favelas, maternal nutritional status, and environmental factors. J Pediatr (Rio J). 2010;86:215–220.
 Ruaida N, Nurdiati DS. The relationship between anemia in pregnant women and the incidence of stunting in children aged 6-24 months in Yogyakarta City.
 Ernawati F, Rosamalina Y, Permanasari Y. Effect of the pregnant women’s protein intake and their baby length at birth to the incidence of stunting among children. Nutrition and Food Research. 2013;36:1–11.
 Permadi MR, Hanim DK, Indarto D. Risiko inisiasi menyusu dini dan praktek ASI eksklusif terhadap kejadian stunting pada anak 6–24 bulan. Penelit Gizi dan Makanan. 2016;39:9–14.