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Kata Kunci : IMT awal kehamilan; pertambahan berat badan ibu hamil;berat lahir
Birth weight is the most important anthropometric measure and is most often used as an indicator of infant growth. Babies with a birth weight of less than 2500 grams indicate a maternal health and nutritional disorder when pregnant, which may increase the risk of infant morbidity and mortality and are associated with the risk of degenerative diseases in adulthood. This study used cross sectional design, using maternity medical record data that gave birth at UPTD Puskesmas Mandirancan from January to December 2016 which amounted to 397 medical records. The result of double linear regression statistic test stated that early pregnancy BMI, maternal weight of pregnant mother, Hb, and Lila were significantly correlated with infant birth weight. The most dominant factor influencing birth weight was early pregnancy IMT factor (β = 0,573) after controlled by weight variable of pregnant mother, Hb level, and Lila. It is recommended that the puskesmas provide information to pregnant women and mothers who will plan for pregnancy, on the importance of early pregnancy IMT, maternal fatigue, Hb, and Lila levels as recommended to achieve normal birth weight.
Key words : Body Mass Index of early pregnancy; Maternal weight gain, birth weight
The prevalence of LBW in Indonesia based on the 2013 Basic Health Research was 10.2% with the proportion of LBW in urban and rural areas 9.4% and 11.2%. This study aims to analyze the dominant factors on LBW occurrence in urban and rural areas in Indonesia. This study is a cross-sectional study using secondary data from the Demographic and Health Survey (IDHS) in 2017. Respondents in this study were 11,188 woman of childbearing age divided into 5,852 in urban areas and 5,336 in rural areas. The results of research in Indonesia showed a significant relationship between respondent’s education level (p = 0,000; OR = 1,471; 95% CI = 1,252-1,730), the frequency of antenatal care (p = 0,000; OR = 1,713; 95% CI = 1,317-2,229 ), gestational age at first examination (p = 0.026; OR = 1,246; 95% CI = 1,031-1,505), and total iron tablet consumption (p = 0,000; OR = 1,312; 95% CI = 1,131-1,621) with LBW. While in urban areas, factors related to LBW are parity (p = 0.039; OR = 1,258; 95% CI = 1,018-1,555), respondent’s education level (p = 0.001; OR = 1,542; 95% CI = 1,199-1,983) and total iron tablet consumption (p = 0.020; OR = 1,283; 95% CI = 1,044-1,576), and in rural areas is respondent’s education level (p = 0.002; OR = 1,423; 95% CI = 1,145-1,769), the frequency of antenatal care ( p = 0,000; OR = 1,878; 95% CI = 1,345-2,622), place of antenatal care (p = 0.037; OR = 0.781; 95% CI = 0.622-0.980), and total iron tablet consumption (p = 0.010; OR = 1.336 95% CI = 1,075-1,660). The most dominant factor for LBW occurrence in Indonesia and rural areas is the frequency of antenatal care, while in urban areas is the education level of respondents. Based on the results of this study, it is expected that socialization and education related to pregnancy such as regular pregnancy checks, increasing formal education level of woman of childbearing age, and regular consumption of TTD.
UNICEF data shows that the prevalence of Low Birth Weight (LBW) in Indonesia has not decreased significantly for a decade and a half [2000 (11.2%) ? 2015 (10%)]. Indonesia is ranked ninth in the world with the highest incidence of LBW. Then, babies born weighing <2500 grams (LBW) are at higher risk of premature death, stunted growth and development, low IQ, and non-communicable diseases. One of the causes of LBW is anemia where iron deficiency is known to be a risk factor. Iron deficiency in pregnant women can be avoided by taking blood-added tablets (TTD) as long as recommended (≥90 tablets). However, pregnant women in Indonesia who consume iron tablets as recommended are still low (38%). Therefore, this study aims to determine the relationship between maternal consumption of iron tablets during pregnancy and low birth weight. The study design used was cross-sectional by analyzing the 2018 Basic Health Research data. Chi-square analysis was used to determine the relationship between exposure (TTD consumption) and outcome (LBW) as well as other variables included in this study. TTD consumption as a determinant and other independent variables are pregnancy complications, gestational age, parity, history of hypertension, desire to have children, gestational age at K1, frequency of ANC, maternal age at pregnancy, education level, employment status, area of residence, and smoking habits. There is a significant relationship between maternal TTD consumption during pregnancy and the incidence of LBW. Mothers who did not take TTD at least 90 tablets had a 1.12 times greater risk of giving birth to LBW (95% CI: 1.02-1.2). Other factors that were significantly associated with LBW were pregnancy complications, gestational age, parity, history of hypertension, desire to have children, frequency of antenatal care, maternal age, maternal education level, employment status, area of residence, and smoking habits. It is expected that during pregnancy the mother routinely consumes 1 tablet of TTD every day at least 90 tablets, and routinely conducts pregnancy checks to unite the growth and development of the baby to prevent the incidence of LBW.
ABSTRAK
Berat lahir bayi digunakan sebagai salah satu indikator untuk memprediksi pertumbuhan dan ketahanan hidup bayi disamping status gizi dan kesehatan bayi. Bayi dengan berat lahir rendah (BBLR) adalah berat lahir kurang dari 2500 gram dengan mengabaikan usia kehamilan. Berbagai penelitian membuktikan terdapat banyak faktor yang mempengaruhi berat lahir, khususnya status gizi ibu. Tujuan dari penelitian yang dilakukan secara potong lintang ini adalah untuk mengetahui apakah Lingkar lengan Atas (LILA) merupakan faktor dominan yang berhubungan dengan berat lahir pada ibu hamil usia remaja dengan menggunakan indikator status gizi lain (Berat Badan sebelum Hamil, Pertambahan Berat Badan selama Hamil, Tinggi Badan), gynecological age, frekuensi antenatal care, tingkat pendidikan dan asupan gizi sebagai prediktor. Penelitian dilakukan pada 94 ibu hamil usia remaja dengan rata-rata usia 18,01±1,12 tahun. Berat lahir, status gizi, frekuensi antenatal care, tingkat pendidikan diperoleh dari rekam medis (kohort Ibu dan buku kunjungan KIA), gynecological age diketahui melalui pengisian kuesioner, dan asupan gizi dihitung dengan menggunakan metode Food Frequency Questionaire (FFQ). Terdapat hubungan yang bermakna antara LILA, Berat Badan sebelum Hamil dan gynecological age dengan berat lahir bayi. Hasil uji statistik menyatakan bahwa LILA merupakan faktor dominan yang berhubungan dengan berat lahir setelah dikontrol variabel Berat Badan sebelum Hamil, Pertambahan Berat Badan selama Hamil, gynecological age, frekuensi antenatal care, asupan energi total dan asupan zat besi. Untuk meningkatkan outcome kehamilan pada remaja, Puskesmas, Sekolah, BKKBN, LSM direkomendasikan untuk mengimplementasikan program peer group yang kegiatannya melibatkan keluarga dan berfokus pada pengendalian dan dukungan pada ibu hamil remaja, peningkatan status gizi, dan promosi asupan yang bergizi seimbang.
ABSTRACT
Baby birth weight was used as one of indicator for predicting baby?s growth and life?s survival beside of baby?s nutrient and health status. Low birth weight baby means a baby who have birth weight less than 2500 gram by ignoring pregnancy age. Some researchs proved that many factors affecting birth weight, mother?s nutrient status in particular. This study aim to understand whether upper arm circumference is the dominant factor which related with baby?s birth weight of teenage pregnant mother by using other nutrient status indicator (body weight before pregnancy, weight increase during pregnancy, body height), gynecological age, antenatal care frequency, education level and nutrients intake as predictor. Study design is cross sectional with 94 teenage pregnant mother. The mean of age was 18,01±1,12 years. Birth weight, nutrient status, antenatal care frequency and education level was recognized by fill in questionnaire while nutrients intakes was calculated by Food Frequency Questionaire (FFQ) method. There was a significant relationship between upper arm circumference, body weight before pregnancy and gynecological age with baby birth weight. Statistical Test showed that upper arm circumference is dominant factor which have a correlation with baby birth weight after controlled by body weight before pregnancy, weight increase during pregnancy, gynecological age, antenatal care frequency, total energy intake and Iron intake variables. To improve teenage pregnancy outcome, Primary Health Center, Schools, Family Planning Coordination Board and Non- Goverment Organization were recommended to implement peer group program which some activities involving family member and focus on controlling and supporting teenage pregnancy mothers, nutrient status improvement and promoting balance nutrients intakes.
