Associations Between ANC History, Anemia, Exclusive Breastfeeding, and Maternal Diet with Nutritional Status of Children Aged 2–5 in Rural Indonesia

Louisa Ariantje Langi; Nur Nunu Prihantini; Louise Kartika Indah

doi:10.56741/IISTR.jphs.00908

Authors

Louisa Ariantje Langi
louisa.langi@uki.ac.id
Universitas Kristen Indonesia
Nur Nunu Prihantini Universitas Kristen Indonesia
Louise Kartika Indah Universitas Kristen Indonesia

Keywords:

Antenatal Care, Exclusive Breastfeeding, Child Nutrition, Stunting , Maternal Health

Abstract

The first thousand days of life, beginning with pregnancy, are crucial for a child's development, influenced by factors like maternal nutrition, health, antenatal care (ANC), exclusive breastfeeding, birth weight, immunization, and complementary feeding. Regular ANC visits are vital for monitoring the health of both mother and fetus. This cross-sectional study examined the association between ANC history, anemia during pregnancy, exclusive breastfeeding, and maternal dietary practices with child nutritional status in Ciranggem Village, Sumedang Regency (2021–2023). Data from 30 mothers of children aged 2–5 years were analyzed using Chi-square tests. Significant associations (p < 0.05) were found between all four maternal factors and child nutritional outcomes, highlighting their collective impact on growth. The study used an analytical observational design with total sampling. Results showed 73.3% of mothers received ANC, practiced exclusive breastfeeding, and maintained a healthy diet, while 26.7% had a history of anemia. Children's nutritional status was as follows: Normal (66.7%, 20 children), Stunting (20%, 6 children), Underweight (10%, 3 children), and Overweight (3.3%, 1 child). Statistical analysis yielded a p-value < 0.05, indicating a significant link between maternal factors and child nutrition.

Downloads

Download data is not yet available.

Author Biographies

Louisa Ariantje Langi, Universitas Kristen Indonesia

Louisa Ariantje Langi is a lecturer at the Department of Medical Community, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia. Currently, she is actively conducting research and community service. (Email: louisa.langi@uki.ac.id).

Nur Nunu Prihantini, Universitas Kristen Indonesia

Nur Nunu Prihantini is a lecturer at the Department of Biochemistry, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia. She is actively engaged in research and community service. (Email: nur.nunu@uki.ac.id).

Louise Kartika Indah, Universitas Kristen Indonesia

Louise Kartika Indah is a lecturer at Universitas Kristen Indonesia, Jakarta. She is actively involved in research and community service, and serves as a clinical nutrition specialist at Harapan Bunda General Hospital, Jakarta. (Email: louise.indah@uki.ac.id).

References

Y. Rosmalina, E. Luciasari, A. Aditianti, and F. Ernawati, “Upaya Pencegahan Dan Penanggulangan Batita Stunting: Systematic Review,” Gizi Indones., vol. 41, no. 1, pp. 1–14, Mar. 2018, [Online]. Available: https://persagi.org/ejournal/index.php/Gizi_Indon/article/view/221 [Eng. Trans: Efforts to Prevent and Control Stunting in Toddlers: Systematic Review] DOI: https://doi.org/10.36457/gizindo.v41i1.221

“Infeksi Emerging.” Mar. 31, 2025. [Online]. Available: https://infeksiemerging.kemkes.go.id/index.php/protokol-covid-19/pedoman-bagi-ibu-hamil-ibu-nifas-dan-bbl-selama-social-distancing [Eng. Trans: Emerging Infections]

M. A. Abdal Qader, I. Badilla, R. Mohd Amin, and H. F. Ghazi, “Influence of Antenatal Care on Birth Weight: A Cross Sectional Study in Baghdad City, Iraq,” BMC Public Health, vol. 12, no. S2, pp. A38,-1471-2458-12-S2-A38, Mar. 2012, doi: 10.1186/1471-2458-12-S2-A38. DOI: https://doi.org/10.1186/1471-2458-12-S2-A38

N. P. Aryani and N. H. Annisa, “Pengaruh Peningkatan Berat Badan Selama Kehamilan Terhadap Berat Badan Bayi Baru Lahir Di Puskesmas Kediri Tahun 2016,” Bunda Edu-Midwifery J., vol. 2, no. 2, pp. 16–23, 2019. [Eng. Trans: The Effect of Weight Gain During Pregnancy on the Birth Weight of Newborns at Kediri Health Center in 2016] DOI: https://doi.org/10.54100/bemj.v2i2.4

D. Mutiarasari, “Hubungan Status Gizi Dengan Kejadian Anemia Pada Ibu Hamil Di Puskesmas Tinggede,” Heal. Tadulako J. (Jurnal Kesehat. Tadulako), vol. 5, no. 2, pp. 42–48, Mar. 2019, [Online]. Available: http://jurnal.fk.untad.ac.id/index.php/htj/article/view/119 [Eng. Trans: Relationship Between Nutritional Status and Incidence of Anemia in Pregnant Women at Tinggede Health Center]

H. Okubo et al., “Maternal Dietary Patterns in Pregnancy and Fetal Growth in Japan: The Osaka Maternal and Child Health Study,” Br. J. Nutr., vol. 107, no. 10, pp. 1526–1533, Mar. 2012, [Online]. Available: https://www.cambridge.org/core/journals/british-journal-of nutrition/article/maternal-dietary-patterns-in-pregnancy-and-fetal-growth-in-japan-the-osaka-maternal-and-child-health-study/8096422E8C320CEB925B11C698F25A2D DOI: https://doi.org/10.1017/S0007114511004636

M. B. Narendra, T. S. Sularyo, S. S. Soetjiningsih, I. Ranuh, and S. Wiradisuria, “Tumbuh Kembang Anak Dan Remaja,” Jakarta Sagung Seto, pp. 100–104, 2002. [Eng. Trans: Child and Adolescent Growth and Development]

“Syarif DR, Lestari ED, Mexitalia M, Nasar SS. Buku Ajar Nutrisi Pediatrik Dan Penyakit Metabolik. Jilid I. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011 - Google Search.” Mar. 31, 2025. [Online]. Available: https://lib.ui.ac.id/detail?id=20507725&lokasi=lokal [Eng. Trans: Pediatric Nutrition and Metabolic Disease Textbook, Volume I]

P. R. Indonesia, “Peraturan Pemerintah Republik Indonesia Nomor 33 Tahun 2012 Tentang Pemberian Air Susu Ibu Eksklusif.” Kementerian Kesehatan, Republik Indonesia, Mar. 31, 2012. [Online]. Available: http://apiycna.org/wp-content/uploads/2014/01/Indonesia_Government-Regulation-no-33-year-2012.pdf [Eng. Trans: Government Regulation of the Republic of Indonesia Number 33 of 2012 Concerning Exclusive Breastfeeding]

L. Barus, “Hubungan Pemberian ASI Eksklusif Dengan Status Gizi Bayi 6-12 Bulan Di Puskesmas Onan Hasang Tahun 2019,” J. Midwifery Sr., vol. 4, no. 1, pp. 69–73, Mar. 2021, [Online]. Available: https://midwifery.jurnalsenior.com/index.php/ms/article/view/62 [Eng. Trans: The Relationship Between Exclusive Breastfeeding and Nutritional Status of Infants Aged 6-12 Months at Onan Hasang Health Center in 2019]

M. Oktarina, Buku Ajar Asuhan Kebidanan Persalinan Dan Bayi Baru Lahir. Deepublish, 2015. [Eng. Trans: Textbook of Midwifery Care for Labor and Newborns]

N. S. Afika, “Hubungan Pengetahuan Dengan Minat Ibu Hamil Trimester III Dalam Melakukan Pregnancy Massage (Di Wilayah Kerja Puskesmas Plandaan, Kecamatan Plandaan, Kabupaten Jombang),” STIKes Insan Cendekia Medika Jombang, 2017. [Online]. Available: https://repository.itskesicme.ac.id/id/eprint/262/ [Eng. Trans: The Relationship Between Knowledge and Interest of Third Trimester Pregnant Women in Performing Pregnancy Massage (In the Working Area of Plandaan Health Center, Plandaan District, Jombang Regency)]

M. H. Luengo, C. Álvarez-Bueno, D. P. Pozuelo-Carrascosa, C. Berlanga-Macías, V. Martínez-Vizcaíno, and B. Notario-Pacheco, “Relationship Between Breast Feeding And Motor Development In Children: Protocol For A Systematic Review And Meta-Analysis,” BMJ Open, vol. 9, no. 9, p. e029063, Mar. 2019, [Online]. Available: https://bmjopen.bmj.com/content/9/9/e029063.abstract DOI: https://doi.org/10.1136/bmjopen-2019-029063

A. Maryunani, “Inisiasi Menyusui Dini, ASI Eksklusif Dan Manajemen Laktasi,” Jakarta Trans Info Media, 2012. [Eng. Trans: Early Breastfeeding Initiation, Exclusive Breastfeeding, and Lactation Management]

R. I. Kemenkes, “Laporan Kinerja Kementerian Kesehatan,” Jakarta. Januari, 2022. [Eng. Trans: Ministry of Health Performance Report]

P. K. Berger, J. F. Plows, E. W. Demerath, and D. A. Fields, “Carbohydrate Composition In Breast Milk And Its Effect On Infant Health,” Curr. Opin. Clin. Nutr. Metab. Care, vol. 23, no. 4, pp. 277–281, Mar. 2020, [Online]. Available: https://journals.lww.com/co-clinicalnutrition/fulltext/2020/07000/Carbohydrate_composition_in_breast_milk_and_its.10.aspx?context=LatestArticles DOI: https://doi.org/10.1097/MCO.0000000000000658

C. A. Politano and J. López-Berroa, “Omega-3 Fatty Acids And Fecundation, Pregnancy And Breastfeeding,” Rev. Bras. Ginecol. e Obs., vol. 42, pp. 160–164, Mar. 2020, [Online]. Available: https://www.scielo.br/j/rbgo/a/JSQkqfpY3rgDhp5BtMqMyGy/ DOI: https://doi.org/10.1055/s-0040-1708090

C. C. Almeida, B. F. Mendonça Pereira, K. C. Leandro, M. P. Costa, B. F. Spisso, and C. A. Conte-Junior, “Bioactive Compounds In Infant Formula And Their Effects On Infant Nutrition And Health: A Systematic Literature Review,” Int. J. Food Sci., vol. 2021, pp. 1–31, Mar. 2021, doi: 10.1155/2021/8850080. DOI: https://doi.org/10.1155/2021/8850080

F. A. Wijaya, “ASI Eksklusif: Nutrisi Ideal Untuk Bayi 0-6 Bulan,” Cermin Dunia Kedokt., vol. 46, no. 4, p. 399945, Mar. 2019, [Online]. Available: https://www.neliti.com/publications/399945/asi-eksklusif-nutrisi-ideal-untuk-bayi-0-6-bulan] [Eng. Trans: Exclusive Breastfeeding: Ideal Nutrition for Infants 0-6 Months]

M. Erick, “Breast Milk Is Conditionally Perfect,” Med. Hypotheses, vol. 111, pp. 82–89, Mar. 2018, [Online]. Available: https://www.sciencedirect.com/science/article/pii/S0306987717306497 DOI: https://doi.org/10.1016/j.mehy.2017.12.020

R. T. Means, “Iron Deficiency And Iron Deficiency Anemia: Implications And Impact In Pregnancy, Fetal Development, And Early Childhood Parameters,” Nutrients, vol. 12, no. 2, p. 447, Mar. 2020, [Online]. Available: https://www.mdpi.com/2072-6643/12/2/447 DOI: https://doi.org/10.3390/nu12020447

K. Grzeszczak, S. Kwiatkowski, and D. Kosik-Bogacka, “The Role Of Fe, Zn, And Cu In Pregnancy,” Biomolecules, vol. 10, no. 8, p. 1176, Mar. 2020, [Online]. Available: https://www.mdpi.com/2218-273X/10/8/1176 DOI: https://doi.org/10.3390/biom10081176

“World Health Organization. Antenatal Iron Supplementation. 2023. https://www.who.int/data/nutrition/nlis/info/antenatal-iron-supplementation.

A. Riyadi, L. Ningsih, and A. Rahmadi, “The Influence Of Calcium And Iron Supplementation In Pregnant Women To Affect Newborn Body Length In Bengkulu,” Natl. Nutr. Journal/Media Gizi Indones., vol. 18, Mar. 2023. DOI: https://doi.org/10.20473/mgi.v18i1SP.38-45

A. Soliman et al., “Early And Long-Term Consequences Of Nutritional Stunting: From Childhood To Adulthood,” Acta Bio Medica Atenei Parm., vol. 92, no. 1, p. e2021168, Mar. 2021, [Online]. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC7975963/

G. T. J. Salakory and I. B. E. U. Wija, “Hubungan Anemia Pada Ibu Hamil Terhadap Kejadian Stunting Di RS Marthen Indey Jayapura Tahun 2018-2019,” Maj. Kedokt. UKI, vol. 37, no. 1, pp. 9–12, Mar. 2021, [Online]. Available: http://ejournal.uki.ac.id/index.php/mk/article/download/3365/2032 [Eng. Trans: Relationship Between Anemia in Pregnant Women and the Incidence of Stunting at Marthen Indey Hospital Jayapura in 2018-2019] DOI: https://doi.org/10.33541/mk.v37i1.3365

A. White, D. B. Nelson, and F. G. Cunningham, “Acute Fatty Liver Of Pregnancy,” Reprod. Med., vol. 5, no. 4, pp. 288–301, Mar. 2024, [Online]. Available: https://www.mdpi.com/2673-3897/5/4/25 DOI: https://doi.org/10.3390/reprodmed5040025

H. I. M. T. Ophie and S. Tjarono, “Kajian Asupan Protein Dan Asam Folat Pada Ibu Hamil Anemia Di Wilayah Lokus Stunting Di Kabupaten Kulon Progo,” Poltekkes Kemenkes Yogyakarta, 2019. [Online]. Available: http://eprints.poltekkesjogja.ac.id/1417 [Eng. Trans: Study of Protein and Folic Acid Intake in Anemic Pregnant Women in the Stunting Locus Area in Kulon Progo Regency]

A. F. A. Hulayya, “Hubungan Antara Riwayat Anemia Dalam Kehamilan Dengan Kejadian Stunting Di Desa Kawedusan Kabupaten Kediri,” Universitas Islam Negeri Maulana Malik Ibrahim, 2021. [Online]. Available: http://etheses.uin-malang.ac.id/29948/ [Eng. Trans: Relationship Between History of Anemia During Pregnancy and Incidence of Stunting in Kawedusan Village, Kediri Regency]

M. De Onis et al., “The World Health Organization’s Global Target For Reducing Childhood Stunting By 2025: Rationale And Proposed Actions,” Matern. Child Nutr., vol. 9, no. S2, pp. 6–26, 2013, doi: 10.1111/mcn.12075. DOI: https://doi.org/10.1111/mcn.12075

B. Ch Rosha, A. Susilowati, N. Amaliah, and Y. Permanasari, “Penyebab Langsung Dan Tidak Langsung Stunting Di Lima Kelurahan Di Kecamatan Bogor Tengah, Kota Bogor (Study Kualitatif Kohor Tumbuh Kembang Anak Tahun 2019) Direct And Indirect Causes Of Stunting At Five Sub-District In Central Bogor District, Bogor City,” Bul. Penelit. Kesehat., vol. 48, no. 3, pp. 169–182, Mar. 2020, [Online]. Available: https://repository.badankebijakan.kemkes.go.id/id/eprint/5127/1/Buletin] penelitian kesehatan artikel-3 169-182%29.pdf DOI: https://doi.org/10.22435/bpk.v48i3.3131

E. K. Dewi and T. S. Nindya, “Hubungan Tingkat Kecukupan Zat Besi Dan Seng Dengan Kejadian Stunting Pada Balita 6-23 Bulan Correlation Between Iron And Zinc Adequacy Level With Stunting Incidence In Children Aged 6-23 Months,” Amerta Nutr., vol. 1, no. 4, pp. 361–368, Mar. 2017. DOI: https://doi.org/10.20473/amnt.v1i4.2017.361-368

Y. F. Nasution, N. I. Lipoeto, and Y. Yulizawati, “Hubungan Kadar Insulin-Like Growth Factor 1 Serum Maternal Dengan Berat Badan Dan Panjang Badan Bayi Baru Lahir Pada Ibu Hamil KEK,” Maj. Kedokt. Andalas, vol. 42, no. 3S, pp. 19–29, 2019. [Eng. Trans: Relationship Between Maternal Serum Insulin-Like Growth Factor 1 Levels and Birth Weight and Length in Pregnant Women with Chronic Energy Deficiency] DOI: https://doi.org/10.25077/mka.v42.i3S.p19-29.2019

T. A. E. Permatasari, “Pengaruh Pola Asuh Pembrian Makan Terhadap Kejadian Stunting Pada Balita,” J. Kesehat. Masy. Andalas, vol. 14, no. 2, pp. 3–11, Mar. 2020, [Online]. Available: https://jurnal.fkm.unand.ac.id/index.php/jkma/article/view/527 [Eng. Trans: The Effect of Feeding Parenting Patterns on the Incidence of Stunting in Toddlers] DOI: https://doi.org/10.24893/jkma.v14i2.527

M. Hutasoit, K. D. Utami, and N. F. Afriyliani, “Kunjungan Antenatal Care Berhubungan Dengan Kejadian Stunting,” J. Kesehat. Samodra Ilmu, vol. 11, no. 1, pp. 38–47, Mar. 2020, [Online]. Available: https://www.academia.edu/download/116224980/7.pdf [Eng. Trans: Antenatal Care Visits Are Related to the Incidence of Stunting] DOI: https://doi.org/10.55426/jksi.v11i1.13

N. Ramadhini, D. Sulastri, and D. Irfandi, “Antenatal Care Relationship To The Incidence Of Stunting In Toddlers Aged 0-24 Months In The Working Area Of The Seberang Padang Health Center In 2019,” J. Ilmu Kesehat. Indones., vol. 1, no. 3, pp. 246–253, 2021, [Online]. Available: 10.25077/jikesi.v1i3.62 DOI: https://doi.org/10.25077/jikesi.v1i3.62

R. I. Kemenkes, “Infodatin Pusat Data Dan Informasi Kementerian Kesehatan RI Situasi Balita Pendek,” Jakarta Bul. Jendela Data Dan Inf., 2016. [Eng. Trans: Infodatin Data and Information Center of the Ministry of Health RI on the Situation of Short Toddlers]

R. Nurul, “Hubungan Antenatal Care Terhadap Kejadian Stunting Pada Balita Usia 0-24 Bulan Di Wilayah Kerja Puskesmas Seberang Padang Tahun 2019,” Universitas Andalas, 2020. [Online]. Available: http://scholar.unand.ac.id/60805/ [Eng. Trans: Relationship Between Antenatal Care and Incidence of Stunting in Toddlers Aged 0-24 Months in the Working Area of Seberang Padang Health Center in 2019]

F. Ernawati, Y. Rosamalina, and Y. Permanasari, “Pengaruh Asupan Protein Ibu Hamil Dan Panjang Badan Bayi Lahir Terhadap Kejadian Stunting Pada Anak Usia 12 Bulan Di Kabupaten Bogor (Effect Of The Pregnant Women’s Protein Intake And Their Baby Length At Birth To The Incidence Of Stunting Among Children,” Penelit. Gizi Dan Makanan (The J. Nutr. Food Res., vol. 36, no. 1, pp. 1–11, Mar. 2013, [Online]. Available: http://pgm.persagi.org/index.php/pgm/article/view/90 [Eng. Trans: The Effect of Pregnant Women’s Protein Intake and Baby Length at Birth on the Incidence of Stunting in Children Aged 12 Months in Bogor Regency]