Association between maternal age, nutritional status, and toddler stunting
DOI:
https://doi.org/10.71357/hsij.v3i2.72Keywords:
Stunting, Maternal nutrition, Chronic energy deficiency, Maternal age, Toddler growthAbstract
Background: Stunting remains a major public health issue in Indonesia, with Central Kalimantan reporting prevalence rates higher than the national. Maternal risk factors—particularly age at pregnancy and nutritional status—are known contributors to stunting, yet their direct influence in regional contexts remains underexplored.
Objective: This study aimed to analyze the association between maternal age and maternal nutritional status during pregnancy with the incidence of stunting among toddlers.
Methods: A retrospective cross-sectional analytic study was conducted from August to October 2024, involving 83 toddlers selected via purposive sampling from a population of 481 registered at the health center. Data were collected from maternal and child health handbooks (KIA), focusing on maternal age at pregnancy, mid-upper arm circumference (MUAC), and toddler height-for-age z-scores. Chi-square tests were performed to assess associations between maternal variables and stunting, with a significance threshold of p < 0.05.
Results: The majority of mothers were aged 20–35 years (74.7%) and had normal nutritional status (72.3%). The prevalence of toddler stunting was 26.5%. A statistically significant association was found between maternal chronic energy deficiency (CED; MUAC < 23.5 cm) and toddler stunting (p < 0.001), with 87% of children born to CED mothers being stunted. However, maternal age showed no significant correlation with stunting (p = 0.970).
Conclusion: Maternal nutritional status during pregnancy, specifically CED, is significantly associated with toddler stunting, underscoring the need for targeted maternal nutrition interventions. Maternal age alone was not a significant factor in this cohort, suggesting other confounders may influence child growth.
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Afrinis, N., Verawati, B., Rizqi, E. K., Lasepa, W., Alini, & Syuryadi, N. (2022). Energy intake and food restriction as determinant factors of chronic energy deficiency among pregnant women in rural area of Sungai Sembilan, Riau, Indonesia. Open Access Macedonian Journal of Medical Sciences, 10(E). https://doi.org/https://doi.org/10.3889/oamjms.2022.9042
Asna, A. F., & Syah, Muh. N. H. (2023). Chronic energy malnutrition in mothers associated with stunting. Jurnal Gizi Dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics), 11(2), 77. https://doi.org/10.21927/ijnd.2023.11(2).77-84
Bari, A., Sultana, N., Mehreen, S., Sadaqat, N., Imran, I., & Javed, R. (2020). Patterns of maternal nutritional status based on mid upper arm circumference. Pakistan Journal of Medical Sciences, 36(3), 382–386. https://doi.org/10.12669/pjms.36.3.1331
Central Statistic Agency. (2021). Statistical Yearbook of Indonesia 2021. Central Statistic Agency.
eClinicalMedicine. (2023). Safeguarding early nutrition. EClinicalMedicine, 62, 102186. https://doi.org/10.1016/j.eclinm.2023.102186
Fibrila, F., May Nurisgainti Dewi, L., Vebriyanti, A., Azzahra, N. R., Nuriy, A. R., Sitiafara, T., & Ridwan, M. (2024). Assistance for pregnant women with chronic energy deficiency to improve nutritional status. Salus Publica: Journal of Community Service, 2(2), 154–161. https://doi.org/10.58905/saluspublica.v2i2.340
Fitriani, H., R, A. S., & Nurdiana, P. (2020). Risk factors of maternal nutrition status during pregnancy to stunting in toddlers aged 12-59 months. Jurnal Keperawatan Padjadjaran, 8(2), 175–183. https://doi.org/10.24198/jkp.v8i2.1305
Franco-Oliva, A., Ávila-Nava, A., Rodríguez-Aguilar, E. A., Trujillo-Mercado, A., García-Guzmán, A. D., Pinzón-Navarro, B. A., Fuentes-Servín, J., Guevara-Cruz, M., & Medina-Vera, I. (2023). Association between phase angle and the nutritional status in pediatric populations: A systematic review. Frontiers in Nutrition, 10, 1142545. https://doi.org/10.3389/fnut.2023.1142545
Govender, I., Rangiah, S., Kaswa, R., & Nzaumvila, D. (2021). Malnutrition in children under the age of 5 years in a primary health care setting. South African Family Practice : Official Journal of the South African Academy of Family Practice/Primary Care, 63(1), e1–e6. https://doi.org/10.4102/safp.v63i1.5337
Kim, K., Melough, M. M., Kim, D., Sakaki, J. R., Lee, J., Choi, K., & Chun, O. K. (2021). Nutritional adequacy and diet quality are associated with standardized height-for-age among U.S. children. Nutrients, 13(5). https://doi.org/10.3390/nu13051689
Kulasekaran, R. (2012). Influence of mothers′ chronic energy deficiency on the nutritional status of preschool children in Empowered Action Group states in India. International Journal of Nutrition, Pharmacology, Neurological Diseases, 2(3), 198. https://doi.org/10.4103/2231-0738.99471
Kuntari, T., Utami, U., Widyasari, V., Supadmi, S., & Choironi, E. A. (2024). Chronic energy deficiency in young pregnant women in rural Indonesia: An analysis of basic health survey 2018. Jurnal Ners, 19(4), 433–440. https://doi.org/10.20473/jn.v19i4.56196
Kurniawati, A., Sujiyatini, & Saputro, N. T. (2022). Association of maternal age during pregnancy with stunting in children age 2-3 years. Informasi Dan Promosi Kesehatan, 1(2), 46–53. https://doi.org/10.58439/ipk.v1i2.17
Larson-Nath, C., & Goday, P. (2019). Malnutrition in children with chronic disease. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 34(3), 349–358. https://doi.org/10.1002/ncp.10274
Lathifah, N., Kusumawati, L., Palimbo, A., & Jannah, F. (2024). The correlations between the determinants of women’s health during pregnancy to the incidence of stunting. Health Sciences International Journal, 2(1), 12–23. https://doi.org/10.71357/hsij.v2i1.17
Ministry of Health. (2020). Basic health research 2020: National report. Jakarta: Ministry of Health
Ministry of Health. (2021). Pocket book - Results of the Indonesian Nutritional Status Study at the national, provincial, and district/city levels in 2021 [in Indonesia]. Jakarta: Ministri of Health. https://www.badankebijakan.kemkes.go.id/buku-saku-hasil-studi-status-gizi-indonesia-ssgi-tahun-2021/
Ministry of Health. (2023). Stunting in Indonesia and its determinants [in Indonesia]. Jakarta: Ministry of Health
Ministry of National Secretariat -Republic of Indonesia. (2024). National strategy for accelerating stunting prevention and reduction 2025–2029 [in Indonesia]. Jakarta: Ministry of National Secretariat – Republic of Indonesia
Morales, F., Montserrat-de la Paz, S., Leon, M. J., & Rivero-Pino, F. (2023). Effects of malnutrition on the immune system and infection and the role of nutritional strategies regarding improvements in children’s health status: A literature review. Nutrients, 16(1). https://doi.org/10.3390/nu16010001
Mukti, B. H. (2025). Sample size determination: Principles and applications for health research. Health Sciences International Journal, 3(1), 127–143. https://doi.org/10.71357/hsij.v3i1.63
O’Brien, S. J., & Omer, E. (2019). Chronic pancreatitis and nutrition therapy. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 34 Suppl 1, S13–S26. https://doi.org/10.1002/ncp.10379
Prameswari, G. A. (2024). Nutritional status of pregnant women and its impact on child stunting incidence in Indonesia: Literature review. World Journal of Advanced Research and Reviews, 21(1), 1912–1915. https://doi.org/10.30574/wjarr.2024.21.1.0145
Price, J. S., Larsen, S. E., Miller, L. A., Smith, H. M., Apps, J. A., & Weis, J. M. (2019). Clinical biopsychosocial reflection on coping with chronic illness and reliance upon nutrition support: An integrated healthcare approach. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 34(2), 220–225. https://doi.org/10.1002/ncp.10263
Putri, A. A., & Salsabila, S. (2023). The impact of Chronic Energy Deficiency (CED) in pregnant women [in Indonesia]. Student Scientific Creativity Journal, 1(3), 246–253. https://doi.org/10.55606/sscj-amik.v1i3.1525
Reinhardt, K., & Fanzo, J. (2014). Addressing chronic malnutrition through multi-sectoral, sustainable approaches: A review of the causes and consequences. Frontiers in Nutrition, 1, 13. https://doi.org/10.3389/fnut.2014.00013
Rodríguez, L., Cervantes, E., & Ortiz, R. (2011). Malnutrition and gastrointestinal and respiratory infections in children: A public health problem. International Journal of Environmental Research and Public Health, 8(4), 1174–1205. https://doi.org/10.3390/ijerph8041174
Sani, M., Solehati, T., & Hendarwati, S. (2020). The relationship between maternal age during pregnancy and stunting in toddlers aged 24–59 months [in Indonesia]. Holistik Jurnal Kesehatan, 13(4), 284–291. https://doi.org/10.33024/hjk.v13i4.2016
Silpia, N., Palimbo, A., Lestari, Y. P., & Salmarini, D. D. (2025). Association of millennial parenting styles, dietary and the incidence of stunting. Health Sciences International Journal, 3(1), 65–79. https://doi.org/10.71357/hsij.v3i1.52
UNICEF-WHO-World Bank. (2021). Levels and trends in child malnutrition, UNICEF/WHO/World Bank Group-Joint child malnutrition estimstes. https://data.unicef.org/resources/jme-report-2021/
United Nations Children’s Fund (UNICEF), & World Health Organization (WHO). (2019). UNICEF-WHO Low birthweight estimates: Levels and trends 2000–2015. World Health Organization.
Wati, E. K., Murwani, R., Kartasurya, M. I., & Sulistiyani, S. (2024). Determinants of chronic energy deficiency (CED) incidence in pregnant women: A cross-sectional study in Banyumas, Indonesia. Narra J, 4(1), e742. https://doi.org/10.52225/narra.v4i1.742
WHO. (2018). Reducing stunting in children: Equity considerations for achieving the Global Nutrition Targets 2025. Geneva: WHO
WHO-UNICEF-World Bank Group. (2023). Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates: key findings of the 2023 edition. Geneva: WHO-UNICEF-World Bank Group.
Wiyono, S., Burhani, A., Harjatmo, T. P., Ngadiarti, I., Prayitno, N., . M., Purbaningrum, R. P., . W., Erowati, D., & Fahira, F. (2020). Study causes of chronic energy deficiency of pregnant in the rural areas. International Journal Of Community Medicine And Public Health, 7(2), 443. https://doi.org/10.18203/2394-6040.ijcmph20200412
Yuliantie, P., Ningrum, N. W., & Istiqamah. (2024). Effective stunting prevention: Empowering maternal nutrition education in rural Indonesia through AKUR PENTING intervention. Health Sciences International Journal, 2(2), 183–190. https://doi.org/10.71357/hsij.v2i2.44
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