Effects of Maternal Socioeconomic, Psychological, Nutritional Factor, and Ambient Smoke Exposure, on the Risk of Low Birth Weight: A Multilevel Evidence from Gunungkidul, Yogyakarta

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Journal of Maternal and Child Health (2020), 05(04): 446-455

Effects of Maternal Socioeconomic, Psychological, Nutritional Factor, and Ambient Smoke Exposure, on the Risk of Low Birth Weight: A Multilevel Evidence from Gunungkidul, Yogyakarta

Isne Susanti1) , Harsono Salimo2) , Yulia Lanti Retno Dewi3) 1)Masters Program in Public Health, Universitas Sebelas Maret 2)Department of Pediatrics, Dr. Moewardi Hospital, Surakarta 3)Department of Nutrition, Faculty of Medicine, Universitas Sebelas Maret

ABSTRACT

Background: Low birth weight (LBW) is one of the main causes of infant mortality. Globally, 2.5 million infants die in the first month after birth, and about 1 million die in the first day of birth. This study aimed to determine the biopsychosocial and contextual factors of community health centers that cause low birth weight in Gunungkidul Regency, Special Region of Yogyakarta, Indonesia.

Case Report: This case-control study was conducted at 25 community health centers in Gunungkidul, Yogyakarta, Indonesia, from January to February 2020. A sample of 200 infants, consisting of 50 infants with LBW (case) and 150 infants with normal birth weight (control) was selected by simple random sampling. The dependent variable was low birth weight. The independent variables were maternal education, early marriage, family income, frequency of ANC visits, maternal age at pregnancy, household cigarette smoke exposure, gestational stress, anemia, and maternal nutritional status. Data were collected using medical records, maternal and child health books, and questionnaires. Data were analyzed using multiple multilevel logistic regression analysis.

Results: The risk of LBW increased with maternal age at pregnancy <20 years or ≥35 years (b= 1.9; 95% CI= 0.01 to 3.73; p= 0.050), cigarette smoke exposure (b= 1.9; 95% CI= 0.33 to 3.49; p= 0.018), high gestational stress (b= 1.8; 95% CI= -0.01 to 3.67; p= 0.050), and anemia (b= 3.1; 95% CI= 1.24 to 4.90; p= 0.001). The risk of LBW decreased with maternal education ≥Senior High School (b= -1.8; 95% CI= -3.14 to -0.53; p= 0.006), family income ≥Rp1,706,525 (b= -2.6; 95% CI= -3.94 to -1.27; p <0.001), and maternal MUAC ≥23.5 cm (b= -1.7; 95% CI = -3.25 to -0.17; p= 0.029).

Conclusion: The risk of LBW increases with maternal age at pregnancy <20 years or ≥35 years, cigarette smoke exposure, high gestational stress, and anemia. The risk of LBW decreases with maternal education ≥Senior High School, family income ≥Rp1,706,525, and maternal MUAC ≥23.5 cm.

Keywords: biopsychosocial, contextual effect, low birth weight Correspondence: Isne Susanti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: isnesusanti@gmail.com. Mobile: +628- 5271128121.