Effects of Maternal Education, Psychosocial Stress, Nutritional Status at Pregnancy, and Family Income, on Birthweight in Nganjuk, East Java

Abstract

Background: Low birth weight (LBW) is one of the primary causes of infant mortality. It shares 27% of infant mortality rate (IMR). The Indonesian Demographic and Health Survey in 2007 reported that the IMR was 34 deaths per 1,000 live births. As much as 30.3% of this rate was accounted by LBW. As such LBW is an important global public health issue. Countries around the world have committed to overcome this problem. This study aimed to investigate the effects of maternal education, psychosocial stress, nutritional status at pregnancy, and family income, on birth weight. Subjects and Method:This was an observational analytic study with case control design. The study was conducted in Ngetos community health center, Nganjuk, East Java, from May to June, 2017. A total sample of 120 were selected for this study by fixed disease sampling, comprising 40 infants with low birth weight and 80 infants with normal birth weight. The dependent variable was birth weight. The independent variables were maternal education, psychosocial stress, nutritional status at pregnancy (middle-upper arm circumference, MUAC), maternal anemia, and family income. MUAC was measured by MUAC measuring tape. Hemoglobin concentration was measured by Sahli meter. Psychosocial stress was measured by Holmes and Rahe stress scale. The other variables were measured by a set of questionnaire. Path analysis was used for data analysis. Results: MUAC ≥23.5 cm(b= -0.80, SE= 0.57; p=0.064), hemoglobin concentration ≥11 g/dL (b= -120.16, SE= 45.14, p=0.008), and low psychosocial stress (b= -0.80, SE= 0.57, p=0.164)directly and negatively affected low birth weight. Maternal education ≥Senior High School(b= 1.28, SE = 0.056, p= 0.022), psychosocial stress (b= -0.001, SE<0.001, p=0.097), and family income (b= 0.97, SE= 0.46, p=0.036) positively affected MUAC. MUAC ≥23.5 cm positively affected hemoglobin concentration ≥11 g/dL (b= 0.19, SE = 20.84, p<0.001). Conclusion: MUAC, hemoglobin concentration, and low psychosocial stress directly and negatively affect low birth weight.

Path Analysis: Maternal Determinants and Hair Zinc Levels as Predictors of Stunting and Developmental Disorders in Children Under Five

“…This study result is in line with the study result by Nurahmawati et al, (2017), which found that there was a direct positive effect between the size of pregnant women's mother's upper arm circumference on the weight of the newborn. Another study, according to Ekayani (2014) also showed that maternal MUAC < 23.5 have 5 times the risk of giving birth to babies with LBW (OR= 5.54; 95% CI= 2.65 to 11.60).…”

Biopsychosocial and Economic Determinants of Low Birth Weight in Jambi, South Sumatera: Path Analysis

“…Terdapat pengaruh positif LiLA Ibu secara langsung yang signifikan secara statistik antara terhadap berat badan lahir (Nurmayanti et al, 2017), dengan demikian LiLA Ibu ≥ 23.5 cm memberikan efek protektif terhadap kejadian bayi berat lahir rendah (Nurahmawati et al, 2017).…”

“…Stres biposikososial ibu hamil dapat menurunkan berat lahir (Nurmayanti et al, 2017).Stres psikososial rendah dapat menurunkan kelahiran bayi berat lahir rendah (Nurahmawati et al,2017). Woods et al (2010), menemukan dari hasil penelitiannya mengenai stres psikososial antenatal menggunakan kuesioner Curry et al (1998), yaitu kuesioner Prenatal Psychosocial Profile: Stress Scale, sebagian besar wanita hamil sebanyak 78% mengalami stres rendah selama masa kehamilan.…”

“…Penelitian Nurmayanti et al (2017), menemukan bahwa pendidikan ibu tinggi dapat meningkatkan pendapatan yang dengan demikian dapat memungkinkan menurunkan kejadian bayi berat lahir rendah dan ditemukan juga pendapatan secara langsung mempengaruhi berat badan lahir. Pendidikan ibu tinggi menurunkan risiko kejadian bayi berat lahir rendah (Nurahmawati et al, 2017).…”

“…Status ekonomi rendah berisiko meningkatkan kejadian bayi berat lahir rendah (Assefa et al, 2012;Pramono dan Paramita, 2015;Mahumud et al, 2017;Shrestha et al, 2016;Taywade dan Pisudde, 2017). Hasil penelitian ini juga sejalan dengan Nurahmawati et al (2017), yang menemukan pendapatan tinggi meningkatkan status gizi (LiLA Ibu ≥ 23.5 cm) yang secara tidak langsung menurunkan risiko kejadian bayi berat lahir rendah.…”