Risk factors of stunting in children aged 24-59 months

  • Arya Krisna Manggala Medical Faculty Udayana University, P.B Sudirman, Denpasar, Bali, Indonesia
  • Komang Wiswa Mitra Kenwa Medical Faculty Udayana University, P.B Sudirman, Denpasar, Bali, Indonesia
  • Made Me Lina Kenwa Medical Faculty Udayana University, P.B Sudirman, Denpasar, Bali, Indonesia
  • Anak Agung Gede Dwinaldo Putra Jaya Sakti Medical Faculty Udayana University, P.B Sudirman, Denpasar, Bali, Indonesia
  • Anak Agung Sagung Sawitri Department of Community and Preventive Medicine, Faculty of Medicine, Udayana University, P.B Sudirman, Denpasar, Bali, Indonesia https://orcid.org/0000-0002-8374-5213
Keywords: stunting, children, risk factor

Abstract

Abstract

Background Childhood stunting (low height-for-age) still remains a global health problem because it increases the risk of disturbances in growth and development as well as mortality. The prevalence of stunting in Bali is 32.5%, with the highest in Gianyar District at 41%. However, little is known about the risk factors of stunting children in Gianyar.

Objective  To investigate the risk factors of stunting in children aged 24-59 months in Gianyar.

Methods  This cross-sectional study involved 166 children, collected consecutively, aged 24-59 months, who visited the integrated health posts in 13 community health centers in Gianyar District, Bali from September to November 2016. Stunting is defined as -2SD below the WHO height-for-age z-score (HAZ), according to sex. Statistical analyses were done with Chi-square and multivariate logistic regression tests.

Results Of 166 subjects, 37 (22.3%) children were stunted. Multivariate analysis revealed that low paternal education (AOR 2.88; 95%CI 1.10 to 7.55; P=0.031), maternal height less than 150 cm (AOR 7.64; 95%CI 2.03 to 28.74; P=0.003), high risk maternal age (AOR 4.24; 95%CI 1.56 to 11.49; P= 0.005), low birth weight (AOR 5.09; 95%CI 1.03 to 25.31; P=0.047), and low birth length (AOR 9.92; 95%CI 1.84 to 53.51; P=0.008) were strongly associated with stunting.

Conclusion  Risk factors for stunting in children are low paternal education, maternal height less than 150 cm, high risk maternal age, low birth weight, and low birth length.

References

World Health Organization. WHA global nutrition targets 2025: stunting policy brief. Geneva: WHO; 2014. p.1-6.

World Health Organization. Nutrition Landscape Information System (NLIS) country profile indicators: interpretation guide. Geneva: WHO; 2010. p. 1.

Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health. 2014;34:250-65.

Fenske N, Burns J, Hothorn T, Rehfuess EA. Understanding child stunting in India: a comprehensive analysis of socio-economic, nutritional, and environmental determinants using additive quantile regression. PLoS One. 2013;8:e78692.

de Onis M, Blössner M, Borghi E. Prevalence and trends of stunting among pre-school children, 1990–2020. Public Health Nutr. 2012;15:142-8.

Badan Penelitian dan Pengembangan Kesehatan, Kementrian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas) 2007. Jakarta: Kemenkes RI; 2008. p. 34-7.

Badan Penelitian dan Pengembangan Kesehatan, Kementrian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas) 2010. Jakarta: Kemenkes RI; 2010. p. 18-22.

Badan Penelitian dan Pengembangan Kesehatan, Kementrian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta: Kemenkes RI; 2013. p. 212-3.

Nurliyana AR, Mohd Shariff Z, Mohd Taib MN, Gan WY, Tan KA. Early nutrition, growth and cognitive development of infants from birth to 2 years in Malaysia: a study protocol. BMC Pediatr. 2016;16:160.

Purnama D, Raksanagara A, Arisanti N. The correlation between maternal behavior in feeding and parenting towards nutritional status of children at Sukaresmi District Garut Regency [thesis]. Pustaka Unpad: Padjajaran University; 2016.

de Onis M, Branca F. Childhood stunting: a global perspective. Matern Child Nutr. 2016;12:12–26.

Dewey KG, Begum K. Long-term consequences of stunting in early life. Matern Child Nutr. 2011;7:5–18.

Prawirohartono EP, Nurdiati D, Hakimi M. Prognostic factors at birth for stunting at 24 months of age in rural Indonesia. Paediatr Indones. 2016;56:48–56.

Shinsugi C, Matsumura M, Karama M, Tanaka J, Changoma M, Kaneko S. Factors associated with stunting among children according to the level of food insecurity in the household: a cross-sectional study in a rural community of Southeastern Kenya. BMC Public Health. 2015;15:441.

Tiwari R, Ausman LM, Agho KE. Determinants of stunting and severe stunting among under-fives: evidence from the 2011 Nepal Demographic and Health Survey. BMC Pediatr. 2014;14:239.

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar dalam Angka Provinsi Bali. Jakarta; Kemenkes RI: 2013. p.253 - 254

Gubernur Bali. Peraturan Gubernur Bali Nomor 1 Tahun 2016 tentang Upah Minimum Kabupaten/Kota. Bali; 2016. p. 1-5.

Tim Nasional Percepatan Penangulangan Kemiskinan (TNPPK). 100 kabupaten/kota prioritas untuk intervensi anak kerdil (Stunting). Vol. 2. Jakarta; 2017. p. 441.

Linda O. Hubungan pendidikan dan pekerjaan orangtua serta pola asuh dengan status gizi balita di Kota dan Kabupaten Tangerang, Banten. Proseding Penelitian Bidang Ilmu Eksaskta 2011 [serial on the Internet]. 2011 [cited 2017 Aug 18];134–41:[about 5 p.]. Available from:http://www.stkipislambumiayu.ac.id.

Nasikhah R, Margawati A. Faktor risiko kejadian stunting pada balita usia 24-36 bulan di Kecamatan Semarang Timur. J Nutr Coll. 2012;1:176–84.

Astari LD, Nasoetion A, Dwiriani CM. Hubungan karakteristik keluarga, pola pengasuhan, dan kejadian stunting anak usia 6-12 bulan. Med Gizi Keluarga. 2005;29:40–6.

Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr. 2013;9:27-45.

Hanum F, Khomsan A, Heryatno Y. Hubungan asupan gizi dan tinggi badan ibu dengan status gizi anak balita. J Gizi Pangan. 2014;9:1-6.

Oktarina Z, Sudiarti T. Faktor risiko stunting pada balita (24-59 bulan) di Sumatera. J Gizi Pangan. 2014;8:175-80.

Sinha B, Taneja S, Chowdhury R, Mazumder S, Rongsen-Chandola T, Upadhyay RP, et al. Low-birthweight infants born to short-stature mothers are at additional risk of stunting and poor growth velocity: evidence from secondary data analyses. Matern Child Nutr. 2018;14:1-9.

Addo OY, Stein AD, Fall CH, Gigante DP, Guntupalli AM, Horta BL, et al. Maternal height and child growth patterns. J Pediatr. 2013;163:549–54.

Murphy VE, Smith R, Giles WB, Clifton VL. Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus. Endocr Rev. 2006;27:141–69.

Lowy C. Regulation of intrauterine growth: the role of maternal health. Horm Res. 1994;42:203-6.

Fall CHD, Sachdev HS, Osmond C, Restrepo-Mendez MC, Victora C, Martorell R, et al. Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Glob Health. 2015;3:e366–77.

Institute of Medicine and National Research Council. Weight gain during pregnancy: reexamining the guidelines. Rasmussen KM, Yaktine AL, editors. The National Academic Press. Washington (DC): The National Academic Press; 2009. p. 1250-3.

Dewey KG. Reducing stunting by improving maternal, infant and young child nutrition in regions such as South Asia: evidence, challenges and opportunities. Matern Child Nutr. 2016;12:27–38.

K Kuntari T, Jamil NA, Kurniati O. Faktor Risiko Malnutrisi pada Balita. Kesmas: National Public Health Journal. 2013;7:572–6. 3United Nations Children’s Fund and World Health Organization. Low birthweight: country, regional and global estimates. UNICEF. New York; 2004. p. 1-31.

Rahayu LS, Sofyaningsih M. Pengaruh BBLR (berat badan lahir rendah) dan pemberian ASI eksklusif terhadap perubahan status stunting pada balita di Kota dan Kabupaten Tangerang Provinsi Banten. In: Seminar Nasional Peran Kesehatan Masyarakat dalam Pencapaian MDG’s di Indonesia. 2011 Apr 12. p. 160-9.

United Nations Children’s Fund and World Health Organization. Low Birthweight: Country, regional and global estimates. UNICEF. New York; 2004. p. 1-31

Alderma H, Shekar M. Nutrition, food security, and health In: Kliegman RM, et al. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier Saunders; 2011. p.170-8

Utami NH, Rachmalina R, Irawati A, Sari K. Short birth length, low birth weight and maternal short stature are dominant risks of stunting among children aged 0-23 months: Evidence from Bogor longitudinal study on child growth and development, Indonesia. Mal J Nutr. 2018;24:11–23.

Martin CR, Ling PR, Blackburn GL. Review of infant feeding: key features of breast milk and infant formula. Nutrients. 2016;8:279.

World Health Organization. Stunted growth and development [framework leaflet]. 2017 [cited 2017 Nov 25]. Available from: www.who.int/nutrition/childhood_stunting_framework_leaflet_en.pdf.

Al-rahmad AH, Miko A, Hadi A. Kajian stunting pada anak balita ditinjau dari pemberian ASI eksklusif, MP-ASI, status imunisasi dan karakteristik keluarga di Kota Banda Aceh. J Kes Ilm Nasuwakes. 2013;6:169-84.

Published
2018-08-07
How to Cite
1.
Manggala A, Kenwa KW, Kenwa M, Sakti AAGDP, Sawitri AA. Risk factors of stunting in children aged 24-59 months. PI [Internet]. 7Aug.2018 [cited 20Apr.2024];58(5):205-2. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1850
Received 2018-04-30
Accepted 2018-07-17
Published 2018-08-07