Association between parental socio-demographic factors and declined linear growth of young children in Jakarta
Background: In Indonesia, approximately 35.5% of children under five years old were stunted. Stunting is related to shorter adult stature, poor cognition and educational performance, low adult wages, lost productivity, and higher risk of nutrition-related chronic disease. The aim of this study was to identify parental socio-demographic risk factors of declined linear growth in children younger than 2 years old.
Methods: This was a cohort-prospective study between August 2012 and May 2014 at three primary community health care centers (Puskesmas) in Jakarta, Indonesia, namely Puskesmas Jatinegara, Mampang, and Tebet. Subjects were healthy children under 2 years old, in which their weight and height were measured serially (at 6–11 weeks old and 18–24 months old). The length-for-age based on those data was used to determine stature status. The serial measurement was done to detect growth pattern. Parental socio-demographic data were obtained from questionnaires
Results: From the total of 160 subjects, 14 (8.7%) showed declined growth pattern from normal to stunted and 10 (6.2%) to severely stunted. As many as 134 (83.8%) subjects showed consistent normal growth pattern. Only 2 (1.2%) showed improvement in the linear growth. Maternal education duration less than 9 years (RR=2.60, 95% CI=1.23–5.46; p=0.02) showed statistically significant association with declined linear growth in children.
Conclusion: Mother with education duration less than 9 years was the determining socio-demographic risk factor that contributed to the declined linear growth in children less than 2 years of age.
WHO. [Internet]. Interpreting growth indicators. In: Training course on child growth assessment. World Health Organization: Geneva; 2008. [cited : 2017 May 26th]. Available in: http://www.who.int /childgrowth/training /module_c_interpreting_indicators.pdf?ua=1.
Dewey KG, Begum K. Long-term consequences of stunting in early life. Matern Child Nutr. 2011;7:5–18. https://doi.org/10.1111/j.1740-8709.2011.00349.x
Bloem MW, de Pee S, Hop LT, Khan NC, Laillou A, Minarto, et al. Key strategies to further reduce stunting in Southeast Asia: Lessons from the ASEAN countries workshop. Food Nutr Bull. 2013;34:S8–S16. https://doi.org/10.1177/15648265130342S103
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51. https://doi.org/10.1016/S0140-6736(13)60937-X
Nasikhak R, Margawati A. Faktor risiko kejadian stunting pada balita 24-36 bulan di Kecamatan Semarang Timur. Tesis. Program Studi Ilmu Gizi Fakultas Kedokteran Universitas Diponegoro, Semarang. 2012. Indonesian.
Handayani F, Siagian A, Aritonang EY. Mother's Education as A Determinant of Stunting among Children of Age 24 to 59 Months in North Sumatera Province of Indonesia. J Hum Soc Sci. 2017;22:58–64. https://doi.org/10.9790/0837-2206095864
Anisa P. Faktor-faktor yang berhubungan dengan kejadian stunting pada balita usia 25–60 bulan di Kelurahan Kalibaru Depok 2012. Thesis. Nutrition Study Program. Community Health Nutrition. Community Health Centre University of Indonesia. Indonesian.
Kramer CV, Allen S. Malnutrition in developing countries. J Paediatr Child Health. 2015;25:422–7. https://doi.org/10.1016/j.paed.2015.04.002
Ministry of Health Republic of Indonesia. Basic Health Survey Report 2013. Jakarta: Ministry of Health; 2013.
Keane VA. Chapter 15: Assessment of growth. In: Nelson Textbook of Pediatrics, 20th Edition. Philadelphia: Elsevier; 2016. p. 84–9.
The Royal Children Hospital Melbourne. [Internet]. Child growth and growth charts in the early years. 2013. [cited 2017 May 30th]. Available in: http://www.rch.org.au/uploadedFiles/Main/Content/childgrowth/DoHA_backgroundreading_April2013.pdf.
Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paedatr Int Child Health. 2014;34:250–65. https://doi.org/10.1179/2046905514Y.0000000158
Walker SP, Chang SM, Powell CA, Simonoff E, Grantham-McGregor SM. Early childhood stunting is associated with poor psychological functioning in late adolescence and effects are reduced by psychosocial stimulation. J Nutr. 2007;137:2464–9. https://doi.org/10.1093/jn/137.11.2464
Casale D, Desmond C. Recovery from stunting and cognitive outcomes in young children: Evidence from the South African birth to twenty cohort study. J Dev Orig Health Dis. 2016;7:163–71. https://doi.org/10.1017/S2040174415007175
Semba RD, de Pee S, Sun K, Sari M, Akhter N, Bloem MW. Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: A cross-sectional study. Lancet. 2008;371:322–8. https://doi.org/10.1016/S0140-6736(08)60793-X
Rachmi CN, Agho KE, Li M, Baur LA. Stunting, underweight and overweight in children aged 2.0-4.9 years in Indonesia: prevalence trends and associated risk factors. PLoS One. 2016;11:e0154756. https://doi.org/10.1371/journal.pone.0154756
Yasmin G. Kustiyah L, Dwiriani CM. Risk factors of stunting among school - aged children from eight provinces in Indonesia. Pakistan J Nutr. 2014;13:557–66. https://doi.org/10.3923/pjn.2014.557.566
Willey BA, Cameron N, Norris SA, Pettifor JM, Griffiths PL. Socio-economic predictors of stunting in preschool children: a population-based study from Johannesburg and Soweto. S Afr Med J. 2009;99:450–6.
Galobardes B, McCormack VA, McCarron P, Howe LD, Lynch J, Lawlor DA, et al. Social inequalities in height: persisting differences today depend upon height of the parents. PLoS One. 2012;7:e29118. https://doi.org/10.1371/journal.pone.0029118
Rahman M. Association between order of birth and chronic malnutrition of children: a study of nationally representative Bangladeshi sample. Cad Saude Publica. 2016;32:e00011215. https://doi.org/10.1590/0102-311x00011215
Jayachandran S, Pande R. [Internet]. Why are Indian children so short? The role of birth order and son preference. National Buraeu of Economic Research Working Paper No. 21036, 2015. [cited 2016 December 12th]. Available in: www.nber.org/papers/w21036.pdf.
Svefors P, Rahman A, Ekström E-C, Khan AI, Lindström E, Persson LÅ, et al. Stunted at 10 Years. Linear growth trajectories and stunting from birth to pre-adolescence in a rural Bangladeshi cohort. PloS One. 2016;11:e0149700. https://doi.org/10.1371/journal.pone.0149700
Sulthan S. Prevalence of stunting and thinness among school-age children of working and non-working mothers in rural areas of Aligarh District. Int J Appl Basic Med Res. 2014;3:51–7.
Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian SV. The association of parental education with childhood undernutrition in low- and middle-income countries: Comparing the role of paternal and maternal education. Int J Epidemiol. 2017;46:312–23. doi:10.1093/ije/dyw133
Indonesian Ministry of Education and Culture. [Internet]. Indonesian Ministry of Education and Culture Regulation Number 12 Year 2015 on Smart Indonesia. [cited 2017 January 30th] Available in:http://dinustek.com/demoapp/disdiksmg/content/image/files/PERMENDIKBUD%20No%2012%20tahun%202015%20ttg%20Program%20Indonesia%20Pintar.pdf.
Copyright (c) 2018 Hartono Gunardi, Soedjatmiko Soedjatmiko, Rini Sekartini, Bernie E. Medise, Anthony C. Darmawan, Rilie Armeilia, Ruth Nadya
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.