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

[摘要] 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.

[学科分类] 食品科学和技术

[关键词] biopsychosocial;contextual effect;low birth weight