Birth spacing, health insurance, source of drinking water, and low birth weight in Indonesia

Yuniar Wardani; Liena Sofiana; Rosyidah Rosyidah; Erni Gustina; Baiq Qatrunnada Hariyanti; Ardyawati Wira Oktaviana; Kania Valentia Febriana

doi:10.22146/bkm.v42i10.29715

Authors

Yuniar Wardani Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Liena Sofiana Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Rosyidah Rosyidah Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Erni Gustina Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Baiq Qatrunnada Hariyanti Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
Ardyawati Wira Oktaviana Masters Program in Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
Kania Valentia Febriana Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia

DOI:

https://doi.org/10.22146/bkm.v42i10.29715

Keywords:

cesarean section, IDHS, low birth weight, maternal factors, social factors

Abstract

Purpose: Low birth weight (LBW) in Indonesia is a major concern and must be addressed immediately, as it affects human resource quality. The study aimed to determine the proximate, intermediate, and distal factors associated with LBW in Indonesia.

Methods: The study used a cross-sectional design to estimate the association between risk factors and LBW in Indonesia using data sources from the 2012 IDHS and 2017 IDHS. We identified women who gave birth in the past five years and had only a singleton baby as eligible respondents.

Results: Infants living in Sumatera (aOR= 0.57; 95% CI= 0.32-0.99) and rural areas (aOR= 0.69; 95% CI= 0.50-0.97) were protective of LBW than those living in Papua and Maluku and their urban counterparts. Meanwhile, households with an improved source of drinking water had a higher risk of LBW than households with an unimproved source (aOR= 1.45; 95% CI= 1.06-1.97). The odds of LBW were four times higher among mothers who never married than among others (aOR= 3.57; 95% CI= 1.08-11.81). The risk of LBW was also higher for mothers who delivered by cesarean section than for those who had no cesarean section/vaginal delivery (aOR= 1.75; 95% CI=1.21-2.52). Furthermore, female infants were approximately 1.35 times more likely to have LBW than male infants (aOR=1.35; 95% CI=1.00-1.83). Although health insurance ownership was not associated with LBW, the data show differences in the number of respondents with and without health insurance.

Conclusion: Residence area, marital status, cesarean section, and infant sex were significant determinants of LBW. A public health strategy should implement targeted antenatal counseling for vulnerable groups such as rural mothers and unmarried mothers by establishing standard protocols for monitoring fetal growth within routine antenatal care services.

References

World Health Organization. Global Nutrition Targets 2025: Low Birth Weight Policy Brief. 2014. Available form: [Website]

United Nations Children’s Fund and World Health Organization. Low birthweight : country, regional and global estimates. New York: UNICEF; 2004. Available from: [Website]

Hyder A, Barnett KS. Low birth weight and preterm birth among Arab-American women in Ohio. Maternal and Child Health Journal. 2021;25(4): 574–83.

Mahumud RA, Sultana M, Sarker AR. Distribution and determinants of low birth weight in developing countries. Journal of Preventive Medicine and Public Health. 2017;50(1):18–28.

Owa K, Bai MKS. Prevalence and risk factors of low birth weight in East Nusa Tenggara, Indonesia. Malahayati International Journal of Nursing and Health Science. 2022;5(1):31–8.

Islam MM, Ababneh F, Akter T, Khan HR. Prevalence and risk factors for low birth weight in Jordan and its association with under-five mortality: a population-based analysis. Eastern Mediterranean Health Journal. 2020;26(10):1273–84.

Blencowe H, Krasevec K, De Onis M, Black R, An X, Stevens GA, et al . National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. The Lancet Global Health. 2019;7(7):e849–60.

Sachs J, Kroll C, Lafortune G, Fuller G, Woelm F, Sustainable Development Report 2021. Cambridge: Cambridge University Press; 2021. Available from: [Website]

Kementerian Kesehatan Republik Indonesia. Indonesia Demographic and Health Survey 2017. 2018.

Oktriyanto O, Rahardja MB, Nury FND, Amrullah H, Pujihasvuty R, Maya PM. Determinants of low birth weight in Indonesia. Jurnal Kesehatan Masyarakat. 2022;17(4):583–93.

Tadese M, Minhaji AS, Mengist CT, Kasahun F, Mulu GB. Determinants of low birth weight among newborns delivered at Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia: a case-control study. BMC Pregnancy and Childbirth. 2021;21(1): 794.

Gupta RD, K. Swasey K. Burrowes V, Hashan MR, Al Kibria GM. Factors associated with low birth weight in Afghanistan: a cross-sectional analysis of the Demographic and Health Survey 2015. BMJ Open. 2019;9(5):e025715.

Safitri HO, Fauziningtyas R, Indarwati R, Efendi F, McKenna L. Determinant factors of low birth weight in Indonesia: Findings from the 2017 Indonesian demographic and health survey. Journal of Pediatric Nursing. 2022;63:e102–6.

Elaabsi M, Loukid M, Lamtali S. Socio-economic and cultural determinants of mothers and fathers for low birth weight newborns in the region of Marrakech (Morocco): A case-control study. PLoS ONE. 2022;17(6):e0269832.

Kaur S, Ng CM, Badon SE, Jalil RA, Maykanathan D, Yim HS, et al. Risk factors for low birth weight among rural and urban Malaysian women. BMC Public Health. 2019;19(4):539.

Demelash H, Motbainor A, Nigatu D, Gashaw K, Melese A. Risk factors for low birth weight in Bale zone hospitals, South-East Ethiopia : a case-control study. BMC Pregnancy and Childbirth. 2015;15:264.

Dahlui M, Azahar N, Oche OM, Aziz NA. Risk factors for low birth weight in Nigeria: evidence from the 2013 Nigeria Demographic and Health Survey. Global Health Action. 2016;9(1): 28822.

Kassaw MW, Abebe AM, Kassie AM, Abate BB, Masresha SA. Trends of proximate low birth weight and associations among children under-five years of age: Evidence from the 2016 Ethiopian demographic and health survey data. PLoS ONE. 2021;16(2): e0246587.

Jember DA, Menji ZA, Yitayew YA. Low birth weight and associated factors among newborn babies in health institutions in Dessie, Amhara, Ethiopia. Journal of Multidisciplinary Healthcare. 2020;13: 1839–48.

Tarekegn SM, Lieberman LS, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey. BMC Pregnancy and Childbirth. 2014;14:161.

Gizaw B, Gebremedhin S. Factors associated with low birthweight in North Shewa zone, Central Ethiopia: case-control study. Italian Journal of Pediatrics. 2018;44(1):76.

Diabelková J, Rimárová K, Urdzík P, Dorko E, Houžvičková A, Andraščíková S, et al. Risk factors associated with low birth weight. Central European Journal of Public Health. 2022;30:S43–9.

Clay SL, Woodson MJ, Kersh R. An exploration of socio-demographic, economic, and environmental factors in black/white disparities in low birth weight outcomes: a cross-sectional study. Journal of Research in Health Sciences. 2021;21(2):e00511.

Adam Z, Ameme DK, Nortey P, Afari EA, Kenu E. Determinants of low birth weight in neonates born in three hospitals in Brong Ahafo region, Ghana, 2016–an unmatched case-control study. BMC Pregnancy and Childbirth. 2019;19(1):174.

Taha Z, Hassan AA, Wikkeling-Scott L, Papandreou D. Factors associated with preterm birth and low birth weight in Abu Dhabi, the United Arab Emirates. International Journal of Environmental Research and Public Health. 2020;17(4):1382.

Momeni M, Danaei M, Kermani AJN, Bakhshandeh M, Foroodnia S, Mahmoudabadi Z, et al. Prevalence and risk factors of low birth weight in the Southeast of Iran. International Journal of Preventive Medicine. 2017;8(1).

Sutan R, Mohtar M, Mahat AN, Tamil AM. Determinants of low birth weight infants : a matched case-control study. Open Journal of Preventive Medicine. 2014;4:91–9.

Lingani M, Zango SH, Valéa I, Somé G, Sanou M, Samadoulougou SO, et al. Low birth weight and its associated risk factors in a rural health district of Burkina Faso: a cross-sectional study. BMC Pregnancy and Childbirth. 2022;22(1):228.

Rohmah N, Masruroh M, Marasabesy NB, Pakaya N, Prasetyo J, Walid S, et al. Factors related to low birth weight in Indonesia. Malaysian Journal of Nutrition. 2022;28(2):253–61.

Mittwoch U. Blastocysts prepare for the race to be male. Human Reproduction. 1993;8(10):1550–5.