Determination Prevalence of Stunting: Logistic Regression Analysis of Maternal and Child Health Factors
DOI:
https://doi.org/10.55489/njcm.170320266092Keywords:
Stunting, Maternal Health, Child Health, Antenatal Care, BreastfeedingAbstract
Background: Stunting remains a significant public health issue in Indonesia, with long-term impacts on child growth and development. Maternal and child health is considered a key factor during pregnancy and early childhood. This study aimed to investigate the association between maternal and child health practices and stunting in toddlers using logistic regression analysis.
Methodology: A cross-sectional design was used in 140 mother-child pairs proportionally selected from four community health centers in urban Surabaya. Data were collected through a structured questionnaire, medical records, and anthropometric measurements. Statistical analysis was performed with a 95% confidence level, with significance determined at p <0.05.
Results: Multivariable logistic regression analysis showed that routine antenatal care was a protective factor against stunting (OR = 0.136; 95% CI: 0.028-0.671; p = 0.014), indicating a substantially lower likelihood of stunting among children whose mothers attended regular ANC. Implementation of early initiation of breastfeeding was also independently protective (OR = 0.165; 95% CI: 0.032-0.852; p = 0.031). In contrast, complementary feeding before 6 months was the strongest risk factor for stunting (OR = 7.793; 95% CI: 2.486-24.432; p <0.001). Other variables were not statistically significant after adjustment.
Conclusions: This study concluded that regular antenatal care and early breastfeeding are protective factors against stunting, while introducing complementary foods before 6 months of age carries significant risks. It is recommended that strengthening antenatal care (ANC) services, adherence to Early Initiation of Breastfeeding (IMD), and early initiation of complementary feeding (MP-ASI) be prioritized in stunting prevention programs.
References
Miranda AV, Sirmareza T, Nugraha RR, Rastuti M, Syahidi H, Asmara R, Petersen Z. Towards stunting eradication in Indonesia: Time to invest in community health workers. Public Health Chall. 2023 Jul 21;2(3):e108. DOI: https://doi.org/10.1002/puh2.108 PMid:40496273 PMCid:PMC12039568
de Onis M, Dewey KG, Borghi E, Onyango AW, Blössner M, Daelmans B, Piwoz E, Branca F. The World Health Organization's global target for reducing childhood stunting by 2025: rationale and proposed actions. Matern Child Nutr. 2013;Sep;9 Suppl 2(Suppl 2):6-26. DOI: https://doi.org/10.1111/mcn.12075 PMid:24074315 PMCid:PMC6860845
Yulika M, Syah NA, Yusrawati. The influence of maternal factors on the incidence of stunting in toddlers: a narrative review. Int J Res Rev. 2024;11(5):693-702. DOI: https://doi.org/10.52403/ijrr.20240580
Siramaneerat I, Astutik E, Agushybana F, Bhumkittipich P, Lamprom W. Examining determinants of stunting in Urban and Rural Indonesian: a multilevel analysis using the population-based Indonesian family life survey (IFLS). BMC Public Health. 2024 May 22;24(1):1371. DOI: https://doi.org/10.1186/s12889-024-18824-z PMid:38778326 PMCid:PMC11110397
Agussalim, Zulkifli A, Noor NN, Ansariadi, Stang, Riskiyani S. Risk factor analysis of stunting in children aged 6-23 months in Tanralili District, Maros Regency, Indonesia. Natl J Community Med. 2024;15(7):559-565. DOI: https://doi.org/10.55489/njcm.150720244014
Department of Women’s Empowerment, Child Protection and Population Affairs, Province of East Java. Technical Guidelines for Jatim Terbaik’s (East Java Responsive to Pregnant Women at Risk of Stunting) 2025 [Internet]. Surabaya: Government of East Java Province; 2025. [cited 2026 Feb 01]. Available from: https://dp3ak.jatimprov.go.id/public/upload/Buku%20Pedoman%20Jatim%20Terbaik%27s.pdf
Suparji, Wahito Nugroho HS, Surtinah N. Handling Stunting in Indonesia: Challenges, Progress and Recommendations. Natl J Community Med 2024;15(2):161-164. DOI: https://doi.org/10.55489/njcm.150220243546
Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Matern Child Nutr. 2018;14(4):e12617. DOI: https://doi.org/10.1111/mcn.12617 PMid:29770565 PMCid:PMC6175423
González-Fernández D, Muralidharan O, Neves PA, Bhutta ZA. Associations of Maternal Nutritional Status and Supplementation with Fetal, Newborn, and Infant Outcomes in Low-Income and Middle-Income Settings: An Overview of Reviews. Nutrients. 2024 Oct 31;16(21):3725. DOI: https://doi.org/10.3390/nu16213725 PMid:39519557 PMCid:PMC11547697
Mulyani AT, Khairinisa MA, Khatib A, Chaerunisaa AY. Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction-A Narrative Review. Nutrients. 2025 Apr 29;17(9):1493. DOI: https://doi.org/10.3390/nu17091493 PMid:40362802 PMCid:PMC12073730
Nugroho AA, Sudrajat A, Azmi IF, Ardiansyah F, Prasetyanti R. Collaborative Governance in Indonesia’s Nutritious Food Policy: A Multi-Stakeholder Implementation Model. J Borneo Adm. 2025;21(2):203-218. DOI: https://doi.org/10.24258/jba.v21i2.1698
Vaivada T, Akseer N, Akseer S, Somaskandan A, Stefopulos M, Bhutta ZA. Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. Am J Clin Nutr. 2020 Sep 14;112(Suppl 2):777S-791S. DOI: https://doi.org/10.1093/ajcn/nqaa159 PMid:32860401 PMCid:PMC7487433
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373-1379. DOI: https://doi.org/10.1016/S0895-4356(96)00236-3 PMid:8970487 PMCid:PMC8670711
Herawati DMD, Sunjaya DK. Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study. Int J Environ Res Public Health. 2022;19(20):13591. DOI: https://doi.org/10.3390/ijerph192013591 PMid:36294173 PMCid:PMC9602846
World Health Organization. WHO recommendations on ante-natal care for a positive pregnancy experience [Internet]. Geneva: World Health Organization; 2016 [cited 2026 Feb 01]. Available from: https://www.who.int/publications/i/item/9789241549912
Kuhnt J, Vollmer S. Antenatal care services and its implications for vital and health outcomes of children: Evidence from 193 surveys in 69 low-income and middle-income countries. BMJ Open. 2017;7(11):e017122. DOI: https://doi.org/10.1136/bmjopen-2017-017122 PMid:29146636 PMCid:PMC5695442
Sharma S, Teijlingen Ev, Belizán JM, Hundley V, Simkhada P, Sicuri E. Measuring What Works: An Impact Evaluation of Women's Groups on Maternal Health Uptake in Rural Nepal. PLoS One. 2016 May 23;11(5):e0155144. DOI: https://doi.org/10.1371/journal.pone.0155144 PMid:27214032 PMCid:PMC4877042
Woldeamanuel GG, Geta TG, Mohammed TP, Shuba MB, Bafa TA. Effect of nutritional status of pregnant women on birth weight of newborns at Butajira Referral Hospital, Butajira, Ethiopia. SAGE Open Med. 2019;7:2050312119827096. DOI: https://doi.org/10.1177/2050312119827096 PMid:30728970 PMCid:PMC6351719
Batubara FR, Mus IPR, Wija IBEU. The Relationship of Antenatal Care Frequency and Incidents of Stunting in Toddlers in Indonesia (Advanced Analysis of Riskesdas 2018). IJGHR;7(2):813-822. DOI: https://doi.org/10.37287/ijghr.v7i2.5854
Hartati C, Sudaryati E, Zuska F. Relationship History of Parenting and Antenatal Care Visits with Stunting Events in Children Aged 24-36 Months in West Aceh Regency. Rand Inter Social Sci J. 2024;5(2):204-215. DOI: https://doi.org/10.47175/rissj.v5i2.949
Pudjirahaju A, Soelistyorini D, Mustafa A, Kristianto Y. Transforming Childhood: Nutrition Interventions in the First 1000 Days of Life to Prevent Stunting and Enhance IQ Children in Trenggalek. Amerta Nutrition 2025;9(1):101-108, DOI: https://doi.org/10.20473/amnt.v9i1.2025.101-108
Limijadi EKS, Devi KS. Impact of nutritional interventions and antenatal care on stunting in Indonesia: a systematic review. RSF Conference Proceeding Series: Business, Management and Social Science. 2024;4(1):229-235. DOI: https://doi.org/10.31098/bmss.v4i1.877
Shofiya D, Sumarmi S, Sulistyono A, Suyanto B, Rachma RA, Rosyida ARA. The onset lactation, early initiation breastfeeding, and frequency of antenatal care as determinants of successful exclusive breastfeeding in primipara mothers. Amerta Nutr. 2024;8(2 Suppl):15-24. DOI: https://doi.org/10.20473/amnt.v8i2SP.2024.15-24
Susianto SC, Suprobo NR, Maharani M. Early Breastfeeding Initiation Effect in Stunting: A Systematic Review. Asian J Heal Res 2022;1(1):1-6. DOI: https://doi.org/10.55561/ajhr.v1i1.11
Purkiewicz A, Regin KJ, Mumtaz W, Pietrzak-Fiećko R. Breastfeeding: The Multifaceted Impact on Child Development and Maternal Well-Being. Nutrients. 2025;17(8):1326. DOI: https://doi.org/10.3390/nu17081326 PMid:40284191 PMCid:PMC12030032
Victora CG, Christian P, Vidaletti LP, Gatica-Domínguez G, Menon P, Black RE. Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. Lancet. 2021;397(10282):1388-1399. DOI: https://doi.org/10.1016/S0140-6736(21)00394-9 PMid:33691094 PMCid:PMC7613170
Masuke R, Msuya SE, Mahande JM, Diarz EJ, Stray-Pedersen B, Jahanpour O, et al. Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: Cohort study. PLoS ONE,2021; 16(5): e0250562. DOI: https://doi.org/10.1371/journal.pone.0250562 PMid:33983950 PMCid:PMC8118559
Yunitasari E, Al Faisal AH, Efendi F, Kusumaningrum T, Yunita FC, Chong MC. Factors associated with complementary feeding practices among children aged 6-23 months in Indonesia. BMC Pediatr. 2022 Dec 21;22(1):727. DOI: https://doi.org/10.1186/s12887-022-03728-x PMid:36539759 PMCid:PMC9769005
Keusch GT, Denno DM, Black RE, Duggan C, et al. Environmental enteric dysfunction: pathogenesis, diagnosis, and clinical consequences. Clin Infect Dis. 2014 Nov 1;59 Suppl 4(Suppl 4):S207-12. DOI: https://doi.org/10.1093/cid/ciu485 PMID: 25305288 PMCID: PMC4481570
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Astuti Setiyani, Siti Alfiah, Hary Sumasto, Suparji Suparji
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.
