Biopsychosocial and Economic Determinants of Low Birth Weight in Jambi, South Sumatera: Path Analysis
Abstract
Background: Low birth weight (LBW) is one of the main risk factors of neonatal mortality and morbidity. It is an important public health issue particularly in developing countries. Worldwide, LBW shares around 15-20% of birth outcome. In Indonesia, LBW shares about 10.2% of birth outcome. In theory, the risk factors of LBW include not only biological aspect but also psychosocial and economic aspects. This study sought to estimate the biopsychosocial and economic determinants of LBW in Jambi, South Sumatera, using path analysis approach.
Subjects and Method: This was an analytic observational study with case-control design. The study was carried out at 20 community health centers in Jambi, South Sumatera, from December 2017 to January 2018. A total sample of 200 newborn infants consisting of 50 LBW and 150 normal birth weight newborn infants were selected for this study by fixed disease sampling. The dependent variable was birth weight. The independent variables were gestational age, infant sex, maternal mid-upper arm circumference (MUAC), maternal gestational stress, maternal education, family income at gestational period, and sanitation. Data on birth weight and MUAC were taken from obstetric record. The other data were collected by questionnaire. The data were analyzed by path analysis.
Results: The risk of LBW directly decreased with gestational age ?37 weeks (b= -5.06; 95% CI= -6.49 to -3.62; p<0.001), male sex (b= -0.99; 95% CI= -2.12 to -0.12; p= 0.081), low maternal stress (b= -2.35; 95% CI= 14.01 to -0.70; p= 0.005), and good sanitation (b= -1.04; 95% CI= -2.13 to -0.05; p= 0.062). Gestational age increased with family income (b= 1.74; 95% CI= 0.96 to 2.52; p<0.001). Low maternal stress was positively affected by high family income (b= 1.34; 95% CI= 0.197 to 2.50; p= 0.022). Good sanitation was positively affected by high family income (b= 0.71; 95% CI= 0.01 to 1.41; p= 0.046). High family income was positively affected by high education level (b= 1.37; 95% CI= 0.57 to 2.18; p= 0.001)
Conclusion: The risk of LBW directly decreases with gestational age ?37 weeks, male sex, low maternal stress, and good sanitation. LBW is indirectly affected by maternal education and family income.
Keywords: biopsychosocial, economic, determinant, LBW
Correspondence:
References
Ahankari A, Bapat S, Myles P, Fogarty A, Tata L (2017). Factors associated with preterm delivery and low birth weight: a study from rural Maharashtra, India. F1000Research, 6(May), 72. https://doi.org/10.12688/f1000research.10659.1.
Andayasari L, Opitasari C (2016). Parity and risk of low birth weight infant in full term pregnancy, 7(1), 13
Aryastami NK, Shankar A, Kusumawardani N, Besral B, Jahari AB (2017). Low birth weight was the most dominant predictor associated with stunting among children aged 12 23 months in Indonesia,1
Assefa N, Berhane Y, Worku A (2012). Wealth Status, Mid Upper Arm Circum ference (MUAC) and Antenatal Care (ANC) Are Determinants for Low Birth Weight in Kersa , Ethiopia, 7(6). https://doi.org/10.1371/journal.pone. 0039957.
Chibwesha CJ et al. (2016). Predictors and outcomes of low birth weight in Lusaka, Zambia, International Journal of Gynecology and Obstetrics. International Federation of Gynecology and Obstetrics, 134(3): 309
Demelash H, Motbainor A, Nigatu D, Gashaw K, Melese A (2015). Risk factors for low birth weight in Bale zone hospitals, SouthEast Ethiopia : a case
Dinas Kesehatan Kota Jambi (2017). Data Angka Kematian Ibu dan Angka Kematian Bayi di Kota Jambi Tahun 2015 dan Tahun 2016. Jambi.
Fikawati S, Syafiq A, Karima K (2015). Gizi Ibu dan Bayi. Jakarta : PT. Rajagrafindo Persada.
Islam MM, ElSayed MK (2015.) Pattern and determinants of birth weight in Oman. Public Health. 129,22. pp: 1618-1626.
Janiwarty B, Pieter HZ (2013). Pendidikan Psikologi untuk Bidan
Kader M, Perera NKP (2014). SociEconomic and Nutritional Determinants of Low Birth Weight in India, 6(7), 1
Kayode GA, Amoakohcoleman M, Agyepong IA, Ansah E, Grobbee, DE, Klipsteingrobusch K (2015). Contextual Risk Factors for Low Birth Weight : A Multilevel Analysis, 9(10), 1
Kementerian Kesehatan RI (2015). Profil Kesehatan Indonesia 2014. Jakarta.
_____ (2016). Profil Kesehatan Indonesia Tahun 2015. Jakarta.
Lau Y (2013). The Effect of Maternal Stress and HealthRelated Quality of Life on Birth, 27(1), 14
Mahmoodi Z, Karimlou M, Sajjadi H, Dejman M, Dolatian M (2013). Working Conditions, Socioeconomic Factors and Low Birth Weight : Path Analysis, 15(9).https://doi.org/10.5812/ircmj. 11449.
Mahumud RA, Sultana M, Sarker AR (2017). Distribution and Determinants of Low Birth Weight in Developing Countries. pp. 18
Momeni M, Danaei M, Jabbari A, Kermani N, Bakhshandeh M, Foroodnia S, Safizadeh H (2017). Prevalence and Risk Factors of Low Birth Weight in the Southeast of Iran, 0
Oltmans TF, Emery RE (2012). Psikologi Abnormal.Yogyakarta:Penerbit Pustaka Pelajar.
Schetter CD (2011). Psychological Science on Pregnancy: Stress Processes, Biopsychosocial Models, and Emerging Research Issues. https://doi.org/10. 1146/annurev.psych.031809.130727.
Sebayang SK, Dibley MJ, Kelly PJ, Shankar AV Shankar AH (2012). Determinants of low birthweight, small for gestationalage and preterm birth in Lombok , Indonesia : analyses of the birthweight cohort of the SUMMIT trial, 17(8), 938
Setyo M, Paramita A (2015). POLA KEJADIAN dan determinan BAYI DENGAN Berat Badan Lahir Rendah (BBLR) DI INDONESIA tahun 2013 (Pattern of Occurrence and Determinants of Baby. 2013, pp. 1
Shrestha M, Gupta SK, Sarmah BK, Baidya M (2016). Socio Economic and Maternal Reproductive Factors Affecting Low Birth Weight Babies in Central Nepal. Journal Nepal Paediatric Soc. Vol. 36, no.3.
Soetjiningsih, Ranuh IGNG (2016). Tumbuh Kembang Anak. Edisi 2. Jakarta : Penerbit Buku Kedokteran EGC.
Sulistyoningsih H (2011). Gizi Untuk Kesehatan Ibu dan Anak. Yogyakarta : Graha Ilmu.
Tandu Umba B, Dedetemo DK, Mananga, GL (2014). Maternal Stress and Pregnancy Outcomes *, (May), 361
Taywade ML, Pisudde PM (2016). Science Direct Study of sociodemographic determinants of low birth weight in Wardha district, India. Clinical Epidemiology and Global Health, 1
Wang J, Zeng Y, Ni Z, Wang G, Liu S (2017). Risk Factors for Low Birth Weight and Preterm Birth :, 37(2), 286
WHO (2014). Global Nutrition Target 2025 Low Birth Weight Policy Brief. Geneva : WHO.
____ (2017). Fetomaternal Nutrition and Low Birth Weight. Geneva : WHO. Tersedia pada : http://www.who.int/nutrition/topics/feto_maternal/en/, diakses pada tanggal 7 Juli 2017.
Yindong T, Xiaoge B, Cen C, Xi Y, Yiren L, Huijiao L, Xuejun W (2017). Science of the Total Environment Impacts of sanitation improvement on reduction of nitrogen discharges entering the environment from human excreta in China. Science of the Total Environment, 593
