e-ISSN: 2549-0257 Publisher: Masters Program in Public Health, Sebelas Maret University Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Prof. Rita Benya Adriani Study Program in Nursing, School of Health Polytechnics, Ministry of Health, Surakarta Description: Journal of Maternal and Child Health (JMCH) is an electronic, open access peer-reviewed journal that publishes research articles on a broad range of topics related to maternal and child health. The journal began its publication on January, 2016, and was published four times yearly. Due to an increasing demand of research work publication, starting Volume 4 Issue 5 the JMCH is published bi-monthly, consisting of 12 articles in each issue. This journal aims to improve knowledge in maternal and child health, and ultimately the health of maternal and child population worldwide. JMCH covers a broad range of disciplines including obstetrics, gynecology, reproductive health, pediatrics, neonatology, nutrition, family planning, developmental psychology, sociology, demography, epidemiology, public health, and preventive medicine. The journal addresses such topics as social determinants of health and disease and disparities in communicable and non-communicable diseases burden affecting the health of infants, children, women, adolescents, and families across the lifespan. Diseases or health care issues affecting populations in the developing world are currently under-documented and underreported in the existing international journals. Therefore, the JMCH encourages authors from developing countries to publish their research papers in this journal. All articles are immediately and permanently free to read and download in pdf files. All of the papers published are freely available as downloadable pdf files. JMCH is currently abstracted and indexed in CABI Global Health, Google Scholar, CrossRef, SINTA, GARUDA. This journal is accredited by the Ministry of Research, Technology, and Higher Education, Government of Indonesia, No 85/M/KPT/2020 No. 21/E/KPT/2018, effective from April 2020 to 2025.
Masters Program in Public Health, Universitas Sebelas Maret, Indonesia
Socio-cultural Factors Influencing the Incidence of Stunting among Children Under Five in the Tengger Tribe, East Java, Indonesia
Background: Indications of stunting incidence in toddlers of the Tengger Tribe in East Java, related to socio-cultural practices in daily life that have an impact on health conditions and nutritional fulfillment of toddlers. This study aims to analyze the socio-cultural factors that affect the incidence of stunting in Tengger Tribe toddlers in East Java. Subjects and Method: This study is a qualitative research with a phenomenological approach. The research was conducted at the Lumajang Regency Health, Population Control, and Family Planning Office (P2KB), Senduro District Office, Senduro Health Center, and Ranupani Village. A total of 9 key informants, including the head of nutrition and public health, the head of population and family planning, the head of the Senduro Health Center, nutritionists, village midwives, family planning field officers of Senduro District, the head of the Ranupani Village government, the traditional shaman of the Tengger Tribe, and the baby shaman. A total of 9 mothers of toddlers as the main informants and 9 supporting informants were purposively sampling, including family members, cadres, health care officers, and sanitarians. Data collection was carried out through interviews, observations, and documentation, then analyzed using the Miles and Huberman interactive model. Results: The study showed limited maternal knowledge about the health conditions and growth of toddlers. Traditional shamans play an important role in social decision-making, while gender equality affects the workload of mothers in economic activities. The parenting and care of toddlers is influenced by the cultural practices of the Tengger Tribe which are still strongly attached to daily life, as well as the environmental conditions of mountain communities who mostly depend on the agricultural sector for their livelihoods. Belief in ancestral spirits influences health decisions, through restrictions on maternal activity and mobility during pregnancy and after childbirth, as well as dietary restrictions that are believed to have adverse effects on pregnancy and toddlers. Conclusion: The incidence of stunting in toddlers of the Tengger Tribe is related to socio-cultural factors which include maternal knowledge, social interaction patterns, toddler parenting patterns, and belief in ancestral spirits in health decision-making.
Copyright (c) 2026 Journal of Maternal and Child Health
Determinants of Chronic Energy Deficiency in Pregnancy at Lebak Wangi Community Health Center, Banten, Indonesia
Background: Malnutrition during pregnancy increases the risk of anemia, hypertension, miscarriage, fetal death, and causes low birthweight and fetal growth disorders that have a long-term impact on quality of life and health costs. Understanding and analyzing the problem of chronic energy deficiency in pregnant women based on comprehensive determinants is indispensable in order to design appropriate policies and treatment actions. This study aims to analyze the influence of the determinants of the incidence of chronic energy deficiency in pregnant women. Subjects and Method: This is a case control study conducted at the "Lebak Wangi" Health Center in Serang-Banten, Indonesia, in November 2025. The sample in this study was 105 pregnant women divided into 2 groups of cases, namely 53 pregnant women who suffered from chronic energy deficiency and a control group of 52 pregnant women with normal nutritional conditions. The exposure variable in this study is chronic energy deficiency). Independent variables were maternal age, gestational age, parity, education, economic status, haemoglobin level, and body mass index. The instrument research was master table. The analysis was carried out by multiple logistic regression. Results: Mothers with a lean body mass index are more likely to experience chronic energy deficiency up to 4.7 times more than mothers with a normal and statistically significant body mass index (aOR= 4.70; 95%CI= 0.34 to 0.83; p <0.001). Older gestational age has a 3.5 times smaller chance of chronic energy deficiency than younger gestational age and is statistically significant (aOR= -3.55; 95%CI= -2.61 to -0.75; p<0.001). Conclusion: The factors that have a significant influence in the case of SEZs are body mass index and gestational age.
Determinants of Low Birth Weight at Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia
Background: Low birth weight (LBW) is a major cause of infant and neonatal mortality in Indonesia. Data from the 2022 Nutritional Status Survey and the 2023 Indonesia Health Survey reported an increase in the prevalence of LBW from 5.9% to 6.1%. Records from Dr. Moewardi General Hospital, Indonesia, also show a rise in the number of LBW cases, from 392 cases in 2023 to 412 cases in 2024. This study examines the effects of maternal education, household income, antenatal care (ANC), anemia during pregnancy, preeclampsia, and chronic energy deficiency (CED) on the incidence of LBW at Dr. Moewardi hospital. Subjects and Method: This quantitative study employed a case–control design. The research was conducted at Dr. Moewardi hospital and included 100 infants with low birth weight and 100 infants with normal birth weight, selected using fixed-disease and random sampling methods. The dependent variable was LBW. The independent variables were maternal education, household income, ANC, anemia during pregnancy, preeclampsia, and CED. Data were collected through questionnaires and medical records, and analyzed using simple logistic regression and path analysis. Results: LBW was directly associated with maternal CED (b= 0.79; 95% CI= 0.08 to 1.51; p= 0.028), maternal anemia (b= 0.91; 95% CI= 0.17 to 1.65; p= 0.015), and preeclampsia (b= 1.45; 95% CI= 0.77 to 2.13; p < 0.001). LBW was indirectly influenced by ANC visits, family income, and maternal education. The path model demonstrated good fit indices (AIC= 1221.24; BIC= 1283.91). Conclusion: LBW directly increases with maternal CED, maternal anemia, and preeclampsia. LBW indirectly affects by ANC visit, family income, and maternal education.
Copyright (c) 2025 Journal of Maternal and Child Health
Effect of Moringa oleifera Leaf and Arachis hypogaea Flour Biscuit Supplementation on Breast Milk Production in Breastfeeding Mothers
Background: Breastfeeding mothers often experience problems in providing exclusive breastfeed­ing, one of which is complaints about insufficient milk production. One safe and easy-to-use non-pharmacological treatment is moringa leaves and peanuts, which contain flavonoids and essential minerals that stimulate the production of the hormones oxytocin and prolactin. This study aimed to determine the effectiveness of supplementing Moringa leaf and peanut flour biscuits on breast milk production in breastfeeding mothers. Subjects and Method: This study used a quasi-experimental design with a pretest-posttest with control group design. The study location was in the community of Palu health office. Data collection was conducted from October to November 2025. The study consisted of two groups: an intervention group receiving 100 g of moringa leaf and peanut flour biscuits once daily for 14 days, and a control group receiving nutrition education for breastfeeding mothers. The dependent variables were infant weight, bowel movements, and urination. The independent variables were supplementation with moringa leaf and peanut flour biscuits and nutrition education for breastfeeding mothers. The analysis technique used was Friedman and Man Whitney. Results: The average weight of infants in the intervention group after being given moringa leaf and peanut flour biscuit supplementation was higher (Mean = 3775.1; SD = 455.5) than before the intervention (Mean = 3353.5; SD = 442.2) and was statistically significant (p <0.001). The average number of bowel movements in the intervention group after being given moringa leaf and peanut flour biscuit supplementation was higher (Mean = 3.6; SD = 0.50) than before the intervention (Mean = 2.95; SD = 0.51) and was statistically insignificant (p = 0.305). The average number of urinations in the intervention group after being given moringa leaf and peanut flour biscuit supplementation was higher (Mean = 6.75; SD = 0.91) than before the intervention (Mean = 5.50; SD = 0.607) and was statistically significant (p = 0.015). Conclusion: Supplementation with moringa leaf flour biscuits and peanuts has been proven effective in increasing breast milk production in breastfeeding mothers, making it a safe and practical non-pharmacological therapy alternative.
Effectiveness of Lemongrass Gel on Pain Intensity and Salivary Cortisol Levels in Adolescent Girls with Primary Dysmenorrhea
Background: Primary dysmenorrhea is menstrual pain caused by increased prostaglandins, which cause excessive uterine contractions. This condition is often experienced by adolescent girls and can cause stress and increased cortisol levels. One safe and easy-to-use non-pharmacological treatment is lemongrass gel (Cymbopogon citratus), which contains essential oils such as citral and geraniol, which have analgesic, anti-inflammatory, and antispasmodic properties. The purpose of this study was to determine the effectiveness of lemongrass gel on pain intensity and salivary cortisol levels in adolescent girls with primary dysmenorrhea. Subjects and Method: This was a randomized controlled trial. The study location was State Vocational High School 11 of Semarang. Data collection was conducted from June to July 2025. The intervention group was given 2 grams of 5% lemongrass gel twice daily for 3 days, and the control group was given hot cream. The dependent variables studied were pain intensity and salivary cortisol levels, while the independent variables were lemongrass gel and analgesic cream (Hot Cream). The analysis technique used a paired sample t-test. Results: The mean pain intensity in the intervention group after being given lemongrass gel was lower (Mean= 2.55; SD= 1.15) compared to before the intervention (Mean= 8.30; SD= 1.13) and was statistically significant (p <0.001). The average salivary cortisol level in the intervention group after being given lemongrass gel was lower (Mean= 12.15; SD= 3.30) compared to before the intervention (Mean= 21.91; SD= 8.05) and was statistically significant (p=0.008). Conclusion: The application of 5% lemongrass gel was proven to be effective in reducing pain intensity and salivary cortisol levels in adolescent girls with primary dysmenorrhea, making it a safe and practical non-pharmacological therapy alternative.
The Effect of Soybean Milk (Glycine Max L.) on Reducing Blood Pressure and Cholesterol Levels in Women of Reproductive Age
Background: Women of reproductive age often experience problems with blood pressure and cholesterol levels. Therefore, researchers innovated in an effort to stabilize blood pressure and cholesterol levels in women of reproductive age by providing an intervention of soy milk. The purpose of this study was to determine the effect of soy milk administration on reducing blood pressure and cholesterol levels in women of reproductive age. Subjects and Methods: This study used a Quasi-Experimental design with Pretest-Posttest Control. The research location was the Pangaribuan Community Health Center, Pangaribuan District, North Tapanuli Regency. Data collection was conducted in June 2025. The two groups consisted of an intervention group receiving 40 grams of soy milk and a control group receiving education on blood pressure and cholesterol levels. The dependent variables studied were blood pressure and cholesterol levels, and the independent variable was soy milk. The analysis techniques used were Repeated Measures ANOVA and Paired Sample T-Test. Results: The average systolic blood pressure in the intervention group after being given soy milk was lower (Mean= 133.92; SD= 10.20) compared to before the intervention (Mean= 143.82; SD= 5.48) and was statistically significant (p <0.001), the average diastolic blood pressure in the intervention group after being given soy milk was lower (Mean= 86.88; SD= 5.08) compared to before the intervention (Mean= 92.88; SD= 5.44) and was statistically significant (p <0.001), the average cholesterol level in the intervention group after being given soy milk was lower (Mean= 232.94; SD= 7.56) compared to before the intervention (Mean= 261.24; SD= 13.27) and was statistically significant (p <0.001). Conclusion: Soy milk is effective in lowering systolic and diastolic blood pressure and cholesterol levels in women of childbearing age.
Gadget, Parenting Style, Work Stress, and Toddler Speech Delay:A Retrospective Analysis in Industrial Area of Bekasi
Background: Speech delay affects around 20% of toddlers in Indonesia and is prevalent in industrial areas where parents face long working hours. This study aimed to analyze the relationship of screen time, parenting style, and parental work stress with speech delay in toddlers. Subjects and Method: This retrospective case-control study was conducted in Bekasi industrial area, August- September 2025. A total of 60 toddlers (13 with speech delay, 47 controls) were selected purposively. Speech delay was diagnosed using Denver II and MacArthur-Bates CDI. Inde¬pendent variables included screen time, parenting style, and work stress, measured with validated questionnaires. Data were analyzed using Chi-square and logistic regression. Results: The prevalence of speech delay was 21.7%. Screen time >1 hour/day was significantly associated with a higher risk of speech delay (OR=13.61; 95% CI=3.21 to 28.94; p=0.002). High parental work stress also increased the risk (OR=10.84; 95% CI=2.13 to 21.77; p=0.013). Parenting style showed no significant association (OR=2.73; p=0.233). Qualitative analysis revealed six themes including digital parenting, alternative stimulation, interactions that limit work stress, responsive vs. permissive parenting, awareness and intervention, and socioeconomic influences. Conclusion: Excessive screen time and parental work stress are dominant risk factors for toddler speech delay in industrial families. Prevention efforts should focus on digital literacy for parents, responsive parenting, and stress management programs at community and workplace levels.
Stress and Maladaptive Psychological Responses as Predictors of Postpartum Depression
Background: Unmanaged stress and maladaptive psychological responses during the postpartum period increase the risk of postpartum depression, highlighting the need for evidence-based interventions in primary health care. This study aimed to analyze the influence of stress levels and psychological adjustment difficulties as risk factors for postpartum depression among mothers in the Singaparna Primary Health Care area. Subjects and Method: A cross-sectional study was conducted in five villages within the Singaparna Primary Health Care. A total of 150 postpartum mothers were recruited purposively. The independent variables were stress levels and psychological adjustment. The was dependent variable was postpartum depression. Data on stress were collected usng the Perceived Stress Scale (PSS-10). Psychological adjustment was measured using the Postpartum Adjustment Questionnaire (PAQ-15). Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Reliability and construct validity were confirmed, and Structural Equation Modeling (SEM) was applied to assess predictive relationships. Results: Maladaptive stress responses significantly reduced postpartum depression (β = 0.54, p= 0.002), Positive stress perception (β = 0.133, p= 0.302) and postpartum adjustment (β= 0.124, p= 0.159) were insignificantly associated. The SEM model showed acceptable fit (RMSEA= 0.06; CFI= 0.89; TLI = 0.88; SRMR= 0.07). Conclusion: Maladaptive stress responses are a key psychosocial risk factor for postpartum depression, whereas postpartum adjustment and positive stress perception show limited influence. Early screening and psychosocial interventions in primary care are essential to reduce postpartum depression and improve maternal mental health outcomes.
Analysis of Factors Influencing the Selection of Contraceptive Methods in Women of Reproductive Age
Background: Only 19% of women of reproductive age in Indonesia use long-term contraceptive methods, with injectable birth control being the most frequently used method at 43.5%. A comprehensive understanding of the factors that influence contraceptive selection is essential for designing effective family planning programs and improving the reproductive health of women of reproductive age. This study aims to identify the factors that affect the selection of contraceptive methods among women of reproductive age in Cikunir Village, Tasikmalaya. Subjects and Method: This study uses an observational analytical design with a cross-sectional study. This research was conducted in Cikunir Village, Tasikmalaya. Samples were taken using purposive sampling techniques, consisting of 153 women of reproductive age (15-44 years) who had more than two children and had no contraindications to birth control. The dependent variable was use of contraceptives. The independent variables were demographic, socio-economic, knowledge, attitudes, accessibility of health services, and the role of health workers. Data collection using a primary questionnaire that had been validated and tested for reliability. Data analysis using chi-square tests and multivariate logistic regression Results: Knowledge (OR=15.08; 95% CI=5.11 to 44.48; p<0.001), husband's support (OR=7.94; 95% CI=2.95 to 21.35; p<0.001), high income (OR=5.50; 95% CI=1.80 to 16.74; p=0.003), and parity (OR= 3.33; 95% CI=1.20 to 9.20; p=0.020) increased the likelihood of contraceptive use. Conclusion: The factors that affect the choice of contraceptive use in women of reproductive age in Cikunir Village are knowledge, husband's support, high income, and parity.
Social relationships and empowerment as risk factors for anemia among anxious pregnant women in Pakistan
Background: Empowered women with social support are more likely to seek healthcare services, leading to better health outcomes. This study investigated spousal relationships, social support, and women's empowerment in relation to anemia in pregnant women living in urban areas of Rawalpindi, Pakistan. Subjects and Method: A cross-sectional study enrolled 1,200 pregnant women at ≤ 22 weeks of gestation from Holy Family Hospital, Pakistan. The anxiety component of the Hospital Anxiety and Depression Scale (HADS) was used to assess eligibility, with a cutoff score of > 8. The quality of marital relationships, social support, and women's empowerment were evaluated using the MacArthur Relationship Questionnaire (MRQ), the Multidimensional Scale of Perceived Social Support (MSPSS), and an empowerment scale, respectively. Blood samples were collected to assess anemia in the participants. Descriptive statistics, risk ratios and bivariate analysis were conducted to explore the association. Results: At enrollment, 29.7% of pregnant women exhibited mild anemia, 14.6% exhibited moderate anemia, and 0.3% exhibited severe anemia. Having a strong spousal relationship was significantly associated with decreased risk of anemia (RR=0.87; 95% CI= 0.82 to 0.93, p<0.001). However, social support from family members (excluding spouses) or friends did not show a significant association with the risk of anemia. Interestingly, financially empowered pregnant women had a higher risk of anemia compared to women who were not financially empowered (RR=1.14; 95% CI= 1.01 to 1.30; p= 0.040). Conclusion: Support from a husband was associated with reduced risk of anemia in pregnant women in Pakistan. Enhancing spousal relationships and incorporating health literacy into empowerment programs could improve maternal health by lowering the risks of anemia.
The Influence of Physical Activity on the Quality of Life of Cervical Cancer Patients Undergoing Chemotherapy Treatment
Background: Cervical cancer is one of the most common types of cancer experienced by women worldwide. During treatment procedures such as chemotherapy and radiotherapy, patients often face challenges in the recovery process, both physically and emotionally, which may lead to a decline in their quality of life. One of the ways to support reproductive health recovery is through physical activity, as it can improve blood circulation and help regulate hormonal balance. This study aims to analyze the effect of physical activity on the quality of life of cervical cancer patients undergoing chemotherapy. Subjects and Method: This is a cross-sectional study conducted at Dr. Soedarso Hospital, Pontianak, West Kalimantan. A total of 30 cervical cancer patients undergoing chemotherapy were selected in this study. The dependent variable was quality of life. The independent variable was physical activity. Data were collected by questionnaire and analyzed using Spearman rho test. Results: Spearman's rho correlation analysis showed a strong and statistically significant relationship between physical activity and quality of life in cancer patients (r = 0.66; p < 0.001). These results indicate that higher levels of physical activity improve the quality of life in cervical cancer patients. Conclusion: The findings demonstrate a strong and significant relationship between physical activity and the quality of life of cervical cancer patients. This indicates that the better the physical activity performed, the better the quality of life of cervical cancer patients.
Psychological Well-Being Among Women with Polycystic Ovary Syndrome: Insights from Buug, Zamboanga Sibugay, Philippine
Background: Traditionally, Polycystic Ovary Syndrome (PCOS) has been classified primarily as an endocrine disorder. Contemporary research, however, has elucidated its multifaceted nature, encompassing metabolic, hormonal, and psychosocial dimensions that substantially influence patients' quality of life. Women with PCOS are often subjected to significant emotional distress due to the syndrome's physical manifestations, fertility issues, and body image challenges, which are frequently accompanied by elevated levels of anxiety, depression, and stress. This study aims to highlight the psychological ramifications of PCOS diagnosis and underscore the imperative of integrating psychological considerations into holistic patient care. Subjects and Method: Utilizing a descriptive-correlational research design, this study assessed the perceived psychological impact of PCOS diagnosis among women in Buug, Zamboanga Sibugay. A sample of 81 randomly selected respondents completed a validated and reliability-tested questionnaire. The dependent variables comprised the perceived impact of PCOS diagnosis on the respondents’ psychological health. The independent variables of the study were the respondents’ perceptions of their PCOS diagnosis in terms of the duration, challenges, and lifestyle changes associated with the condition. Data were analyzed using Spearman’s rho and Pearson correlation coefficients. Results: The findings indicate that the duration of PCOS diagnosis, the associated challenges, and subsequent lifestyle modifications significantly affect participants' psychological well-being. Statistical analysis indicated significant correlations between psychological health and the duration of diagnosis (p < 0.001), diagnostic challenges (p < 0.001), and lifestyle changes (p < 0.001), highlighting their critical impact on psychological outcomes. Conclusion: The study emphasizes the critical need to incorporate psychological aspects into the management of PCOS. Effective intervention that addresses both the physical and psychological dimensions of PCOS can substantially enhance patient care and improve overall quality of life for women affected by this syndrome.
A Scoping Review of Maternal Birth Experience in Low- and Middle-Income Countries from 2014-2024
Background: Childbirth experiences differ widely, shaped by cultural beliefs, socioeconomic status, healthcare infrastructure, and delivery location. In low- and middle-income countries (LMICs), limited access to quality care and higher maternal mortality rates deeply affect women’s experiences and outcomes. While prior studies have typically examined economic, social, or structural influences independently, a comprehensive approach that integrates these domains is needed. This study aims to examine the economic, social, and structural factors influencing maternal experiences in LMICs and assess how these factors shape both the choice of delivery location and maternal care experience. Subjects and Method: A literature search of studies from 2014 to 2024 was conducted using MEDLINE and Google Scholar. Controlled vocabulary (e.g., MeSH terms) and Boolean operators combined terms such as “midwives,” “birth assistants,” “LMICs,” “hospital birth,” and “maternal mortality rates.” Only peer-reviewed quantitative and qualitative English-language studies examining maternal birth experience in LMICs were included. Grey literature, reviews, and opinion pieces were excluded. Findings were organized using a global framework on maternal health determinants. Results: Of 114 articles identified, 8 met the inclusion criteria, covering studies from Bangladesh, Ethiopia, rural Sierra Leone, Kenya, rural Zambia, Chiapas (Mexico), and Eritrea. These studies revealed that maternal experience and delivery location are shaped by economic, social and structural factors. Hospital fees and informal costs discouraged facility-based births, while limited education, cultural norms and male-dominated decision-making reduced women’s autonomy in choosing their delivery location. Structural challenges, including staff shortages, lack of privacy, and poor rural access, further limited hospital deliveries. Conclusion: Maternal birth experiences in LMICs are influenced by hospital delivery costs, cultural beliefs, limited education and awareness, and inadequate healthcare facilities, which reduce access to quality care and undermine women’s autonomy. Targeted interventions, such as affordable, culturally sensitive, and accessible healthcare and education-focused initiatives, are essential to enhancing maternal birth experiences and outcomes.
Family Role on the Pregnant Women’s Knowledge Toward Obstetric Danger Signs
Background: Obstetric danger signs are an important indicator that pregnant women need to recognize to prevent complications and reduce maternal mortality. This study aims to analyze the determinants of knowledge about obstetric danger signs in pregnant women, with a special focus on the role of family function as measured by the family APGAR instrument. Subjects and Method: A cross-sectional study was conducted on 48 pregnant women who visited the Padang Bulan Community Health Center, Medan, during August-September 2024. The dependent variable is the level of knowledge about obstetric danger signs. Independent variables were age, education level, employment status, number of pregnancies (parity), income, and family function (APGAR score). Data collection was conducted using questionnaires on obstetric danger signs and family APGAR instruments. Data analysis included univariate, bivariate (Chi-Square), and multivariate (logistic regression) analysis. Results: The majority of subjects (72.9%) had good knowledge of obstetric danger signs. Bivariate analysis showed that education level (p=0.008) and family function (p=0.005) had a significant relationship with knowledge level, while age, employment status, parity, and income showed no significant relationship. Multivariate analysis confirmed that highly functional family function (OR= 10.47; 95% CI= 1.56 to 70.40; p =0.016) and higher education levels (OR= 6.83; 95% CI= 1.31 to 35.61; p = 0.023) were significant independent predictors for good knowledge of obstetric danger signs. Conclusion: Family function and education level are the main determinants of pregnant women's knowledge about obstetric danger signs. Maternal health education programs need to consider family involvement and pay special attention to pregnant women with low levels of education to improve understanding of obstetric danger signs, which can ultimately contribute to a decrease in maternal morbidity and mortality rates.
Effect of Iron and Folic Acid Supplementation on the Infants Birth Weight: A Meta-Analysis
Background: Low birth weight (LBW), defined as a birth weight of less than 2,500 grams, is associated with an increased risk of neonatal mortality and developmental disorders. Efforts to prevent and manage LBW can be made through the administration of iron and folic acid supplements during pregnancy. This study aims to estimate and analyze the effect of iron and folic acid supplementation on the birth of infants with low birth weight. Subjects and Method: This study is a systematic review and meta-analysis of relevant previous studies conducted using the PRISMA guidelines. The population included pregnant women, interventions involving iron and folic acid supplementation compared to no supplementation, and outcomes related to low birth weight. Article searches were conducted in the PubMed, ScienceDirect, Scopus, and Google Scholar databases, published between 2013 and 2025. The search terms were ("Pregnant woman" OR "Expectant mother") AND ("Iron and folic acid supplements" OR "IFA supplements") AND ("Low Birth Weight" OR "Low-weight newborns"). Inclusion criteria included full-text articles with a cross-sectional study design and reporting adjusted odds ratio (aOR) values. Findings from the primary research articles were analyzed using Review Manager 5.3. Results: The included primary studies comprised 21 articles from China, India, Nepal, Pakistan, Malawi, and Ethiopia. The results of this meta-analysis indicate that pregnant women who consumed iron and folic acid supplements had an average 0.87 unit lower risk of giving birth to LBW infants compared to pregnant women who did not consume iron and folic acid supplements (aOR= 0.87; 95% CI = 0.75 to 1.00; p= 0.040). Conclusion: The administration of iron and folic acid supplements can reduce the incidence of low birth weight.
Infant Massage and Its Effects on Maternal-Infant Bonding, Sleep Quality, and Jaundice Reduction: A Meta-Analysis
Background: Baby massage is defined as the oldest tactile therapy practiced for hundreds of years and can affect a baby's development. Baby massage is essential for the emotional bonding process of mother and child. In terms of sleep quality, massaged babies will have better sleep quality. Baby massage is also effective in lowering blood bilirubin levels in babies with jaundice. This study aims to estimate the effect size based on the results of previous similar primary studies. Subjects and Method: A meta-analysis was conducted on a number of primary studies with a Randomized Controlled Trial (RCT) design. The research questions were conducted in the PICO format. Population: infants aged 0-3 years, Intervention: infant massage, Comparison: no infant massage, Outcome: emotional relationship between mother and child, sleep quality, blood bilirubin level. The article search was conducted using a database of journals including PubMed, Sains direct, Google Scholar, Publish or Perish and SpringerLink Articles for the 2012-2023 period with the keywords "baby massage" or "infant massage" and "sleep quality" or "baby sleep quality" and "attachment" or " bonding" and "jaundice" or "hyperbilirubinemia" and "randomized control trial". Data analysis in this study was carried out using the Review Manager application (RevMan 5.4). Results: This meta-analysis was conducted on 20 primary studies of Randomized Controlled Trials (RCTs), originating from Indonesia, Taiwan, Iran, Turkey, and Iceland. The total sample size is 2,043 children. The results of the meta-analysis discovered that infant massage lowered bilirubin levels (SMD = -2.07; 95% CI = -2.71 to -1.43, p<0.001). Infant massage improved sleep quality (SMD = 0.90; 95% CI = 0.44 to 1.36, p<0.001) and maternal and child emotional bonding (SMD = 9.92; 95% CI= 7.72 to 12.12, p<0.001). Conclusion: Baby massage lowers bilirubin levels. Baby massage improves the quality of sleep and the emotional relationship of mother and child.
Socioeconomic Factor Association to Knowledge and Attitude of Indonesian Young Adults Regarding Family Planning: A Cross-Sectional Multicenter Study
Background: Young adults are prone to unwanted pregnancy due to their nature of self-discovery, identity construction, poor knowledge, and low birth self-efficacy. This study aims to identify which socioeconomic factors are associated with knowledge and attitude toward family planning in Indonesian young adults. Subjects and Method: This cross-sectional, observational, multicenter research was conducted in 27 universities across Java and Sumatra using convenience sampling. Indonesian citizens aged 16–25 were recruited to complete an online questionnaire, with minimum sample size of 349 participants. The dependent variable were knowledge and attitude levels were measured using translated and validated questionnaire. The independent variable were socioeconomic factors were assessed using self-administered questionnaire. Chi-square and odds ratio were used to identify significant associations, followed by logistic regression for independent analysis. Results: From total of 581 participants, knowledge of family planning was significantly higher in females (OR= 1.50; p= 0.036), married respondents (OR= 0.20; p <0.001), those with children (OR= 2.12; p= 0.040), contraceptive users (OR= 0.49; p = 0.043), respondents from health-related backgrounds (OR= 2.82; p <0.001), and those with higher media exposure (OR= 4.29; p <0.001).Among these, respondents using contraception (OR= 0.48; p= 0.033) and with higher media exposure (OR= 1.63; p=0.017) demonstrated more favorable attitudes toward family planning. Conclusion: This study identified media exposure and access to education as key factors influencing knowledge and attitudes toward family planning. In the globalization era, media exposure has the potential to dismantle entrenched socioeconomic barriers, narrowing gaps between privileged and disadvantaged groups. These findings highlight the role of social media as an important educational tool that can bridge demographic and socioeconomic divides.
Correlation between Blood Sodium and CD4 Level in Pediatrics with Human Immunodeficiency Virus Infection
Background: Electrolyte disorders such as hyponatremia are often found in human immuno­deficiency virus (HIV) patients. It is closely correlated with HIV morbidity and mortality. Sodium levels have also been reported to correlate with cluster of differentiation 4 (CD4) in adult subjects, but it is not yet known how in children with HIV infection.This study conducted to analyze the correlation between electrolyte levels, especially sodium, and CD4 levels in children with HIV infection. Subjects and Method: Descriptive analytical study with a cross-sectional design. The subjects were 42 pediatric HIV patients aged 0-18 years who were willing to undergo sodium and CD4 level examinations. Subjects with liver cancer, liver cirrhosis and cardiovascular disease and opportu­nistic infections in HIV were excluded. Subjects were selected by consecutive sampling. The dependent variables was blood sodium levels, while the independent variables was CD4 counts, and the confounding variables were age, and ARV duration use. Sodium levels were measured using the Cbs400, Jokoh ex-d and smarlyte devices while CD4 levels were measured using the BD FACSCount device by flow cytometry. The correlation between sodium and ARV duration use on CD4 levels analyzed by Pearson test, while correlation between patient’s age and CD4 levels analyzed by Spearman rank test. The multiple linear regression used to control the confounding variables. Results: The average sodium level in pediatric HIV patients at Dr. Moewardi Surakarta Regional General Hospital (Mean= 131.19; SD= 5.68 mEq/L), while the average CD4 level (Mean= 940.40; SD= 464.81 cells/μL). Pearson test showed a positive and weak correlation between sodium levels and CD4 counts (r= 0.32; p = 0.040), meaning that the higher the sodium level, the higher the CD4 count. There was a negative and very weak correlation with the duration of ARV use (r= -0.18; p= 0.254), meaning that the higher the sodium level, the lower the CD4 count. Spearman Rank test showed a correlation between age and CD4 count (r= -0.52; p<0.001), meaning that the older the person, the lower the CD4 count. The results of linear regression showed that there was a significant influence between sodium levels on CD4 count (b= 24.99; p= 0.029) and patient age (b= -55.21; p=0.003). Conclusion: Sodium levels have a moderate positive correlation with CD4 levels in pediatric patients with HIV infection. Examination of sodium levels can be an additional parameter in routine monitoring of the immunodeficiency status of pediatric HIV patients.
Path Analysis of the Relationship between Nutritional Status, Maternal Knowledge, Dietary Compliance and Health-Related Quality of Life in Children with Acute Lymphoblastic Leukemia
Background: Acute Lymphoblastic Leukemia (ALL) is the most common type of blood cancer in children. Treatment for ALL may affect the patient's quality of life. Factors such as nutritional status, maternal knowledge of nutrition, and dietary compliance play a role in determining the quality of life of children with ALL. This study aims to analyze the relationship between nutritional status, maternal knowledge, and dietary compliance with health-related quality of life (HRQoL) in children with ALL. Subjects and Method: This study used a cross-sectional design with a sample of 52 children with ALL at the Pediatric Hematology Clinic of Dr. Moewardi Surakarta Hospital in October-November 2024. The independent variables were nutritional status, maternal knowledge, and dietary compliance, while the dependent variable was HRQoL. Data were collected using anthropometric instruments and questionnaires, then analyzed with single logistic regression and path analysis. Results: Single logistic regression analysis showed that nutritional status (OR= 4.60; 95% CI= 1.311 to 16.139; p = 0.017) and dietary compliance (OR= 4.82; 95% CI= 1.39 to 16.78; p= 0.013) were significantly associated with HRQoL. Maternal knowledge had no significant effect (OR= 1.88; 95% CI = 0.35 to 10.18; p = 0.467). Path analysis showed that nutritional status, dietary compliance, and body mass index had a direct positive association with the child's quality of life. The path analysis model showed a good fit with the data (goodness of fit p = 0.594). Conclusion: Nutritional status and dietary compliance are major factors in improving the quality of life of children with ALL. Although maternal knowledge does not have a direct effect, the mother's role remains important through improving the child's dietary compliance. Multidisciplinary interventions that integrate nutrition education and family support are needed to enhance HRQoL in pediatric patients with ALL.
The Influence of Environmental Sanitation on Incidence of Stunting: A Systematic Review
Background: Stunting is a chronic health problem that has long-term impacts on child growth and development, especially in developing countries. Poor environmental sanitation is believed to be one of the main risk factors; however, this needs to be further examined based on empirical study findings. This study aims to analyze this issue systematically. Subjects and Method: This is a systematic review using the PRISMA Flow Diagram. The PICO framework includes: Population (P): Children under five years of age; Intervention (I): Poor environmental sanitation; Comparison (C): Adequate environmental sanitation; Outcome (O): Stunting. Articles were retrieved from databases including PubMed, Scopus, ScienceDirect, and Google Scholar. Keywords used were “hygiene AND sanitation AND stunting AND under five AND cross-sectional.” The quality of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal tool. Results: A total of 9 articles from four studies were conducted in Asia, all of which from Indonesia, and five studies were conducted in Africa, all of which from the Ethiopia, indicated that access to proper sanitation, clean water, as well as appropriate feces disposal and handwashing practices, are strongly associated with a reduction in stunting incidence. The risk of stunting increases among children living in environments with unimproved latrines, untreated drinking water, and poor hygiene practices. Additional factors such as the child’s age, mother’s education level, and socioeconomic status also influence stunting outcomes. Conclusion: Inadequate environmental sanitation plays a significant role in the occurrence of stunting. Preventive interventions should prioritize improving sanitation access, promoting hygiene behavior education, and implementing cross-sectoral approaches to sustainably reduce stunting prevalence.