Determinants of Anaemia in Pregnancy in Indonesia: A Systematic Review
DOI:
https://doi.org/10.30442/ahr.1103-01-288Keywords:
Anaemia, BMI, Maternal age, Nutritional status, Pregnancy, Systematic reviewAbstract
Background: Anaemia is a significant global health issue impacting pregnant women, potentially leading to adverse birth outcomes. To mitigate maternal and infant mortality complications, it is crucial to investigate the determinants contributing to maternal anaemia systematically.
Objectives: To identify the primary determinants of maternal anaemia in Indonesia.
Methods: A systematic review was conducted to examine the determinants of maternal anaemia in Indonesia, focusing on articles published between 01 January 2014 and 31 December 2023. Research databases, including Medline/PubMed, ProQuest, ScienceDirect, and additional manual searches, were used. Articles were selected using MeSH terms and relevant keywords, targeting a population of pregnant women within analytical observational studies.
Results: A total of 22 articles met the inclusion criteria. Bivariate and/or multivariate analyses identified 29 statistically significant variables (p < 0.05) associated with maternal anaemia. There were five major determinants significantly related to maternal anaemia in Indonesia.
Conclusion: The educational level of pregnant women, Body mass index (BMI) or nutritional status of pregnant women, parity, chronic energy deficiency (CED) status, and maternal age were the main determinants of maternal anaemia in Indonesia.
References
1. World Health Organisation (WHO). Anaemia 1. May 2023;1–5. https://www.who.int/health-topics/anaemia#tab=tab_1.
2. Khezri R, Salarilak S, Jahanian S. The association between maternal anaemia during pregnancy and preterm birth. Clin Nutr ESPEN. 2023;56:13–17. https://doi.org/10.1016/j.clnesp.2023.05.003.
3. Heydarpour F, Soltani M, Najafi F, Tabatabaee HR, Etemad K, Hajipour M, et al. Maternal anaemia in various trimesters and related pregnancy outcomes: Results from a large cohort study in Iran. Iran J Pediatr 2019;29:1-7. https://doi.org/10.5812/ijp.69741.
4. Triharini M, Nursalam, Sulistyono A, Adriani M, Armini NKA, Nastiti AA. Adherence to iron supplementation amongst pregnant mothers in Surabaya, Indonesia: Perceived benefits, barriers and family support. Int J Nurs Sci 2018;5:243–248. https://doi.org/10.1016/j.ijnss.2018.07.002.
5. Sumiyati, Jusuf EC, Aminuddin, Rachmat M. Determinant of Anaemia in pregnancy at Polewali Mandar District, South Sulawesi, Indonesia. Gac Sanit 2021;35:319-321. https://doi.org/10.1016/j.gaceta.2021.10.044
6. Aji AS, Yusrawati Y, Malik SG, Lipoeto NI. Anaemia prevalence and its associated risk factors among Minangkabau pregnant women in West Sumatra, Indonesia: Findings from VDPM cohort study. Proc Nutr Soc 2020;79:E780. https://doi.org/10.1017/S0029665120007661.
7. Fitriahadi E, Ayuningtyas D. The Identification of Maternal Characteristics and The Incidence of Anaemia in Pregnant Women. Pak J Med Health Sci 2021;15:1516–1520. https://doi.org/10.53350/pjmhs211561516.
8. Kurniati A, Astirin OP, Suryani N. Effect of Maternal Education, Family Income, Mother-Midwife Interface, and the Incidence of Iron Deficiency Anaemia in Pemalang, Central Java. J Matern Child Health 2016;1:220–229. https://doi.org/10.26911/thejmch.2016.01.04.03.
9. Nadiyah, Meilinda E, Simanjuntak AC. Relationship between Characteristics and Nutrient Intake with Anaemia among Pregnant Women at Kebon Jeruk Public Health Center, Jakarta. Int J Nurs Health Serv 2021;4:303–312. https://doi.org/10.35654/ijnhs.v4i3.454.
10. Arnianti A, Adeliana A, Hasnitang H. Analisis Faktor Risiko Anaemia dalam Kehamilan pada Masa Pandemi COVID-19. Jurnal Ilmiah Kesehatan Sandi Husada 2022;11:437–444. https://doi.org/10.35816/jiskh.v11i2.807.
11. Andriani Y, Respati SH, Astirin OP. Effectiveness of Pregnant Woman Class in The Prevention of Pregnancy Anaemia in Banyuwangi, East Java. J Matern Child Health 2016;1:230–241. https://doi.org/10.26911/thejmch.2016.01.04.04.
12. Mocking M, Savitri AI, Uiterwaal CS, Amelia D, Antwi E, Baharuddin M, et al. Does body mass index early in pregnancy influence the risk of maternal anaemia? An observational study in Indonesian and Ghanaian women. BMC Public Health 2018;18:1–9. https://doi.org/10.1186/s12889-018-5704-2.
13. Lestari S, Fujiati II, Keumalasari D, Daulay M, Martina SJ, Syarifah S, et al. The prevalence of anaemia in pregnant women and its associated risk factors in North Sumatera, Indonesia. IOP Conf Ser Earth Environ Sci 2018;125:012195. https://doi.org/10.1088/1755-1315/125/1/012195.
14. Opitasari C, Andayasari L. Young mothers, parity and the risks of anaemia in the third trimester of pregnancy. Health Sci J Indones 2015;6:7–11.
15. Safrina D, Dewi O, Damayanti IP. Analysis of Factors that Correlated with Anaemia Incidence in Pregnant Women at Working Area of the Sidomulyo Health Center Outpatient UPTD Pekanbaru City. BIoHS J 2020;3:105–114.
16. Ridwan DA, Nurjannah N, Yeni CM, Suhanda R. Determinant Analysis of Gestational Anaemia in Indonesia. Int Res J Pharm Med Sci 2023;6:15–23. https://irjpms.com/wp-content/uploads/2023/03/IRJPMS-V6N2P202Y23.pdf.
17. Pusporini AD, Salmah AU, Wahyu A, Seweng A, Indarty A, Suriah, et al. Risk factors of anaemia among pregnant women in community health center (Puskesmas) Singgani and Puskesmas Tipo Palu. Gac Sanit 2021;35:S123-S126. https://doi.org/10.1016/j.gaceta.2021.10.010.
18. Azmi U, Puspitasari Y. Literature Review: Risk Factors of Anaemia in Pregnant Women. J Qual Public Health 2022;6:244–256. https://doi.org/10.30994/jqph.v6i1.428.
19. Dewi SSS, Hasibuan A, Aswan Y, Harahap M, Anggraini W. Relationship Between Diet and Physical Activity with the Event of Anaemia in Pregnant Women. Int J Public Health Excellence 2022;1:87–92.
20. Iswardani O, Hakimi M, Kurnia AR, Information A. Association of Iron Pills Consumption during Pregnancy with Incidence of Maternal Anaemia in Indonesia (IFLS 5 Advanced Analysis Study). J Health Educ 2019;4:29–36. https://doi.org/10.15294/jhe.v4i1.27756.
21. Judistiani RTD, Gumilang L, Nirmala SA, Irianti S, Wirhana D, Permana I, et al. Association of cholecalciferol, ferritin, and Anaemia among pregnant women: Results from a cohort study on Vitamin D status and its impact during pregnancy and childhood in Indonesia. Hindawi. 2018;2018. https://doi.org/10.1155/2018/2047981.
22. Triharini M, Rahmawati A, Nastiti AA, Dewi YS, Mani SK, et al. Factors Affecting Anaemia Prevention Behavior in Pregnant Women based on Lawrence Green’s Theory. J Int Dent Med Res 2021;14:1705–1708.
23. Yuniati T, Judistiani RTD, Natalia YA, Irianti S, Madjid TH, Ghozali M, et al. First trimester maternal Vitamin D, ferritin, hemoglobin level and their associations with neonatal birthweight: Results from a cohort study on Vitamin D status and its impact during pregnancy and childhood in Indonesia. J Neonatal-Perinatal Med 2020;13:91–96. https://doi.org/10.3233/NPM-180043.
24. Margawati A, Syauqy A, Utami A, Adespin D. A. Prevalence of Anaemia and Associated Risk Factors among Pregnant Women in Semarang, Indonesia, during the COVID-19 Pandemic. Ethiop J Health Sci 2023;33:451–462. https://doi.org/10.4314/ejhs.v33i3.8
25. Mulyantoro DK, Kusrini I. Protein Energy Deficiency Increases the Risk of Anaemia in Pregnant Women. IOP Conference Series: Earth Environ Sci 2021:810:1–6. https://doi.org/10.1088/1755-1315/810/1/012043
26. Kusrini I, Mulyantoro DK, Tjandrarini DH, Ashar H. Profile of Double of Undernutrition Problem, Coexistence with Anaemia among Pregnant Women in Indonesia 2018 : A Cross-Sectional Survey. Macedonian J Med Sci 2021;9:1250–1255.
27. Arnianti A, Adeliana A, Hasnitang H. Analysis of Risk Factors for Anaemia in Pregnancy During the Covid-19 Pandemic. Jurnal Ilmiah Kesehatan Sandi Husada 2022;11:437–444. https://doi.org/10.35816/jiskh.v11i2.807.
28. Jasmi J, Rahmi J, Noviyanti A, Franciska Y. (2022). Relationship Between Husband’s Support And The Incidence Of Anaemia In Pregnancy In The Working Area Of The Rumbai Health Center. J Matern Child Health Sci 2022;2:193–198. https://doi.org/10.36086/maternalandchild.v2i2.1473.
29. Sari NAN, Fauziah M. The Factors Associated with the Incidence of Anaemia in Pregnant Women in Pisangan Public Health Center Visitors in 2020. Muhammadiyah Jurnal of Epidemiologi 2021;1(1):16–23.
30. Fitriahadi E, Ayuningtyas D. The Identification of Maternal Characteristics and The Incidence of Anaemia in Pregnant Women. Pak J Med Health Sci 2021;15:1516–1520. https://doi.org/10.53350/pjmhs211561516.
31. Mahmudian AA, Dian Aby R, Sugijati S. Hubungan KEK dengan Anaemia Gravidarum pada Ibu Riwayat BBLR. ARTERI : Jurnal Ilmu Kesehatan 2021:2:80–85. https://doi.org/10.37148/arteri.v2i3.165.
32. Helliyana H, Aritonang EY, Sanusi SR. The Associations between Maternal Education, Chronic Energy Deficit, and Anaemia in Pregnant Women: An Evidence from Lhokseumawe, Indonesia. J Matern Child Health 2019;4:302–306. https://doi.org/10.26911/thejmch.2019.04.05.02.
33. Rahardjo S, Wati EK. Differences in Factors Causing Anaemia in Pregnant Women in Rural and Urban Areas. Prosiding TIN PERSAGI 2022;4:349–351.
34. Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. The Lancet 2011;378:2123–2135. https://doi.org/10.1016/S0140-6736(10)62304-5.
35. Kavle JA, Landr M. Addressing barriers to maternal nutrition in low‐ and middle‐income countries: A review of the evidence and programme implications. Maternal Child Nutr 2018;14(1):e12508. https://doi.org/10.1111/mcn.12508.
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