FACTORS ASSOCIATED WITH THE INCIDENCE OF ANEMIA IN PREGNANT WOMEN IN INDONESIA: ANALYSIS OF INDONESIAN HEALTH SURVEY (SKI) 2023 DATA
DOI:
https://doi.org/10.63953/jisn.v3i4.64Keywords:
Anemia, Pregnant women, Meat consumption, Pregnancy interval, Supplementary feeding (PMT)Abstract
Anemia is a common nutritional issue among vulnerable populations, including toddlers, adolescents, women of reproductive age, and pregnant women. Anemia in pregnant women impacts both the mother and fetus. For the mother, it reduces quality of life and can lead to mortality. Babies born to anemic mothers are at risk of congenital abnormalities, stillbirth, and stunting. Maternal health issues during pregnancy affect the critical first 1000 days of a child's life, with permanent consequences for survival, necessitating appropriate interventions to minimize these risks. The 2023 SKI Report indicates a 27.7% prevalence of anemia among pregnant women in Indonesia, classified as a moderate public health issue. This study is a quantitative study using a cross-sectional design aimed to identify factors associated with anemia in pregnant women in Indonesia in 2023, utilizing secondary data from the 2023 SKI. The dependent variable was anemia, with independent variables from socio-demographic factors, lifestyle factors, dietary patterns, and pregnancy-related factors. Data analysis used complex samples, including univariate and bivariate analyses with chi-square tests. The study found significant associations between anemia in pregnant women and consumption of meat, poultry, and their processed products (p-value = 0.047), pregnancy interval (p-value = 0.033), and consumption of supplementary feeding (PMT) (p-value = 0.001) in Indonesia in 2023.
References
World Health Organization (WHO). Guideline on haemoglobin cutoffs to define anaemia in individuals and populations [Internet]. World Health Organization; 2024. Available from: https://www.who.int/publications/i/item/9789240088542
World Health Organization (WHO). Nutritional anaemias: tools for effective prevention and control [Internet]. World Health Organization; 2017. Available from: https://iris.who.int/bitstream/handle/10665/259425/9789241513067-eng.pdf
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Buku Saku Pencegahan Anemia Pada Ibu Hamil dan Remaja Putri. Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia); 2023.
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 26th ed. New York: McGraw Hill Professional; 2022.
Sungkar A, Bardosono S, Irwinda R, Manikam NRM, Sekartini R, Medise BE, et al. A Life Course Approach to the Prevention of Iron Deficiency Anemia in Indonesia. Nutrients. 2022 Jan 10;14(2):277.
Helmyati S, Fauziah LA, Kadibyan P, Sitorus NL, Dilantika C. Relationship between Anemia Status, Sleep Quality, and Cognitive Ability among Young Women Aged 15-24 Years in Indonesia (Analysis of Indonesian Family Life Survey (IFLS) 5): Hubungan Status Anemia, Kualitas Tidur, dan Kemampuan Kognitif pada Wanita Muda Usia 15-24 Tahun di lndonesia (Analisis Data Indonesian Family Life Survey (IFLS) 5). AMNT [Internet]. 2024 Feb. 15 [cited 2025 Dec. 16];7(3SP):1-9. Available from: https://e-journal.unair.ac.id/AMNT/article/view/52970
Edelson PK, Cao D, James KE, Ngonzi J, Roberts DJ, Bebell LM, et al. Maternal anemia is associated with adverse maternal and neonatal outcomes in Mbarara, Uganda. The Journal of Maternal-Fetal & Neonatal Medicine [Internet]. 2023 Jun 13;36(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10419325/
Oktarina C, Charisma Dilantika, Sitorus NL, Basrowi RW. Relationship Between Iron Deficiency Anemia and Stunting in Pediatric Populations in Developing Countries: A Systematic Review and Meta-Analysis. Children. 2024 Oct 19;11(10):1268–8.
Hamamy H, Alwan N. Maternal iron status in pregnancy and Long-Term health outcomes in the offspring. Journal of Pediatric Genetics [Internet]. 2015 Jul 31;04(02):111–23. Available from: https://doi.org/10.1055/s-0035-1556742
Eweis M, Farid EZ, El-Malky N, Abdel-Rasheed M, Salem S, Shawky S. Prevalence and determinants of anemia during the third trimester of pregnancy. Clinical Nutrition ESPEN [Internet]. 2021 Jul 2;44:194–9. Available from: https://doi.org/10.1016/j.clnesp.2021.06.023
Georgieff MK. Iron deficiency in pregnancy. American Journal of Obstetrics and Gynecology [Internet]. 2020 Mar 14;223(4):516–24. Available from: https://doi.org/10.1016/j.ajog.2020.03.006
Breymann C. Iron deficiency anemia in pregnancy. Seminars in Hematology [Internet]. 2015 Jul 11;52(4):339–47. Available from: https://doi.org/10.1053/j.seminhematol.2015.07.003
Stevens G.A., et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. The Lancet Global Health. 2013 Jul;1(1):e16–25.
Nair M., et al. Relationship between anaemia, coagulation parameters during pregnancy and postpartum haemorrhage at childbirth: a prospective cohort study. BMJ Open. 2021 Oct;11(10):e050815.
World Health Organization (WHO), United Nations Children’s Fund (UNICEF). The extension of the 2025 Maternal, Infant and Young Child nutrition targets to 2030 [Internet]. UNICEF. 2019. Available from: https://data.unicef.org/resources/who-unicef-discussion-paper-nutrition-targets/
Sunuwar DR, Singh DR, Chaudhary NK, Pradhan PMS, Rai P, Tiwari K. Prevalence and factors associated with anemia among women of reproductive age in seven South and Southeast Asian countries: Evidence from nationally representative surveys. PLoS ONE [Internet]. 2020 Aug 13;15(8):e0236449. Available from: https://doi.org/10.1371/journal.pone.0236449
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Laporan Nasional Riskesdas 2018. Agency of Health Research and Development (Badan Kebijakan dan Pengembangan Kesehatan Kemenkes RI); 2019.
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Laporan Survei Kesehatan Indonesia (SKI) 2023 Dalam Angka. Agency of Health Research and Development (Badan Kebijakan Pembangunan Kesehatan Kemenkes RI); 2023.
President of the Republic of Indonesia. Peraturan Presiden Republik Indonesia Nomor 12 Tahun 2025 tentang Rencana Pembangunan Jangka Menengah Nasional Tahun 2025-2029. Jakarta, Indonesia; 2025.
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Pedoman Pengisian Kuesioner Survei Kesehatan Indonesia (SKI) 2023. Agency of Health Research and Development (Badan Kebijakan Pembangunan Kesehatan); 2023.
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Pedoman Analisis Data SKI 2023. Agency of Health Research and Development (Badan Kebijakan Pembangunan Kesehatan); 2023.
Lemeshow S, World Health Organization. Adequacy of sample size in health studies. Chichester, England: Wiley; 1993.
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Pedoman Gizi Seimbang Ibu Hamil dan Ibu Menyusui. Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia); 2021.
Samuel S, Darebo T, Desta DT, Mulugeta A. Socio‐economic and dietary diversity characteristics are associated with anemia among pregnant women attending antenatal care services in public health centers of Kembata Tembaro Zone, Southern Ethiopia. Food Science & Nutrition. 2020 Mar 6;8(4):1978–86.
Ghiffari EM, Harna H, Angkasa D, Wahyuni Y, Purwara L. Kecukupan Gizi, Pengetahuan, dan Anemia Ibu Hamil. Ghidza: Jurnal Gizi dan Kesehatan. 2021 Jul 7;5(1):10–23.
Sunardi D, Bardosono S, Basrowi RW, Wasito E, Vandenplas Y. Dietary Determinants of Anemia in Children Aged 6–36 Months: A Cross-Sectional Study in Indonesia. Nutrients. 2021 Jul 13;13(7):2397.
Fadl N, Ice GH, Haile ZT. Association Between Maternal High-risk Factors and Anemia Among Women in Ethiopia. Nutrition. 2021 Jun;91-92:111404.
Fikawati S, Syafiq A, Karima K. Gizi Ibu dan Bayi. PT RajaGrafindo Persada; 2018.
Riyani R, Marianna S, Hijriyati Y. Hubungan Antara Usia dan Paritas dengan Kejadian Anemia Pada Ibu Hamil. Binawan Student Journal. 2020 Apr 30;2(1):178–84.
Tempali S, Astuti N, Pani W, Asrawaty, Kusika Y, Amriani N, et al. Hubungan Usia dan Paritas dengan Kejadian Anemia pada Ibu Hamil Trimester III. Napande Jurnal Bidan. 2024;3(1):19–26.
Barakat R, Ruiz JR, Lucia A. Exercise During Pregnancy and Risk of Maternal anaemia: a Randomised Controlled Trial. British Journal of Sports Medicine. 2009 Jan 12;43(12):954–6.
Food and Agriculture Organization (FAO). Contribution of terrestrial animal source food to healthy diets for improved nutrition and health outcomes. Food & Agriculture Org.; 2023.
Tarigan, N., Sitompul, L. and Zahra, S. (2021) 'Asupan Energi, Protein, Zat Besi, Asam Folat dan Status Anemia Ibu Hamil di Wilayah Kerja Puskesmas Petumbukan,' Wahana Inovasi : Jurnal Penelitian Dan Pengabdian Masyarakat UISU, 10(1), pp. 117–127. https://jurnal.uisu.ac.id/index.php/wahana/article/download/4325/3103
Kavanaugh M, Rodgers D, Rodriguez N, Leroy F. Considering The Nutritional Benefits and Health Implications of Red Meat in the Era of Meatless Initiatives. Frontiers in Nutrition. 2025 Jan 27;12.
Morales-Suárez-Varela M, Peraita-Costa I, Marcos Puig B, Álvarez-Álvarez L, Llopis-Morales J, Llopis-González A. Fish Intake in Pregnant Women and Its Impact on Maternal–fetal Health Status. Medicina de Familia SEMERGEN. 2023 Sep 1;49(6):101996–6.
Gropper S, Smith J, Carr T. Advanced Nutrition And Human Metabolism. 8th ed. S.L.: Cengage Learning Custom P; 2021.
Ghose B, Yaya S. Fruit and vegetable consumption and anemia among adult non-pregnant women: Ghana Demographic and Health Survey. PeerJ [Internet]. 2018 Feb 21;6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826990/
Piskin E, Cianciosi D, Gulec S, Tomas M, Capanoglu E. Iron Absorption: Factors, Limitations, and Improvement Methods. ACS Omega. 2022 Jun 10;7(24):20441–56.
Bencaiova G, Burkhardt T, Breymann C. Anemia—Prevalence and Risk Factors in Pregnancy. European Journal of Internal Medicine. 2012 Sep;23(6):529–33.
Amini A, Pamungkas CE, Harahap AP. Usia Ibu dan Paritas Sebagai Faktor Risiko yang Mempengaruhi Kejadian Anemia Pada Ibu Hamil Di Wilayah Kerja Puskesmas Ampenan. Midwifery Journal: Jurnal Kebidanan UM Mataram. 2018 Sep 30;3(2):108.
Wendt A, Gibbs CM, Peters S, Hogue CJ. Impact of Increasing Inter-pregnancy Interval on Maternal and Infant Health. Paediatric and Perinatal Epidemiology [Internet]. 2012 Jun 28;26(1):239–58. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562277/
Mruts KB, Gebremedhin AT, Tessema GA, Scott JA, Pereira G. Interbirth Interval and Maternal Anaemia in 21 sub-Saharan African countries: a fractional-polynomial Analysis. Todd CS, editor. PLOS ONE. 2022 Sep 23;17(9):e0275155.
Agrawal S, Chaudhary M, Das V, Agarwal A, Pandey A, Kumar N, et al. Association of long and short interpregnancy intervals with maternal outcomes. Journal of Family Medicine and Primary Care. 2022;11(6):2917.
Georgieff M, Krebs N, Cusick S. The Benefits and Risks of Iron Supplementation in Pregnancy and Childhood. Annual Review of Nutrition [Internet]. 2019 Aug 21;39(1):121–46. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173188/
Sekartini R, Aisiyah Widjaja N, Ratna N, Manikam M, Jo J, Basrowi R, et al. Iron-Deficiency Anemia: Indonesia’s Striving. Asia Pac J Paediatr Child Health [Internet]. 2022 ;5. Available from: https://www.apjpch.com/pdfs/2297hJz080011.pdf
Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia). Petunjuk Teknis Petunjuk Teknis Pemberian Makanan Tambahan (PMT) Berbahan Pangan Lokal untuk Balita dan Ibu Hamil. Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia); 2023
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Jessica Reitanya Putri
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
LICENSE TO PUBLISH
- All material published by the Journal of Indonesian Specialized Nutrition is protected under International copyright and intellectual property laws. Journal of Indonesian Specialized Nutrition is licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA) or an equivalent license as the optimal license for the publication, distribution, use, and reuse of scholarly works.
- This license permits anyone to compose, repair, and make derivative creations even for commercial purposes, as long as appropriate credit and proper acknowledgment of the original publication from a journal are made to allow users to trace back to the original manuscript and author.
- You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. If you remix, transform or build upon the material, you must distribute your contributions under the same license as the original.
