Anemia in Pregnancy and Low Birth Weight Before and During the COVID-19 Pandemic in Kalijambe
Abstract
Pregnant women and infants were a vulnerable group during the COVID-19 pandemic. This research aimed to determine anemia in pregnancy and Low Birth Weight (LBW) before and during the COVID-19 pandemic and analyze their associated factors. This was a cross-sectional study used secondary data from maternal and child health records in Kalijambe Public health center, Sragen. A total of 1169 birth records from the period of 2019-2020 were collected. The chi-square and logistic regression were used to analyze the differences and significant associated factors. The prevalence of anemia in pregnancy increased from 38.33% in 2019 to 49.21% in 2020 (p=0.013). However, the LBW proportion decreased from 7.26% in 2019 to 6.02% in 2020 (p=0.415). Mother who suffered from chronic energy deficiency marked by Mid-Upper Arm Circumference (MUAC) < 23.5 cm was higher risk of anemia (aOR 1.86;95%CI 1.13-3.08). Considering the gestational age when the hemoglobin (Hb) test, anemia was more likely to be found at the second (aOR 2.59;95%CI 1.37-4.86) and third trimester (aOR 6.97;95%CI 3.98-12.20). High-risk pregnancy had higher odds of LBW (aOR 8.57;95%CI 1.65-44.37), while anemia showed no effect on LBW (aOR 1.80;95% CI 0.34-9.45). These results were adjusted for mothers’ age, parity, abortus, infection during pregnancy, high-risk pregnancy, MUAC, preterm birth, and gestational age. COVID-19 pandemic increased the prevalence of anemia in pregnancy but had no impact on LBW. Several factors for anemia and LBW were significantly associated. This finding suggests the need for early risk detection and routine, standardized, and comprehensive antenatal care.
References
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32. Stewart T, Lambourne J, Thorp-jones D, Thomas DW. Implementation of Early Management of Iron Deficiency Pregnancy During the SARS-Cov-2 Pandemic. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2020;258:60–62.
33. Ghosh S, Spielman K, Kershaw M, Ayele K, Kidane Y, Zillmer K, et al. Nutrition-Specific and Nutrition-Sensitive Factors Associated with Mid-Upper Arm Circumference as A Measure of Nutritional Status in Pregnant Ethiopian Women: Implications for Programming in the First 1000 Days. PLoS One. 2019;14(3):1–14.
34. WHO. WHA Global Nutrition Targets 2025 : Low Birth Weight Policy Brief [Internet]. Vol. 28. World Health Organization 2014. Available from: https://www.who.int/ nutrition/topics/globaltargets_lowbirthweight_policybrief.pdf.
35. Nur AF. Anemia dan Kejadian Berat Badan Lahir Rendah di Rumah Sakit Umum Anutapura Palu. Ghidza: Jurnal Gizi dan Kesehatan. 2018;2(2):63–66.
36. Berghella V, Boelig R, Roman A, Burd J, Anderson K. Decreased Incidence of Preterm Birth During Coronavirus Disease 2019 Pandemic. American Journal of Obstetrics & Gynecology MFM. 2020;2(4):1-3.
37. Anil KC, Basel PL, Singh S. Low Birth Weight and Its Associated Risk Factors: Health Facility-Based Case-Control Study. PLoS One. 2020;15(6):1–10.
38. Islamiyanti, Katharina K, Oktaviani I. Hubungan Anemia Ibu Hamil dengan Bayi Berat Lahir Rendah. Jurnal Kesehatan Metro Sai Wawai. 2012;V(2):9–16.
2. Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women with and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatrics. 2021;175(8):817–826.
3. D’Antonio F, Sen C, Mascio D Di, Galindo A, Villalain C, Herraiz I. Maternal and Perinatal Outcomes in High Compared to Low Risk Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 Infection (Phase 2): The World Association of Perinatal Medicine Working Group on Coronavirus Disease 2019. American Journal of Obstetrics & Gynecology MFM. 2020:1–7.
4. Zaigham M, Andersson O. Maternal and Perinatal Outcomes with COVID-19: A Systematic Review of 108 Pregnancies. Acta Obstetricia et Gynecologica Scandinavica. 2020;99(7):823–829.
5. Ifdil I, Fadli RP, Gusmaliza B, Putri YE. Mortality and Psychological Stress in Pregnant and Postnatal Women During COVID-19 Outbreak in West Sumatra, Indonesia. Journal of Psychosomatic Obstetrics and Gynecology. 2020;41(4):251–252.
6. Ariestanti Y, Widayati T, Sulistyowati Y. Determinan Perilaku Ibu Hamil Melakukan Pemeriksaan Kehamilan (Antenatal Care) pada Masa Pandemi Covid-19. Jurnal Bidang Ilmu Kesehatan. 2020;10(2):203–216.
7. Rofiasari L, Noprianty R, Yusita I, Mulyani Y, Suryanah A. Assistance for Pregnant Women Class in Providing Antenatal Care Motivation as an Effort to Improve Maternal and Fetal Health in the Pandemic Covid-19. Jurnal Peduli Masyarakat. 2020;2(4):197–204.
8. Mahumud RA, Sultana M, Sarker AR. Distribution and Determinants of Low Birth Weight in Developing Countries. Journal of Preventive Medicine & Public Health. 2017;50(1):18–28.
9. Kirchengast S, Hartmann B. Pregnancy Outcome During the First Covid 19 Lockdown in Vienna, Austria. International Journal of Environmental Research and Public Health. 2021;18(7):1–14.
10. Philip RK, Purtill H, Reidy E, Daly M, Imcha M, McGrath D, et al. Unprecedented Reduction in Births of Very Low Birth Weight (VLBW) and Extremely Low Birth Weight (ELBW) Infants During the COVID-19 Lockdown in Ireland: A ‘Natural Experiment’ Allowing Analysis of Data From the Prior Two Decades. BMJ Global Health. 2020;5(9):1-10.
11. Shmakov RG, Prikhodko A, Polushkina E, Shmakova E, Pyregov A, Bychenko V, et al. Clinical Course of Novel COVID-19 Infection in Pregnant Women. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1–7.
12. Banaei M, Ghasemi V, Saei Ghare Naz M, Kiani Z, Rashidi-Fakari F, Banaei S, et al. Obstetrics and Neonatal Outcomes in Pregnant Women with Covid-19: A Systematic Review. Iranian Journal of Public Health. 2020;49:38–47.
13. Figueiredo ACMG, Gomes-Filho IS, Silva RB, Pereira PPS, Da Mata FAF, Lyrio AO, et al. Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(5):1–17.
14. Aditianti A, Djaiman SPH. Meta Analisis: Pengaruh Anemia Ibu Hamil Terhadap Berat Bayi Lahir Rendah. Jurnal Kesehatan Reproduksi. 2020;11(2):163–177.
15. Nainggolan S, Siagian FE. The Prevalence of Anemia in Pregnant Women in the 10 Priority Villages for Stunting Control in Sumedang District, West Java: A Community-Based Survey. International Journal of Community Medicine and Public Health. 2019;6(9):3760-3767.
16. Kemenkes RI. Profil Kesehatan Indonesia 2018. Jakarta: Kementerian Kesehatan RI; 2019.
17. Kecamatan Kalijambe. Profil Kalijambe. [Internet]. Jawa Tengah: Kecamatan Kalijambe; 2021 [Cited 2021 Sep 7]. Available from: http://kalijambe. sragenkab.go.id/index.php/penduduk/.
18. BPS Provinsi Jawa Tengah. Jumlah Bayi La-hir, Bayi Berat Badan Lahir Rendah (BBLR), dan Bergizi Kurang Menurut Kabupat-en/Kota di Provinsi Jawa Tengah (Jiwa), 2019-2021. [Internet]. Jawa Tengah: Badan Pusat Statistik Provinsi Jawa Tengah;2021 [Cited 2021 Sep 7]. Available from: https://jateng. bps.go.id/indicator/30/378/1/jumlah-bayi-lahir-bayi-berat-badan-lahir-rendah-bblr-bblr-dirujuk-dan-bergizi-buruk-menurut-kabupaten-kota-di-provinsi-jawa-tengah.html.
19. Bisanzio D, Kraemer MUG, Bogoch II, Brewer T, Brownstein JS, Reithinger R. Use of Twitter Social Media Activity as A Proxy for Human Mobility to Predict the Spatiotemporal Spread of COVID-19 at Global Scale. Geospatial Health. 2020;15(882):19–24.
20. Ricalde AE, Velásquez-Meléndez G, Tanaka AC d’A., Siqueira AAF de. Mid-Upper Arm Circumference in Pregnant Women and Its Relation to Birth Weight. Revista de Saude Publica. 1998;32(2):112–117.
21. Stephen G, Mgongo M, Hussein Hashim T, Katanga J, Stray-Pedersen B, Msuya SE. Anaemia in Pregnancy: Prevalence, Risk Factors, and Adverse Perinatal Outcomes in Northern Tanzania. Hindawi Anemia. 2018: 1-9.
22. Kemenkes RI. Profil Kesehatan Indonesia 2019. Jakarta: Kementrian Kesehatan RI. 2020.
23. WHO. WHO Global Anaemia Estimates, 2021 Edition. [Internet]. World Health Organization: The Global Health Observatory; 2021 [Cited 2022 May 13]. Available from: https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children#:~:text=In 2019%2C global anaemia prevalence,39.1%25) in pregnant women.
24. Kemenkes RI. Pedoman Pelayanan Antenatal, Persalinan, Nifas, dan Bayi Baru Lahir di Era Adaptasi Baru. Jakarta: Kementerian Kesehatan RI; 2020.
25. Aranda Z, Binde T, Tashman K, Tadikonda A, Mawindo B, Maweu D, et al. Disruptions in Maternal Health Service Use During the COVID-19 Pandemic in 2020: Experiences from 37 Health Facilities in Low-Income and Middle-Income Countries. BMJ Global Health. 2022;7(1):1–10.
26. UNICEF, UNFPA, WHO and SickKids’ Center for Global Child Health. Direct and Indirect Effects of the COVID-19 Pandemic and Response in South Asia; 2021. [Internet]. 2021;57. Available from: https://www.unicef.org/rosa/reports/direct-and-indirect-effects-covid-19-pandemic-and-response-south-asia
27. Lebso M, Anato A, Loha E. Prevalence of Anemia and Associated Factors Among Pregnant Women in Southern Ethiopia: A Community Based Cross-Sectional Study. PLoS One. 2017;12(12):1–11.
28. Tan J, He G, Qi Y, Yang H, Xiong Y, Liu C, et al. Prevalence of Anemia and Iron Deficiency Anemia in Chinese Pregnant Women (IRON WOMEN): A National Cross-Sectional Survey. BMC Pregnancy and Childbirth. 2020;20(670):1–12.
29. Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron Deficiency Anemia in Pregnancy: Novel Approaches for An Old Problem. Oman Medical Journal. 2020;35(5):1–9.
30. Anggraini DD, Purnomo W, Trijanto B. Interaksi Ibu Hamil dengan Tenaga Kesehatan dan Pengaruhnya terhadap Kepatuhan Ibu Hamil Mengonsumsi Tablet Besi (Fe) dan Anemia di Puskesmas Kota Wilayah Selatan Kota Kediri. Buletin Penelitian Sistem Kesehatan. 2018;21(2):82–89.
31. Ahmad A, Wagustina S, Dwiriani CM, Estuti W, Salfiyadi T, Arnisam A, et al. The Efficacy of Nutrition Education on Anemia and Upper Arm Circumference among Pregnant Women in Aceh Besar District of Indonesia during the Covid-19 Pandemic. Jurnal Gizi dan Pangan. 2022;17(1):27–36.
32. Stewart T, Lambourne J, Thorp-jones D, Thomas DW. Implementation of Early Management of Iron Deficiency Pregnancy During the SARS-Cov-2 Pandemic. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2020;258:60–62.
33. Ghosh S, Spielman K, Kershaw M, Ayele K, Kidane Y, Zillmer K, et al. Nutrition-Specific and Nutrition-Sensitive Factors Associated with Mid-Upper Arm Circumference as A Measure of Nutritional Status in Pregnant Ethiopian Women: Implications for Programming in the First 1000 Days. PLoS One. 2019;14(3):1–14.
34. WHO. WHA Global Nutrition Targets 2025 : Low Birth Weight Policy Brief [Internet]. Vol. 28. World Health Organization 2014. Available from: https://www.who.int/ nutrition/topics/globaltargets_lowbirthweight_policybrief.pdf.
35. Nur AF. Anemia dan Kejadian Berat Badan Lahir Rendah di Rumah Sakit Umum Anutapura Palu. Ghidza: Jurnal Gizi dan Kesehatan. 2018;2(2):63–66.
36. Berghella V, Boelig R, Roman A, Burd J, Anderson K. Decreased Incidence of Preterm Birth During Coronavirus Disease 2019 Pandemic. American Journal of Obstetrics & Gynecology MFM. 2020;2(4):1-3.
37. Anil KC, Basel PL, Singh S. Low Birth Weight and Its Associated Risk Factors: Health Facility-Based Case-Control Study. PLoS One. 2020;15(6):1–10.
38. Islamiyanti, Katharina K, Oktaviani I. Hubungan Anemia Ibu Hamil dengan Bayi Berat Lahir Rendah. Jurnal Kesehatan Metro Sai Wawai. 2012;V(2):9–16.
Authors
Surya, S. S. ., Jamil, N. A., Cahyanti, D., Rahma, A., D. S, A. A. ., & Dewi, T. M. (2021). Anemia in Pregnancy and Low Birth Weight Before and During the COVID-19 Pandemic in Kalijambe . Media Kesehatan Masyarakat Indonesia, 17(4), 152-162. https://doi.org/10.30597/mkmi.v17i4.18206
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